How is the Hartmann procedure for sigmoid volvulus performed?

Updated: Nov 28, 2018
  • Author: Scott C Thornton, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

The patient is placed in a supine position, and a low midline incision is made. The omega loop of the sigmoid colon is resected. The proximal divided end of the colon is mobilized sufficiently to create a tension-free end colostomy. The distal stapled end of the bowel remains in the pelvis (see the image below). A Hartmann procedure is also a good option in a severely debilitated, bedridden patient who requires long-term care.

Hartmann procedure for sigmoid volvulus. Hartmann procedure for sigmoid volvulus.

Patients who undergo a Hartmann procedure may be candidates for colostomy reversal in 3-6 months. This decision whether to proceed with reversal is based on the patient’s overall clinical condition and ability to withstand another major surgical procedure. Debilitated patients who require long-term institutional care may not benefit from colostomy reversal.


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