45562 Exploration, repair, and presacral drainage for rectal injury

Name of the Procedure:

Exploration, repair, and presacral drainage for rectal injury
Common name(s): Rectal injury repair, Presacral drainage

Summary

Exploration, repair, and presacral drainage for rectal injury is a surgical procedure to examine and fix injuries to the rectum and to drain any infections or fluids that have accumulated in the pelvic area.

Purpose

This procedure addresses injuries to the rectum, which could result from trauma, surgery, or other medical conditions. The goals include repairing the rectal injury, preventing infection by draining fluids, and promoting healing.

Indications

• Traumatic injuries to the rectum (e.g., from accidents or surgery)
• Symptoms of rectal perforation (e.g., severe pain, bleeding, infection)
• Infections or abscesses in the pelvic area

Preparation

• Fasting for a certain period before the surgery (typically 8-12 hours)
• Adjustments to current medications as instructed by a doctor
• Preoperative imaging and assessments, such as a CT scan or MRI
• Blood tests to check for infection or other related issues

Procedure Description

1. Anesthesia: The patient is given general anesthesia to ensure they are asleep and pain-free.
2. Exploration: The surgeon makes an abdominal incision to access the pelvic area and examine the extent of the rectal injury.
3. Repair: The damaged rectal tissue is surgically repaired using sutures.
4. Presacral Drainage: A drainage tube is placed in the presacral space to remove any accumulated fluids or infection.

5. Closure: The abdominal incision is closed with stitches or staples, and dressings are applied.

   Tools: Surgical instruments (scalpel, sutures), drainage tubes, imaging equipment (intraoperative, if necessary).

Duration

The procedure typically takes 2-4 hours, depending on the complexity of the injury.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Surgeon (typically a colorectal or general surgeon)
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common: Infection, bleeding, temporary pain
• Rare: Damage to surrounding organs, prolonged bowel dysfunction, anesthetic complications
• Management of complications involves antibiotics, additional surgeries, and supportive care.

Benefits

• Proper healing of rectal injury and prevention of further complications
• Reduced risk of infections due to efficient drainage
• Most patients can expect to see benefits and improvement in symptoms within a few weeks.

Recovery

• Hospital stay for monitoring (usually 3-7 days)
• Pain management with medications
• Instructions on wound care and activity restrictions
• Follow-up appointments for assessment and possible removal of the drainage tube
• Full recovery may take several weeks; avoid heavy lifting and strenuous activities during this time.

Alternatives

• Conservative management with antibiotics and monitoring (for minor injuries)
• Non-surgical drainage procedures
• The benefits of the surgical approach generally include faster and more reliable healing compared to conservative management, but it comes with higher risks and longer recovery.

Patient Experience

During the procedure: The patient will be under general anesthesia and will not experience any sensations. After the procedure: Pain and discomfort around the surgical site, managed with medications. Possible temporary restrictions on diet and activities to support healing. Regular follow-up visits for monitoring.