Laparoscopic Hartmann's Procedure: A Feasible Approach for Stable Patients with Colonic Trauma

Cristina Frattini, MD; Arianna Birindelli, MD; Edoardo Segalini, MD; Alberto Casati, MD; Gregorio G. Tugnoli, MD; Salomone Di Saverio, MD, FACS

Product Details
Product ID: ACS-5657
Year Produced: 2018
Length: 11 min.


Two cases of traumatic colonic perforation came to our attention: a 72 year-old man, who developed abdominal pain and tenderness after the insertion of a rectal foreign body, and a 77 year-old man with blunt abdominal trauma after a car crash. In both cases, patients were hemodynamically stable, so they underwent a CT scan, which showed the presence of free abdominal air and free fluid, suggestive for bowel perforation. In the first case an explorative laparoscopy revealed a perforation at the rectosigmoid junction caused by the foreign body, while in the second, a laceration involving 270° of the sigmoid colon circumference was discovered. In both cases, a laparoscopic Hartmann's procedure was performed, and patients were discharged in good condition after a week. Laparoscopic treatment of traumatic colonic perforation, with a minimally invasive Hartmann's procedure, is a valid option in hemodinamically stable patients with blunt or penetrating colonic trauma in presence of laparoscopic expertise.