Colectomy, partial; abdominal and transanal approach
CPT4 code
Name of the Procedure:
Colectomy, Partial (Abdominal and Transanal Approach)
Summary
A partial colectomy is a surgical procedure to remove a portion of the colon. This specific approach uses both abdominal and transanal methods to access and excise the diseased section of the colon.
Purpose
This procedure is indicated for treating conditions like colon cancer, diverticulitis, or Crohn's disease. The goal is to remove the affected part of the colon to alleviate symptoms and prevent disease progression.
Indications
- Colon cancer
- Severe diverticulitis
- Crohn's disease
- Large, symptomatic polyps
- Intractable bleeding
Preparation
Patients are usually advised to:
- Fast for at least 8 hours before the procedure
- Undergo bowel preparation (laxatives or enemas) to clear the colon
- Stop taking certain medications like blood thinners
- Complete preoperative assessments including blood tests, ECG, and imaging studies
Procedure Description
- Anesthesia: Administered to ensure the patient is asleep and pain-free.
- Abdominal Access: Small incisions are made in the abdomen to insert a laparoscope and surgical instruments.
- Transanal Approach: A specially designed scope and instruments are inserted through the anal canal to reach the colon.
- Excision: The diseased section of the colon is identified, isolated, and removed.
- Anastomosis: The healthy ends of the colon are reconnected.
- Closure: Incisions are closed with sutures or staples.
Duration
The procedure typically takes 2 to 4 hours.
Setting
Colectomies are usually performed in a hospital operating room.
Personnel
- General Surgeon or Colorectal Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Infection
- Bleeding
- Anastomotic leak (where the colon ends are joined)
- Bowel obstruction
- Reactions to anesthesia
Management of these complications involves antibiotics, additional surgery, or other medical interventions.
Benefits
- Relief of symptoms (pain, bleeding, obstruction)
- Removal of diseased tissue
- Prevention of disease progression or recurrence
- Improved quality of life
Beneficial effects might be realized shortly after recovery, typically within a few weeks.
Recovery
- Hospital stay of 3 to 7 days
- Pain management with prescribed medications
- Gradual reintroduction to normal diet
- Avoid heavy lifting for several weeks
- Follow-up appointments for monitoring recovery
Alternatives
- Medical management (medications, diet changes)
- Minimally invasive procedures like endoscopic resections
- Other surgical options such as total colectomy
Each alternative has its own set of risks, benefits, and suitability depending on the patient's condition and overall health.
Patient Experience
Patients might experience discomfort, bloating, and changes in bowel habits immediately after the procedure. Pain is managed with medications, and most patients return to routine activities within a few weeks.