44121 Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure)

Name of the Procedure:

Enterectomy; resection of small intestine; each additional resection and anastomosis

Summary

An Enterectomy is a surgical procedure where a section of the small intestine is removed. This description specifically refers to additional resections and anastomoses that are performed in conjunction with the primary procedure.

Purpose

Enterectomy addresses conditions such as bowel obstruction, Crohn's disease, and gastrointestinal cancers. The goal is to remove diseased sections of the intestine and connect the remaining healthy parts to restore normal function.

Indications

• Chronic or severe bowel obstruction
• Intestinal trauma or injury
• Crohn's disease
• Intestinal cancers or tumors
• Severe intestinal bleeding Patients must generally have significant symptoms or have not responded to other treatments.

Preparation

• Patients are usually instructed to fast for 8-12 hours before surgery.
• Medications may need to be adjusted; blood thinners are often paused.
• Pre-operative assessments, including blood tests, imaging studies (like CT scans), and a physical examination, are required.

Procedure Description

1. Anesthesia: The patient is given general anesthesia.
2. Incision: A surgical incision is made in the abdomen.
3. Resection: The diseased section of the small intestine is identified and removed.
4. Anastomosis: The two ends of the healthy intestines are then sewn back together.
5. Additional Resection: If additional sections need to be removed, the process is repeated.
6. Closure: The incision is closed with sutures or staples.

The tools used include scalpels, retractors, suturing materials, and sometimes laparoscopic instruments.

Duration

The procedure typically lasts 2-4 hours, depending on the complexity and number of resections.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

• Lead Surgeon
• Surgical Nurses
• Anesthesiologist
• Surgical Technicians

Risks and Complications

• Common Risks: Infection, bleeding, adverse reaction to anesthesia
• Rare Risks: Bowel leakage at the site of anastomosis, injury to surrounding organs, prolonged ileus (temporary paralysis of the intestines)

Benefits

• Relief from symptoms like pain, obstruction, or bleeding
• Improvement in the quality of life
• Potential cure for underlying conditions like cancer

Recovery

• Hospital stay of 5-7 days post-surgery
• Pain management with medications
• Gradual reintroduction to fluids and then solid foods
• Follow-up appointments are essential to monitor recovery
• Recovery period ranges from 4-6 weeks

Alternatives

• Non-surgical treatments like medication for Crohn's disease or intestinal stents for obstruction
• Endoscopic procedures for minor issues
• Each alternative has different pros and cons, mainly concerning effectiveness and recovery time.

Patient Experience

• Patients are under general anesthesia during the procedure, so they won't feel anything.
• Postoperatively, patients may experience pain and discomfort, which is managed with medication.
• Full recovery involves gradual improvement in daily function and diet.

Pain management and comfort measures include regular pain assessments, effective pain medications, and support from a healthcare team for mobilization and return to activities.