Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct
CPT4 code
Name of the Procedure:
Excision of Meckel's Diverticulum or Omphalomesenteric Duct (Diverticulectomy).
Summary
This surgical procedure involves removing a Meckel's diverticulum, which is a small pouch in the wall of the intestine, or addressing issues with the omphalomesenteric duct, a vestigial structure from embryonic development. The surgery aims to alleviate symptoms and prevent complications associated with these conditions.
Purpose
Medical Condition: This procedure is performed to treat complications arising from Meckel's diverticulum, such as inflammation (diverticulitis), bleeding, or obstruction of the small intestine. It also addresses abnormalities related to the omphalomesenteric duct.
Goals/Expected Outcomes: The primary goals are to eliminate discomfort, treat any bleeding or infection, prevent life-threatening complications like bowel obstruction and perforation, and improve the patient's overall digestive health.
Indications
Symptoms/Conditions: Abdominal pain, gastrointestinal bleeding, signs of intestinal obstruction, inflammation, or infection related to Meckel's diverticulum.
Patient Criteria: Patients presenting with symptomatic Meckel's diverticulum, unexplained gastrointestinal bleeding, or diagnosed omphalomesenteric duct anomalies.
Preparation
Pre-procedure Instructions: Patients may need to fast for 6-8 hours before the surgery. Adjustments to medications, particularly blood thinners, may be required.
Diagnostic Tests: Blood tests, imaging studies such as a CT scan or ultrasound, and sometimes a Meckel's scan (technetium-99m pertechnetate scan) to localize the diverticulum.
Procedure Description
- Anesthesia: Administered general anesthesia to ensure the patient is asleep and pain-free during the procedure.
- Incision: A small incision is made in the abdomen, often using laparoscopic techniques to minimize invasiveness.
- Resection: The surgeon identifies and removes the Meckel's diverticulum or abnormal omphalomesenteric duct.
- Closure: The intestines are sutured, and the abdominal incision is closed with stitches or staples.
- Completion: The surgical site is sealed, and the patient is moved to recovery.
Duration
The procedure typically takes 1 to 2 hours.
Setting
Performed in a hospital operating room or a specialized surgical center.
Personnel
Involves a surgical team including a general surgeon, anesthesiologist, surgical nurses, and possibly a surgical assistant.
Risks and Complications
Common Risks: Infection, bleeding, and adverse reactions to anesthesia.
Rare Complications: Injury to surrounding organs, post-operative bowel obstruction, or leakage from the site where the intestine is sutured. Management typically includes additional medication, monitoring, or further surgical intervention if necessary.
Benefits
The patient can expect relief from symptoms such as pain and bleeding. The procedure reduces the risk of severe complications like bowel obstruction or perforation. Recovery of normal intestinal function is anticipated within weeks.
Recovery
Post-procedure Care: Includes pain management, antibiotics to prevent infection, and gradual reintroduction of diet.
Expected Recovery Time: Full recovery usually occurs within 2 to 4 weeks. Patients are advised to avoid heavy lifting and vigorous activities during this period. Follow-up appointments are necessary to monitor healing.
Alternatives
Treatment Options: Conservative management includes medications to manage symptoms, though these are often temporary solutions.
Comparison: Surgery is generally more definitive and curative compared to medical management, which may not fully address the underlying problem and can lead to recurrent symptoms.
Patient Experience
During the Procedure: The patient will be under general anesthesia and will not experience pain or awareness during the surgery.
After the Procedure: Pain and discomfort are common in the initial days, managed with prescribed pain medications. Patients may experience some restrictions on activity and diet until fully recovered.