Modified Hartmann's procedure to avoid double-barreled stoma

A modified Hartmann's procedure which has only one stoma has been performed instead of a double-barrel stoma in 3 patients. The technique of modified Hartmann's procedure is as follows: The distal colorectum is closed with a mechanical device following colectomy, and interrupted seromuscular sutures are then placed between the colorectal walls. A closed colorectal stump is brought up into the subcutaneous tissue of the abdominal wound and fixed to the rectus sheath. Skin stitches are roughly performed over the colorectal stump so as to know the postoperative status of the stump easily. This procedure was performed in a case with ulcerative colitis and two cases of colon cancer with peritonitis. No complications associated with this procedure, including wound infection, have been observed. Tapering the steroid was possible after subtotal colectomy with ileostomy and modified Hartmann's procedure in a patient with ulcerative colitis. A surgical dissection and a searching out the distal remnant were easily completed in two, patients who had a second operation. This procedure is recommended as a safe and useful operation to avoid a double-barreled stoma.