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Dec 16, 2023

Hartmann's Reversal Experiences and Advice

The topic is about someone who had an emergency Hartmann’s procedure due to perforated diverticulitis and now has a colostomy. They are considering a robotic reversal surgery to reconnect the large bowel without creating an internal pouch. While eager to remove the stoma, they are concerned about potential complications and are seeking advice from others who have undergone similar procedures.

Here are some helpful insights and advice shared by others:

1. **Surgeon Selection and Research**
- It's important to thoroughly research and ask detailed questions about the procedure. Ensure the surgeon has experience with this type of surgery, as confidence in your surgeon is crucial.

2. **Reversal vs. Keeping the Stoma**
- Some people caution that reconnections or pouch procedures can sometimes fail, so consider the long-term quality of life. However, a direct colon-to-colon reconnection generally has higher success rates than pouch construction.

3. **Recovery Experiences**
- Many found the reversal less traumatic than the initial emergency surgery.
- For open reversal, recovery to normalcy took about three weeks with minimal pain, and staples were removed on day 14.
- For robotic or laparoscopic reversal, some went home in three days, with or without an NG tube for 3–4 days.
- Recovery is often quicker because you are healthier going into the surgery compared to the emergency situation.

4. **NG Tube**
- If an NG tube is used, it is usually removed within a few days. While not pleasant, many found it tolerable for the short time it was needed.

5. **Stapler and Internal Staples**
- Circular staplers are commonly used for reattachment, and the staples remain inside. Patients typically do not feel them, and they generally do not cause issues.

6. **Polyps Before Reversal**
- Polyps can often be removed during the reversal surgery. Routine surveillance colonoscopy is usually scheduled one year after the reversal.

7. **Travel and Activity Post-Reversal**
- Many felt in control by three weeks post-op, suggesting that a flight in May (about three months after a February surgery) is feasible if there are no complications. It's best to discuss this with your surgical team.

8. **Psychological Tips**
- Focus on positive stories and remember that elective reversal is done when you are stable and strong. Connecting with others who have undergone the same procedure can provide reassurance and practical advice.
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