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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.).
In human anatomy, the inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The regions supplied by the IMA are the descending colon, the sigmoid colon, and part of the rectum. [1]
Suture anastomosis of sigmoid colon. When the resection is complete, the surgeon has the option of reconnecting the bowel by stitching or stapling together the cut ends of the bowel (primary anastomosis) or performing a colostomy to create a stoma, an opening of the bowel to the abdominal wall that provides an alternate exit for the contents of ...
A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis is used to restore colonic continuity after the resection of colon cancer .
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A bowel resection or enterectomy (enter-+ -ectomy) is a surgical procedure in which a part of an intestine (bowel) is removed, from either the small intestine or large intestine. Often the word enterectomy is reserved for the sense of small bowel resection, in distinction from colectomy , which covers the sense of large bowel resection.
It descends into the pelvis between the layers of the mesentery of the sigmoid colon, crossing the left common iliac artery and vein. It divides, opposite the third sacral vertebra into two branches, which descend one on either side of the rectum. About 10 or 12 cm from the anus, these branches break up into several small branches. [1]
Colostomy or ileostomy is now rarely performed for rectal cancer, with surgeons usually preferring primary resection and internal anastomosis, [3] e.g. an ileo-anal pouch. In place of an external appliance , an internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to act as a new rectum to replace the removed ...