Reduction of volvulus, intussusception, internal hernia, by laparotomy
CPT4 code
Name of the Procedure:
Reduction of volvulus, intussusception, internal hernia by laparotomy
- Also known as: Open Reduction of Bowel Obstruction
Summary
This surgical procedure involves making an incision in the abdomen (laparotomy) to correct complications such as a twisted bowel (volvulus), a telescoping bowel segment (intussusception), or an internal hernia. The aim is to restore normal bowel function by untangling or removing the obstruction.
Purpose
- Medical Condition: Treats life-threatening bowel obstructions caused by volvulus, intussusception, or internal hernias.
- Goals: Ensure the bowel is restored to its normal position, preserve bowel tissue, and prevent complications like bowel ischemia or perforation.
Indications
- Severe abdominal pain
- Bloating and distension
- Vomiting
- Not passing stools or gas
- Criteria: Suspected or diagnosed volvulus, intussusception, or internal hernia via imaging or clinical evaluation.
Preparation
- Fasting: Typically, no food or drink for 8 hours before surgery.
- Medications: Adjustments as advised by the healthcare provider.
- Tests: Blood tests, imaging studies (e.g., CT scan, ultrasound).
Procedure Description
- Incision: A surgical incision is made in the abdomen.
- Exploration: The surgeon examines the abdominal organs to locate the obstruction.
- Reduction: The bowel is untwisted and any obstructions are cleared.
- Repair: Damaged sections of the bowel may be repaired or removed.
- Closure: The surgical site is closed with sutures or staples.
- Tools: Scalpels, retractors, suture materials.
- Anesthesia: General anesthesia to ensure the patient is unconscious and pain-free.
Duration
The procedure typically takes 1-3 hours, depending on the complexity of the obstruction.
Setting
Performed in a hospital operating room equipped for major surgeries.
Personnel
- Surgeons
- Surgical Nurses
- Anesthesiologists
- Surgical Technicians
Risks and Complications
- Common Risks: Infection, bleeding, injury to surrounding organs.
- Rare Risks: Blood clots, respiratory complications, prolonged ileus (temporary bowel paralysis).
- Management: Close monitoring and immediate management of any arising complications.
Benefits
- Restored Bowel Function: Immediate relief from obstruction symptoms.
- Pain Relief: Substantial reduction in abdominal pain post-procedure.
- Prevention: Avoidance of severe complications like bowel perforation and sepsis.
Recovery
- Post-Procedure Care: Pain management, antibiotics, gradual reintroduction of diet.
- Recovery Time: Typically 4-6 weeks; full recovery may take longer.
- Restrictions: Limited physical activity, no heavy lifting; follow-up appointments for wound and condition assessment.
Alternatives
- Less Invasive Methods: Endoscopic reduction for some cases.
- Non-Surgical Options: May include bowel rest and nasogastric decompression.
- Pros and Cons: Alternatives may be less invasive but could be less effective or not applicable for severe cases.
Patient Experience
- During Procedure: Under general anesthesia; no awareness or pain.
- After Procedure: Possible pain and discomfort managed with medication; gradual return to normal activities.
- Pain Management: Standard post-operative pain management protocols to enhance comfort.