{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:18:21Z","timestamp":1788351501248,"version":"build-2803163510"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007195","name":"Universit\u00e0 degli Studi di Napoli Federico II","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007195","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Hartmann\u2019s procedure is often performed in emergency settings for complicated diverticulitis, obstructive colorectal cancer, or colonic perforations when primary anastomosis is not feasible. Hartmann Reversal (HR) is technically demanding, primarily due to dense intra-abdominal adhesions, and is traditionally performed in open or laparoscopic surgery. However, laparoscopic reversal is associated with high conversion rates, often due to difficulties in adhesiolysis. Robotic surgery, offering enhanced visualization and instrument dexterity, has been proposed as a promising alternative. This retrospective multicenter study analyzed 89 patients who underwent minimally invasive Hartmann reversal across six Italian tertiary colorectal centers from 2013 to 2023. Of these, 45 patients underwent robotic reversal and 44 laparoscopic reversal. Only procedures that included standardized surgical steps\u2014adhesiolysis, colostomy and rectal stump mobilization, and colorectal anastomosis\u2014were included. The primary outcome was the conversion rate to open surgery. Secondary outcomes included intraoperative complications, postoperative morbidity, and recovery parameters. Baseline demographics and comorbidities were similar between groups. The conversion rate was significantly lower in the robotic group (0% vs. 20.5%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), though operative time was longer (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). There were no statistically significant differences in overall postoperative complications (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.052), anastomotic leaks (0 vs. 3,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.285), or recovery outcomes. Multivariate analysis showed that no baseline variables significantly affected conversion risk. This is the first comparative study between robotic and laparoscopic Hartmann reversal. The findings suggest that robotic surgery may reduce conversion rates and improve procedural feasibility. Larger prospective studies are needed to confirm these results and assess long-term outcomes.\n                  <\/jats:p>","DOI":"10.1007\/s13304-026-02583-0","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:30:28Z","timestamp":1780036228000},"page":"1863-1870","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic versus laparoscopic Hartmann reversal: a multicentric analysis by ICoRS (Italian club of robotic Surgery)"],"prefix":"10.1007","volume":"78","author":[{"given":"Michele","family":"Manigrasso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Anoldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Andreuccetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziano","family":"Ceccarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Cianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Coratti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"D\u2019Amore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"De Capua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Filotico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampaolo","family":"Formisano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fortuna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Giuliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Giuratrabocchetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Guarriello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giusto","family":"Pignata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Rondelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Staderini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Pietro","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5612-1926","authenticated-orcid":false,"given":"Marco","family":"Milone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"2583_CR1","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1001\/archsurg.1980.01380060088026","volume":"115","author":"E Sanderson","year":"1980","unstructured":"Sanderson E (1980) Henri Hartmann and the Hartmann operation. Arch Surg 115:792\u2013793. https:\/\/doi.org\/10.1001\/archsurg.1980.01380060088026","journal-title":"Arch Surg"},{"key":"2583_CR2","first-page":"94","volume":"132","author":"AM Boyden","year":"1950","unstructured":"Boyden AM (1950) The surgical treatment of diverticulitis of the colon. Ann Surg 132:94\u2013109","journal-title":"Ann Surg"},{"key":"2583_CR3","first-page":"69","volume":"3","author":"CA Anderson","year":"1993","unstructured":"Anderson CA, Fowler DL, White S, Wintz N (1993) Laparoscopic colostomy closure. Surg Laparosc Endosc 3:69\u201372","journal-title":"Surg Laparosc Endosc"},{"key":"2583_CR4","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1007\/S00464-017-5725-4","volume":"32","author":"KY Pei","year":"2018","unstructured":"Pei KY, Davis KA, Zhang Y (2018) Assessing trends in laparoscopic colostomy reversal and evaluating outcomes when compared to open procedures. Surg Endosc 32:695\u2013701. https:\/\/doi.org\/10.1007\/S00464-017-5725-4","journal-title":"Surg Endosc"},{"key":"2583_CR5","doi-asserted-by":"publisher","unstructured":"Brathwaite S, Kuhrt M, Yu L et al (2015) Retrospective evaluation of laparoscopic versus open hartmann\u2019s reversal: A Single-Institution experience. Surg Laparosc Endosc Percutan Tech 25. https:\/\/doi.org\/10.1097\/SLE.0000000000000201","DOI":"10.1097\/SLE.0000000000000201"},{"key":"2583_CR6","doi-asserted-by":"publisher","first-page":"245","DOI":"10.4240\/WJGS.V5.I8.245","volume":"5","author":"N De\u2019angelis","year":"2013","unstructured":"De\u2019angelis N, Brunetti F, Memeo R et al (2013) Comparison between open and laparoscopic reversal of hartmann\u2019s procedure for diverticulitis. World J Gastrointest Surg 5:245. https:\/\/doi.org\/10.4240\/WJGS.V5.I8.245","journal-title":"World J Gastrointest Surg"},{"key":"2583_CR7","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/SLE.0B013E3180F61762","volume":"17","author":"JP Faure","year":"2007","unstructured":"Faure JP, Doucet C, Essique D et al (2007) Comparison of conventional and laparoscopic hartmann\u2019s procedure reversal. Surg Laparosc Endosc Percutan Tech 17:495\u2013499. https:\/\/doi.org\/10.1097\/SLE.0B013E3180F61762","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"2583_CR8","doi-asserted-by":"publisher","first-page":"4780","DOI":"10.1007\/S00464-018-6227-8","volume":"32","author":"N Horesh","year":"2018","unstructured":"Horesh N, Lessing Y, Rudnicki Y et al (2018) Comparison between laparoscopic and open hartmann\u2019s reversal: results of a decade-long multicenter retrospective study. Surg Endosc 32:4780\u20134787. https:\/\/doi.org\/10.1007\/S00464-018-6227-8","journal-title":"Surg Endosc"},{"key":"2583_CR9","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1111\/ANS.13979","volume":"88","author":"HD Kwak","year":"2018","unstructured":"Kwak HD, Kim J, Kang DW et al (2018) Hartmann\u2019s reversal: a comparative study between laparoscopic and open approaches. ANZ J Surg 88:450\u2013454. https:\/\/doi.org\/10.1111\/ANS.13979","journal-title":"ANZ J Surg"},{"key":"2583_CR10","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/S13304-016-0363-2","volume":"68","author":"A Lucchetta","year":"2016","unstructured":"Lucchetta A, De Manzini N (2016) Laparoscopic reversal of Hartmann procedure: is it safe and feasible? Updates Surg 68:105\u2013110. https:\/\/doi.org\/10.1007\/S13304-016-0363-2","journal-title":"Updates Surg"},{"key":"2583_CR11","doi-asserted-by":"publisher","first-page":"1603","DOI":"10.1007\/S00384-015-2325-4","volume":"30","author":"V Celentano","year":"2015","unstructured":"Celentano V, Giglio MC, Bucci L (2015) Laparoscopic versus open hartmann\u2019s reversal: a systematic review and meta-analysis. Int J Colorectal Dis 30:1603\u20131615. https:\/\/doi.org\/10.1007\/S00384-015-2325-4","journal-title":"Int J Colorectal Dis"},{"key":"2583_CR12","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/J.1463-1318.2008.01667.X","volume":"11","author":"J Vermeulen","year":"2009","unstructured":"Vermeulen J, Coene PPLO, Van Hout NM et al (2009) Restoration of bowel continuity after surgery for acute perforated diverticulitis: should hartmann\u2019s procedure be considered a one-stage procedure? Colorectal Dis 11:619\u2013624. https:\/\/doi.org\/10.1111\/J.1463-1318.2008.01667.X","journal-title":"Colorectal Dis"},{"key":"2583_CR13","doi-asserted-by":"publisher","unstructured":"Roig JV, Cantos M, Balciscueta Z et al (2011) Hartmann\u2019s operation: how often is it reversed and at what cost? A multicentre study. Colorectal Dis 13. https:\/\/doi.org\/10.1111\/J.1463-1318.2011.02738.X","DOI":"10.1111\/J.1463-1318.2011.02738.X"},{"key":"2583_CR14","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1111\/ans.12667","volume":"84","author":"PF Yang","year":"2014","unstructured":"Yang PF, Morgan MJ (2014) Laparoscopic versus open reversal of hartmann\u2019s procedure: a retrospective review. ANZ J Surg 84:965\u2013969. https:\/\/doi.org\/10.1111\/ans.12667","journal-title":"ANZ J Surg"},{"key":"2583_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/530140","volume":"2014","author":"A Toro","year":"2014","unstructured":"Toro A, Ardiri A, Mannino M et al (2014) Laparoscopic reversal of hartmann\u2019s procedure: state of the Art 20 years after the first reported case. Gastroenterol Res Pract 2014:1\u20138. https:\/\/doi.org\/10.1155\/2014\/530140","journal-title":"Gastroenterol Res Pract"},{"key":"2583_CR16","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s10151-021-02560-2","volume":"26","author":"D Chavrier","year":"2022","unstructured":"Chavrier D, Alves A, Menahem B (2022) Is laparoscopy a reliable alternative to laparotomy in hartmann\u2019s reversal? An updated meta-analysis. Tech Coloproctol 26:239\u2013252. https:\/\/doi.org\/10.1007\/s10151-021-02560-2","journal-title":"Tech Coloproctol"},{"key":"2583_CR17","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.1007\/s00268-019-04962-8","volume":"43","author":"F Guerra","year":"2019","unstructured":"Guerra F, Coletta D, Del Basso C et al (2019) Conventional versus minimally invasive Hartmann takedown: A Meta-analysis of the literature. World J Surg 43:1820\u20131828. https:\/\/doi.org\/10.1007\/s00268-019-04962-8","journal-title":"World J Surg"},{"key":"2583_CR18","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1111\/CODI.12807","volume":"17","author":"CH Richards","year":"2015","unstructured":"Richards CH, Roxburgh CSD (2015) Surgical outcome in patients undergoing reversal of hartmann\u2019s procedures: a multicentre study. Colorectal Dis 17:242\u2013249. https:\/\/doi.org\/10.1111\/CODI.12807","journal-title":"Colorectal Dis"},{"key":"2583_CR19","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3390\/jpm12020307","volume":"12","author":"M Milone","year":"2022","unstructured":"Milone M, Manigrasso M, Anoldo P et al (2022) The role of robotic visceral surgery in patients with adhesions: A systematic review and Meta-Analysis. J Pers Med 12:307. https:\/\/doi.org\/10.3390\/jpm12020307","journal-title":"J Pers Med"},{"key":"2583_CR20","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s11701-014-0458-z","volume":"8","author":"N de\u2019Angelis","year":"2014","unstructured":"de\u2019Angelis N, Felli E, Azoulay D, Brunetti F (2014) Robotic-assisted reversal of hartmann\u2019s procedure for diverticulitis. J Robot Surg 8:381\u2013383. https:\/\/doi.org\/10.1007\/s11701-014-0458-z","journal-title":"J Robot Surg"},{"key":"2583_CR21","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1111\/CODI.14683","volume":"21","author":"OY Kudsi","year":"2019","unstructured":"Kudsi OY, Gokcal F (2019) Robotic Staplerless Hartmann colostomy reversal - a video vignette. Colorectal Dis 21:1095\u20131096. https:\/\/doi.org\/10.1111\/CODI.14683","journal-title":"Colorectal Dis"},{"key":"2583_CR22","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1016\/J.JMIG.2019.12.005","volume":"27","author":"L Mutlu","year":"2020","unstructured":"Mutlu L, Kim S, Altwerger G, Menderes G (2020) Robotic colostomy takedown in a patient with extensive ventral hernias and adhesive disease. J Minim Invasive Gynecol 27:1256\u20131257. https:\/\/doi.org\/10.1016\/J.JMIG.2019.12.005","journal-title":"J Minim Invasive Gynecol"},{"key":"2583_CR23","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1111\/CODI.16583","volume":"25","author":"J Douissard","year":"2023","unstructured":"Douissard J, Dupuis A, Ris F et al (2023) One-step totally robotic Hartmann reversal and complex abdominal wall reconstruction with bilateral posterior component separation: a technical note. Colorectal Dis 25:1523\u20131528. https:\/\/doi.org\/10.1111\/CODI.16583","journal-title":"Colorectal Dis"},{"key":"2583_CR24","doi-asserted-by":"publisher","first-page":"2391","DOI":"10.1007\/s13304-023-01672-8","volume":"75","author":"M Barone","year":"2023","unstructured":"Barone M, Ippoliti M, Masetti M, Mucilli F (2023) Robotic hartmann\u2019s reversal\u2014feasibility and technical aspects. Updates Surg 75:2391\u20132394. https:\/\/doi.org\/10.1007\/s13304-023-01672-8","journal-title":"Updates Surg"},{"key":"2583_CR25","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1097\/DCR.0000000000002571","volume":"67","author":"RA Bealer","year":"2024","unstructured":"Bealer RA, Ailabouni L (2024) Robotic hartmann\u2019s reversal. Dis Colon Rectum 67:e7\u2013e8. https:\/\/doi.org\/10.1097\/DCR.0000000000002571","journal-title":"Dis Colon Rectum"},{"key":"2583_CR26","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1111\/codi.16639","volume":"25","author":"NZ Teo","year":"2023","unstructured":"Teo NZ, Ngu JC (2023) Robotic reversal of open hartmann\u2019s procedure for Hinchey 3 diverticulitis: A video vignette. Color Dis 25:1564\u20131565. https:\/\/doi.org\/10.1111\/codi.16639","journal-title":"Color Dis"},{"key":"2583_CR27","doi-asserted-by":"publisher","first-page":"1734","DOI":"10.1111\/codi.15249","volume":"22","author":"G Giuliani","year":"2020","unstructured":"Giuliani G, Formisano G, Milone M et al (2020) Full robotic hartmann\u2019s reversal: technical aspects and preliminary experience. Color Dis 22:1734\u20131740. https:\/\/doi.org\/10.1111\/codi.15249","journal-title":"Color Dis"}],"container-title":["Updates in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-026-02583-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13304-026-02583-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-026-02583-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:42:09Z","timestamp":1788349329000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13304-026-02583-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["2583"],"URL":"https:\/\/doi.org\/10.1007\/s13304-026-02583-0","relation":{},"ISSN":["2038-131X","2038-3312"],"issn-type":[{"value":"2038-131X","type":"print"},{"value":"2038-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"22 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"all authors have no conflict of interest to declare.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}