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A proctosigmoidectomy, Hartmann's operation or Hartmann's procedure is the surgical resection of the rectosigmoid colon with closure of the anorectal stump and formation of an end colostomy. It was used to treat colon cancer or inflammation (proctosigmoiditis, proctitis, diverticulitis, volvulus, etc.).
Before removal, the portion of the bowel to be resected must be freed or mobilized. This is done by dissection and removal of the mesentery and other peritoneal attachments. Resection of any part of the colon entails mobilization and the cutting and sealing, or ligation, of the blood vessels supplying the portion of the colon to be removed. [8]
The sigmoid colon is completely surrounded by peritoneum (and thus is not retroperitoneal), which forms a mesentery (sigmoid mesocolon), which diminishes in length from the center toward the ends of the loop, where it disappears, so that the loop is fixed at its junctions with the iliac colon and rectum, but enjoys a considerable range of movement in its central portion.
A human colon is considered abnormally enlarged if it has a diameter greater than 12 cm [3] in the cecum (it is usually less than 9 cm [4]), greater than 6.5 cm [3] in the rectosigmoid region and greater than 8 cm [3] for the ascending colon. The transverse colon is usually less than 6 cm in diameter.
The colon is then mobilized from the retroperitoneum. Care is taken to avoid injury to the ureters and duodenum. The surgery then follows the same steps as small bowel resection. However, due to the colon's placement in the retroperitoneum, more dissection is often required to allow for tension free anastomosis. [5] [6]
Another way of categorizing surgery for prolapse of pelvic organs is suspensive or resective (involving removal of sections of the bowel wall). Ventral rectopexy alone is a syspensive type surgery, a category which also includes colposacropexy. [10] Resection rectopexy additionally involves removal of a section of the sigmoid colon ...
Investigations are underway in India’s Navsari district after a 23-year-old nursing student tragically passed away following a sexual encounter with someone who has reportedly been identified as ...
They also use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum. [1] With flexible sigmoidoscopy, the physician can see intestinal bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or ...