Indications and Surgical Process

Hartmann’s procedure is a surgical intervention primarily used to treat severe colorectal conditions where resection and immediate anastomosis (reconnection) of the bowel are not safe or feasible. This procedure is often indicated in emergency situations, such as complicated diverticulitis, perforated diverticulum, colorectal cancer, and obstructed or perforated colon. It is also utilized when there is a high risk of infection or poor healing in the bowel, such as in cases of severe inflammation or infection. The procedure involves resecting the diseased portion of the colon and creating an end colostomy, where the proximal end of the colon is brought out through the abdominal wall to form a stoma. The distal end of the colon or rectum is typically closed off and left in the abdominal cavity.

The surgical process for Hartmann’s procedure begins with the patient under general anesthesia. The surgeon makes an incision in the abdomen to access the affected section of the colon. The diseased or damaged segment is then removed, and the remaining end of the colon is brought out through the abdominal wall to create a stoma. This stoma allows waste to exit the body into a colostomy bag, bypassing the rectum and lower part of the colon. The distal bowel end is usually closed off and left inside the abdomen. This method effectively diverts fecal flow, helping to prevent further infection and allowing the resected area to heal. Hartmann’s procedure can be a life-saving intervention, particularly in emergency settings where other surgical options are not viable.

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Recovery and Considerations After Hartmann's Procedure

Recovery from Hartmann’s procedure involves a multifaceted approach to ensure proper healing and adaptation to the colostomy. Initially, patients stay in the hospital for monitoring and management of postoperative pain, infection prevention, and gradual reintroduction to eating. The stoma requires special care and patients are typically trained on how to manage their colostomy bags and maintain stoma hygiene. The healing process can vary, with most patients experiencing significant changes in bowel habits and lifestyle adjustments. It is crucial for patients to follow their medical team’s guidance closely during this period.

Long-term considerations after Hartmann’s procedure include ongoing stoma care and potential plans for stoma reversal. In some cases, if the underlying condition has sufficiently healed and the patient is in good health, a second surgery may be performed to reverse the stoma and reconnect the colon. This decision depends on various factors including the patient’s overall health, the reason for the initial surgery, and the healing progress of the bowel. Even with the possibility of reversal, some patients may live with a permanent colostomy. Psychological support and counseling can be beneficial to help patients adapt to life with a colostomy, addressing both physical and emotional challenges. With proper care and support, many patients can lead a comfortable and active life after Hartmann’s procedure.

Our team can schedule a personal consultation with Dr. Anuj Dua to discuss your disorder and treatment options.