Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
CPT4 code
Name of the Procedure:
Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
Common Name(s): Partial laparoscopic colectomy with anastomosis and colostomy
Summary
A minimally invasive surgery where a portion of the colon is removed, the remaining part is connected to the rectum (low pelvic anastomosis), and a temporary or permanent colostomy is created for waste elimination.
Purpose
Medical Condition: This procedure primarily addresses colorectal diseases such as colon cancer, diverticulitis, or severe inflammatory bowel disease.
Goals: The primary goal is to remove the diseased section of the colon, restore bowel continuity through anastomosis, and create a stoma for waste diversion, if necessary.
Indications
Symptoms: Chronic abdominal pain, bowel obstruction, rectal bleeding, drastic weight loss, and persistent bowel habit changes.
Criteria: Diagnosis of colorectal cancer, severe diverticulitis, inflammatory bowel disease, or other non-responsive colorectal conditions.
Preparation
Instructions: Patients may be required to fast for at least 12 hours before surgery. Bowel preparation with laxatives or enemas is often necessary.
Assessments: Pre-operative tests include blood work, colonoscopy, CT scans, or MRI, and consultations with a surgical team.
Procedure Description
- Anesthesia: The patient is placed under general anesthesia.
- Incision: Small incisions are made in the abdominal wall.
- Laparoscope Insertion: A laparoscope (camera) is inserted to provide visual guidance.
- Colon Resection: Diseased section of the colon is removed.
- Anastomosis: The remaining colon is connected to the rectum (low pelvic anastomosis).
Colostomy Creation: An opening (stoma) is made in the abdominal wall for waste elimination, if needed.
Tools Used: Laparoscope, surgical instruments for resection and anastomosis, stapling devices.
Duration
Typically, the procedure takes 3 to 4 hours, depending on complexity.
Setting
Performed in a hospital's surgical suite.
Personnel
Healthcare Team: Surgeon, surgical assistants, anesthesiologist, operating room nurses.
Risks and Complications
Common Risks: Infection, bleeding, and reactions to anesthesia.
Rare Complications: Anastomotic leak, injury to nearby organs, hernia formation, and stoma-related issues.
Benefits
Expected Benefits: Relief from symptoms such as pain and bleeding, removal of diseased tissue, and potential cure or management of colorectal disease.
Timing: Benefits may be realized immediately but full recovery and symptom relief can take weeks.
Recovery
Post-procedure Care: Pain management, wound care, diet changes, and colostomy care education.
Recovery Time: Initial hospital stay of 5-7 days, with additional 4-6 weeks for full recovery. Follow-up appointments will be necessary.
Alternatives
Other Options:
- Non-Surgical: Medications, dietary adjustments, less invasive interventions.
Other Surgeries: Full colectomy, alternative anastomosis procedures.
Comparison: Non-surgical options might be less invasive but may not be effective for advanced disease stages. Full colectomy is more extensive with a longer recovery time.
Patient Experience
During Procedure: The patient will be under general anesthesia and will not feel any pain.
After Procedure: Possible discomfort and pain, managed with medications. Patients may experience changes in bowel habits and will receive support for colostomy care.