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Scientific article
Open access
English

One-step totally robotic Hartmann reversal and complex abdominal wall reconstruction with bilateral posterior component separation: a technical note

Published inColorectal disease, vol. 25, no. 7, p. 1523-1528
Publication date2023-07
First online date2023-05-09
Abstract

Aim: This paper describes a robotic approach to combined gastrointestinal continuity restoration and complex abdominal wall reconstruction after Hartmann's procedure complicated by large midline and parastomal hernias.

Methods: A robotic Hartmann reversal is performed, followed by robotic retromuscular abdominal wall reconstruction of all ventral defects with bilateral posterior component separation using the double-docking approach. Surgical steps are thoroughly described, and the accompanying video highlights critical steps of the procedure, anatomical landmarks and technical details relevant to successful completion.

Results: Complete restoration of the anatomy was achieved with an operative time of 6.5 h. Mobilization occured on day 1, and bowels were opened on day 3. Surgical discharge was possible on day 5. No intra-operative surgical complication occurred and follow-up at 6 months showed no recurrence or mid-term complication.

Conclusion: Combined minimally invasive reconstruction of the gastrointestinal tract and abdominal wall was feasible using a robotic system. In addition, potential advantages of postoperative rehabilitation and reduced surgical site complications are suggested. Prospective evaluation of the technique is ongoing.

eng
Keywords
  • Hartmann reversal
  • Abdominal wall reconstruction
  • Colostomy closure
  • Parastomal hernia
  • Posterior component separation
  • Robotic surgery
  • Surgical complications
  • Transversus abdominis release
  • Ventral hernia
  • Abdominal Muscles / surgery
  • Abdominal Wall / surgery
  • Abdominoplasty / methods
  • Hernia, Ventral / surgery
  • Herniorrhaphy / methods
  • Humans
  • Robotic Surgical Procedures / methods
  • Surgical Mesh / adverse effects
Citation (ISO format)
DOUISSARD, Jonathan et al. One-step totally robotic Hartmann reversal and complex abdominal wall reconstruction with bilateral posterior component separation: a technical note. In: Colorectal disease, 2023, vol. 25, n° 7, p. 1523–1528. doi: 10.1111/codi.16583
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ISSN of the journal1462-8910
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Technical informations

Creation05/11/2023 8:57:08 AM
First validation01/30/2024 5:57:58 PM
Update time01/30/2024 5:57:58 PM
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