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Colotomy, for exploration, biopsy(s), or foreign body removal
CPT4 code
Name of the Procedure:
Colotomy (Surgical Opening of the Colon)
Summary
A colotomy is a surgical procedure involving the creation of an opening in the colon. This procedure can be used for exploring, obtaining a biopsy, or removing a foreign body.
Purpose
The purpose of a colotomy is to diagnose or treat conditions affecting the colon. It can help in identifying abnormalities through biopsy, removing obstructive or harmful foreign bodies, and exploring unexplained symptoms.
Indications
- Unexplained abdominal pain or symptoms needing exploration
- Presence of a foreign body in the colon
- Suspected colon cancer requiring biopsy
- Blockages or obstructions within the colon
Preparation
- Patients are usually required to fast for several hours before the procedure.
- Bowel preparation may be necessary to clear the colon.
- Medications may need adjustment, particularly blood thinners.
- Pre-procedure assessments might include blood tests and imaging studies like a CT scan.
Procedure Description
- The patient receives anesthesia to ensure they are comfortable and pain-free.
- A surgeon makes an incision in the abdominal wall to access the colon.
- The colon is then incised to provide a view of the internal structures.
- Any foreign body is removed, or a tissue sample is taken for biopsy.
- Once completed, the incision in the colon and the abdominal wall is sutured closed.
Duration
The procedure typically lasts between 1 to 3 hours, depending on the complexity.
Setting
A colotomy is typically performed in a hospital operating room.
Personnel
- Surgeon
- Surgical nurse
- Anesthesiologist
- Operating room staff
Risks and Complications
- Infection at the surgical site
- Bleeding
- Damage to nearby organs or tissues
- Anastomotic leakage (leak where the incision was made)
- Blood clots
- Adverse reactions to anesthesia
Benefits
- Accurate diagnosis through biopsy
- Relief from symptoms caused by a foreign body
- Clearer understanding of unexplained symptoms
- Potential early detection and treatment of colon cancer
Recovery
- Patients may stay in the hospital for a few days post-surgery.
- Pain management with prescribed medications.
- Instructions on diet, wound care, and activity levels.
- Follow-up appointments to monitor healing and address any complications.
Alternatives
- Colonoscopy for less invasive exploration and biopsy.
- Imaging studies like CT colonography.
- Endoscopic foreign body removal.
- These alternatives may have fewer risks but may not be as definitive as a colotomy.
Patient Experience
- During the procedure, patients are under anesthesia and will not feel pain.
- Post-surgery, they may experience discomfort or pain at the incision site, managed with medications.
- Gradual return to normal activities over the course of weeks, guided by healthcare providers.
- Clear instructions and support for recovery and wound care to enhance healing.