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Laparoscopy, surgical; colectomy, partial, with anastomosis

CPT4 code

Name of the Procedure:

Laparoscopy, Surgical; Colectomy, Partial, with Anastomosis

  • Common Name(s): Laparoscopic Partial Colectomy
  • Technical Terms: Minimally Invasive Colectomy, Laparoscopic Colon Resection

Summary

A laparoscopic partial colectomy is a minimally invasive surgery to remove part of the colon. Surgeons use small incisions and a camera to guide them, leading to a faster recovery and less pain compared to traditional open surgery. The procedure often includes an anastomosis, where the remaining sections of the colon are reconnected.

Purpose

This procedure addresses various conditions affecting the colon, such as cancer, diverticulitis, and inflammatory bowel diseases. The goal is to remove diseased or damaged sections of the colon and restore normal function with minimal impact on surrounding tissues.

Indications

  • Colon cancer
  • Diverticulitis
  • Crohn’s disease
  • Ulcerative colitis
  • Colon polyps that are too large to remove endoscopically
  • Severe gastrointestinal bleeding

Preparation

  • Fasting for a specified period before surgery.
  • Bowel cleansing regimen as instructed by the healthcare provider.
  • Adjustments to medications, particularly blood thinners.
  • Preoperative tests such as blood work, imaging studies, and possibly a colonoscopy.

Procedure Description

  1. Anesthesia: General anesthesia is administered.
  2. Incisions: Several small incisions are made in the abdomen.
  3. Insertion of Tools: A camera (laparoscope) and surgical instruments are inserted through these incisions.
  4. Resection: The surgeon identifies the diseased section of the colon and carefully removes it.
  5. Anastomosis: The healthy sections of the colon are reconnected.
  6. Closure: The incisions are closed with sutures or staples.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

The surgery is performed in a hospital, often in a specialized surgical suite equipped for laparoscopic procedures.

Personnel

  • Surgeon: Performs the operation.
  • Surgical Assistants: Assist the surgeon during the procedure.
  • Anesthesiologist: Manages anesthesia and monitors the patient’s vitals.
  • Nursing Staff: Provides support and care before, during, and after the procedure.

Risks and Complications

  • Common Risks: Infection, bleeding, and reactions to anesthesia.
  • Rare Complications: Injury to nearby organs, anastomotic leak, and prolonged ileus (temporary paralysis of the bowel).

Benefits

  • Expected Benefits: Removal of diseased tissue, relief of symptoms, and prevention of further complications.
  • Realization of Benefits: Improved quality of life and resolution of underlying conditions within weeks.

Recovery

  • Post-Procedure Care: Pain management, gradual reintroduction of diet, and early mobilization.
  • Expected Recovery Time: 4 to 6 weeks for full recovery.
  • Restrictions: Limited heavy lifting and strenuous activity. Follow-up appointments are necessary to monitor healing.

Alternatives

  • Other Options: Open colectomy, medical management, and, in some cases, less invasive endoscopic procedures.
  • Comparison: Laparoscopic surgery typically offers faster recovery and less post-operative pain compared to open surgery but may not be suitable for all patients.

Patient Experience

Patients might experience some pain and discomfort, which can be managed with medication. There is typically less post-operative pain and scarring due to the minimally invasive nature of the surgery. Most patients can expect to return to their normal activities within a few weeks.

Pain management and comfort measures, such as the use of pain relievers and support from nursing staff, are integral to the recovery process.

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