Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis
CPT4 code
Name of the Procedure:
Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis.
Summary
In this procedure, a surgeon uses small incisions and a camera (laparoscope) to remove a segment of the small intestine that may be diseased or damaged. The remaining ends of the small intestine are then reconnected, allowing for normal digestion and nutrient absorption.
Purpose
This procedure is typically performed to treat conditions such as Crohn's disease, tumors, intestinal blockages, and severe gastrointestinal bleeding. The main goal is to remove the problematic section of the small intestine and restore normal bowel function.
Indications
- Persistent or severe abdominal pain.
- Obstruction of the small intestine.
- Diagnosis of Crohn's disease.
- Tumors or polyps in the small intestine.
- Severe gastrointestinal bleeding.
Patients typically considered for this procedure are those who have not responded to conservative treatments like medication or diet changes.
Preparation
Patients are generally instructed to fast for about 8-12 hours before the procedure. They may also need to stop certain medications, especially blood thinners, as advised by their healthcare provider. Pre-procedure tests often include blood work, imaging studies (such as a CT scan), and sometimes a colonoscopy.
Procedure Description
- The patient is placed under general anesthesia.
- Small incisions are made in the abdominal wall.
- A laparoscope (camera) and surgical instruments are inserted through these incisions.
- The surgeon locates the diseased or damaged section of the small intestine.
- This section is carefully removed, and the two healthy ends are stitched or stapled together (anastomosis).
- The instruments are removed, and the incisions are closed with sutures or surgical glue.
Duration
The procedure typically takes about 2 to 4 hours, depending on the complexity of the case.
Setting
This surgery is performed in a hospital operating room.
Personnel
- Surgeon
- Surgical assistants
- Anesthesiologist
- Operating room nurses
Risks and Complications
Common risks include infection, bleeding, and reactions to anesthesia. More rare complications might involve injury to surrounding organs, leakage from the site of anastomosis, or bowel obstruction due to scar tissue. These complications are managed through careful surgical technique and postoperative monitoring.
Benefits
Removal of the diseased or damaged portion of the small intestine often results in significant symptom relief and improved quality of life. Benefits can often be seen within a few weeks of recovery.
Recovery
Patients are usually required to stay in the hospital for a few days after the procedure. Post-operative care involves pain management, a gradual reintroduction of fluids and food, and monitoring for any signs of complications. Full recovery typically takes 4-6 weeks, during which strenuous activities should be avoided, and follow-up appointments are necessary.
Alternatives
Alternative treatments might include medication management, dietary changes, or minimally invasive procedures like endoscopic dilation. The choice of treatment depends on the severity and specifics of the patient's condition, and these alternatives might be less invasive but also less definitive in resolving the issue.
Patient Experience
During the procedure, patients are under general anesthesia and will not feel anything. Post-operatively, they might experience some pain at the incision sites and abdominal discomfort, which can be managed with pain medication. There may be some dietary restrictions initially, but normal diet can usually be resumed progressively under the guidance of healthcare providers.