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Laparoscopy

Single-Port Laparoscopic Hartmann's Reversal Outperforms Open Surgery in Several Key Aspects

Strategic Insights

— 1 min read

A recent study conducted at Marmara University Pendik Training and Research Hospital in Istanbul, Turkey, aimed to compare the intraoperative and postoperative outcomes of single-port laparoscopic Hartmann's reversal (SPLHR) and open Hartmann's reversal (OHR). The study retrospectively analyzed consecutive patients who underwent OHR and SPLHR between 2019 and 2021. The results show that SPLHR significantly outperformed OHR in several key aspects, including estimated blood loss, operation time, postoperative complications, and length of hospital stay.

Key Takeaways:

  • SPLHR showed significantly lower estimated blood loss compared to OHR (100 vs. 175 ml, p = 0.011).
  • The median operation time was shorter in the SPLHR group (92 vs. 120 min, p = 0.016).
  • Inadvertent bowel injury was more frequently observed in the OHR group (37.5% vs. 8.7%, p = 0.02).
  • Wound infections were significantly more common in the OHR group (33.3% vs. 4.3%, p = 0.023).
  • The SPLHR group experienced a shorter time to first flatus (median 2 vs. 3 days, p = 0.04) and a shorter time to resuming a soft diet (median 2 vs. 3 days, p = 0.002).
  • The length of hospital stay was also shorter in the SPLHR group (4 vs. 4.5 days, p = 0.007).
  • The study concluded that SPLHR has several advantages in terms of perioperative morbidity and postoperative outcomes compared with OHR in selected patients.

Statistics:

  • 23 patients underwent single-port laparoscopic Hartmann's reversal (SPLHR).
  • 24 patients underwent open Hartmann's reversal (OHR).
  • Median age, gender, body mass index (BMI), comorbidities, and presence of midline/parastomal hernias were similar across the groups.
  • The SPLHR group had a significantly lower estimated blood loss (100 ml vs. 175 ml).
  • The median operation time was shorter in the SPLHR group (92 min vs. 120 min).

Sources:

  • Single-port laparoscopic versus open Hartmann's reversal: a retrospective analysis on surgical and postoperative outcomes. Techniques in Coloproctology, 2025;29(1):180.
  • A. Akmercan, General Surgery Department, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
  • K. D. Batun, H. I. Sevindi, T. Akmercan, and T. K. Uprak.
  • Springer-verlag Italia Srl, Via Decembrio, 28, Milan, 20137, Italy.

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