Laparoscopy, surgical; ileostomy or jejunostomy, non-tube
CPT4 code
Name of the Procedure:
Laparoscopy, surgical; ileostomy or jejunostomy, non-tube
Common name(s): Laparoscopic ileostomy, Laparoscopic jejunostomy
Summary
A minimally invasive surgical procedure to create an opening (stoma) in the abdominal wall to divert the small intestine (either ileum or jejunum) to an external collection bag.
Purpose
The medical condition or problem it addresses: Used to bypass diseased or damaged parts of the small intestine.
The goals or expected outcomes of the procedure: To provide a new path for waste to leave the body when the intestine cannot be used normally due to diseases like Crohn's disease, cancer, or blockages.
Indications
Specific symptoms or conditions that warrant the procedure: Severe gastrointestinal diseases, injuries, blockages, inflammation, or infections that prevent normal bowel function.
Patient criteria or factors that make the procedure appropriate: Patients with confirmed small intestine issues unresponsive to other treatments, requiring long-term bowel rest or diversion.
Preparation
Pre-procedure instructions for the patient: Fasting for 12 hours before surgery, stopping certain medications as instructed.
Any diagnostic tests or assessments required beforehand: Blood tests, imaging studies such as an abdominal CT scan or MRI, and a pre-operative assessment by the surgical team.
Procedure Description
Detailed step-by-step explanation:
- Anesthesia is administered.
- Small incisions are made in the abdomen.
- A laparoscope and surgical tools are inserted through these incisions.
- The surgeon locates the ileum or jejunum.
- An opening (stoma) is created in the abdominal wall.
- The end of the small intestine is pulled through the opening and secured.
- The external part is attached to a collection bag.
- The incisions are closed.
Tools, equipment, or technology used: Laparoscope, surgical instruments, sutures, stoma bag.
Anesthesia or sedation details: General anesthesia is used, rendering the patient unconscious and pain-free.
Duration
How long the procedure typically takes: Approximately 2-3 hours.
Setting
Where the procedure is performed: Hospital operating room.
Personnel
Healthcare professionals involved: Surgeons, nurses, anesthesiologists, and surgical technicians.
Risks and Complications
Common and rare risks associated with the procedure: Infection, bleeding, bowel obstruction, stoma complications, injury to nearby organs.
Possible complications and their management: Infection managed with antibiotics; bleeding controlled during surgery; stoma complications may require additional corrective procedures.
Benefits
Expected benefits and how soon they might be realized: Relief from symptoms caused by gastrointestinal diseases; improved quality of life. Benefits can be realized immediately after recovery from the surgery.
Recovery
Post-procedure care and instructions: Hospital stay for a few days, regular stoma care, pain management with prescribed medications.
Expected recovery time and any restrictions or follow-up appointments: Recovery may take a few weeks, with gradual return to normal activities; follow-up appointments for stoma care and monitoring.
Alternatives
Other treatment options available: Medication management, endoscopic procedures, dietary changes.
Pros and cons of alternatives compared to the described procedure: Less invasive but may not be as effective in severe cases; surgery provides a definitive solution but carries risks.
Patient Experience
What the patient might feel or experience during and after the procedure: Discomfort or pain managed with medication; gradual adjustment to living with a stoma and using a collection bag. Pain management and comfort measures include prescribed analgesics and support from a stoma care nurse.