The Hartmann procedure involves resection of the rectosigmoid colon with creation of a colostomy. It was first described by Henri Albert Hartmann at the 30th Congress of the French Surgical Association in 1921. Hartmann reported two patients with obstructive cancer of the sigmoid colon, whom he treated by performing a laparotomy with creation of a proximal colostomy and sigmoid resection with closure of the rectal stump.
Hartmann developed this procedure as a response to the high mortality associated with the abdominoperineal resection described by Miles in 1908. With the Hartmann procedure, operative mortality was 8.8% (compared with 38% with the Miles resection) because “cases were as uneventful as a procedure for a cold appendix