Proctoplasty; for stenosis
CPT4 code
Name of the Procedure:
Proctoplasty for Stenosis (Anoplasty)
Summary
Proctoplasty for stenosis is a surgical procedure to widen a narrowed area (stenosis) of the rectum or anus. It aims to restore normal function and relieve symptoms such as pain and difficulty in passing stools.
Purpose
The procedure addresses rectal or anal stenosis, a condition where this area becomes abnormally narrow. The goals are to ease bowel movements, reduce pain, and prevent future blockages or complications.
Indications
- Chronic constipation
- Pain during bowel movements
- Rectal bleeding or discharge
- Incomplete bowel evacuation
- Physical examination showing narrowing of the rectal or anal canal
Preparation
- Fasting for at least 8 hours before the procedure
- Adjusting or stopping certain medications as advised by the doctor
- Undergoing pre-operative tests such as a colonoscopy, blood tests, or imaging studies
Procedure Description
- The patient is given anesthesia — either general or regional (spinal/epidural).
- The surgeon makes an incision in the affected area to access the narrowed segment.
- Special surgical tools are used to remove scar tissue or widen the narrow area.
- The incision is then carefully closed with sutures.
- In some cases, temporary stents or dilators might be placed to maintain the widened passage.
Duration
Typically, the procedure lasts 1 to 2 hours.
Setting
Proctoplasty is usually performed in a hospital or outpatient surgical center.
Personnel
- Surgeon specializing in colorectal or general surgery
- Anesthesiologist
- Operating room nurses
- Surgical technologists
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Scar tissue recurrence and restenosis
- Pain or discomfort post-surgery
- Adverse reaction to anesthesia
- Damage to surrounding organs or tissues
Benefits
- Relief from pain and discomfort during bowel movements
- Improved bowel function and regularity
- Reduced risk of future complications related to stenosis
- Enhanced quality of life
Recovery
- Hospital stay of 1-2 days, depending on the case
- Pain management with prescribed medications
- Instruction on diet adjustments and stool softeners
- Avoiding heavy lifting and strenuous activities for a few weeks
- Follow-up appointments to monitor healing and progress
Alternatives
- Balloon dilation: temporarily stretches the narrowed area, typically less invasive.
- Endoscopic procedures: using a scope to treat the stenosis internally.
- Medication: managing symptoms with stool softeners and anti-inflammatories.
- Pros and cons: Non-surgical options might provide temporary relief but are often less effective for severe cases. Surgery typically offers a more permanent solution but comes with higher risks.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel any pain. Post-surgery, there may be discomfort and pain managed with medications. Full recovery generally takes a few weeks, with patients often experiencing significant symptom relief in a short period. Regular follow-up visits ensure proper healing and prevent complications.