Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)
CPT4 code
Name of the Procedure:
Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy
Summary
Laparoscopy for mobilization of the splenic flexure is a minimally invasive surgical technique performed in conjunction with a partial colectomy. The procedure involves freeing and repositioning the splenic flexure of the colon to facilitate the removal of a diseased section of the colon.
Purpose
The procedure is done to address conditions such as colon cancer, diverticulitis, or other diseases affecting the colon that require partial colectomy. The goal is to safely and effectively resect the diseased portion of the colon while minimizing complications and preserving overall bowel function.
Indications
- Colorectal cancer at or near the splenic flexure
- Diverticulitis or diverticular disease
- Inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis)
- Large polyps not amenable to endoscopic removal
- Bowel obstructions
Preparation
- Patients are typically required to fast for 8-12 hours before the procedure.
- Bowel preparation, such as laxatives or enemas, might be necessary to clear the intestines.
- Patients should inform their healthcare provider about any medications they are taking, some of which might need to be adjusted.
- Preoperative diagnostic tests may include blood work, imaging studies like CT scans, and colonoscopy.
Procedure Description
- The patient is placed under general anesthesia.
- Small incisions are made in the abdominal wall.
- A laparoscope (a thin, flexible tube with a camera) and specialized surgical instruments are inserted through the incisions.
- The surgeon carefully mobilizes the splenic flexure by freeing it from surrounding tissues.
- The diseased section of the colon is identified and resected.
- The remaining sections of the colon are reconnected (anastomosis).
- Incisions are closed, and the laparoscope and instruments are removed.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity and any complications that may arise.
Setting
This procedure is generally performed in a hospital operating room due to the need for general anesthesia and specialized surgical equipment.
Personnel
- Surgeons specializing in colorectal surgery
- Anesthesiologists
- Surgical nurses
- Operating room technicians
Risks and Complications
- Common risks include infection, bleeding, and reactions to anesthesia.
- Rare complications may involve injury to surrounding organs, blood clots, or leaks at the anastomosis site.
- Management of complications may require further treatment or additional surgeries.
Benefits
- Minimally invasive approach reduces recovery time and postoperative pain.
- Effective treatment of underlying conditions like cancer or diverticulitis.
- Improved overall bowel function following removal of diseased tissue.
- Many patients can resume normal activities within a few weeks.
Recovery
- Patients may stay in the hospital for a few days post-surgery.
- Pain management typically includes analgesics and anti-inflammatory medications.
- Gradual return to normal diet as tolerated.
- Avoid heavy lifting and strenuous activities for several weeks.
- Follow-up appointments to monitor healing and check for any complications.
Alternatives
- Open colectomy, which is more invasive and requires a larger incision.
- Endoscopic removal for smaller polyps or lesions.
- Conservative management, including medications or non-surgical therapies, although these may be less effective for severe conditions.
Patient Experience
Patients might experience some pain and discomfort, but this is generally well-managed with medication. There will be small scars from the incisions, and initial post-op dietary restrictions are often necessary. Close monitoring and follow-up ensure any issues are promptly addressed, offering a smoother recovery experience.