What is Hartmann’s procedure?

Hartmann’s procedure involves removing a piece of large bowel (colon). It is usually performed as an emergency. The two ends of bowel were not joined together because your surgeon decided the risks were too high. Your surgeon made a colostomy (your large bowel opening onto your skin). The other end was closed as a rectal stump. Your surgeon has decided it is safe to join the two ends of your bowel back together.

What are the benefits of surgery?

You should be able to open your bowels in the normal way and you should no longer have a stoma bag.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about 90 minutes to 3 hours.

Your surgeon will free up the end of your bowel inside your abdomen and the end used to make the colostomy. Your surgeon will join the two ends back together and place your bowel inside your abdominal cavity.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• acute kidney injury
• chest infection
• developing a hernia in the scar
• blood clot in your leg
• blood clot in your lung

Specific complications of this operation

Keyhole surgery complications

• damage to structures such as your bowel, bladder or blood vessels
• developing a hernia
• surgical emphysema
• gas embolism

Reversal of Hartmann's complications

• anastomotic leak
• continued bowel paralysis
• diarrhoea
• damage to other structures inside your abdomen
• tissues can join together in an abnormal way
• death. The risk is less the fitter you are

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

It is usual for your bowel to stop working for a few days.

You should be able to go home after 5 to 10 days.

It can take up to 3 months to return to normal activities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery.

Summary

Reversal of Hartmann’s procedure will allow you to open your bowels in the normal way. You will no longer need a stoma bag.

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