Modified Hartmann procedure in emergency sigmoid colectomy

A new technique has been added to the Hartmann procedure to suture the rectal stump to the presacral fascia using black silk sutures at the time of the initial resection and closure of rectal stump. This will prevent contraction of the rectal stump behind the bladder or vagina deep in the pelvis and makes reanastomosis of the proximal colon to the rectal stump very easy. Also discussed are the advantages of the modified Hartmann procedure in cases of emergency sigmoid colectomy as opposed to the conventional three stage procedure.