44227 Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis

Name of the Procedure:

Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis

Summary

A laparoscopy is a minimally invasive procedure that uses small incisions and specialized instruments to perform surgery. This specific procedure involves closing an enterostomy (an opening created in the intestine) and may include removing a portion of the intestine (resection) and reconnecting the remaining sections (anastomosis).

Purpose

This procedure addresses complications from enterostomies, including infection, blockage, or digestive issues. The goal is to restore the normal function of the intestine and improve the patient's quality of life.

Indications

• Persistent infection or leakage at the enterostomy site
• Intestinal blockage
• Poor wound healing or irritation
• Functional issues such as difficulties in nutrient absorption
• Candidates typically have a previously created enterostomy that now needs closure.

Preparation

• Patients are usually instructed to fast for 8-12 hours before the procedure.
• Medication adjustments, particularly blood thinners, as directed by the physician.
• Pre-procedure diagnostic tests may include blood work, imaging studies like CT scans, and a thorough medical history review.

Procedure Description

1. The patient is placed under general anesthesia.
2. Several small incisions are made in the abdominal area.
3. A laparoscope (a thin tube with a camera) is inserted to provide visual guidance.
4. Specialized surgical instruments are used to close the enterostomy site.
5. If necessary, a portion of the intestine is removed (resection).
6. The two ends of the intestine are reconnected (anastomosis).
7. The incisions are closed with sutures or staples.

Tools used include a laparoscope, surgical staplers, and other minimally invasive instruments.

Duration

The procedure typically lasts 2-4 hours.

Setting

Performed in a hospital or specialized surgical center.

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding organs
• Leakage at the anastomosis site
• Potential need for a temporary or permanent stoma
• Blood clots

Benefits

• Restoration of normal intestinal function
• Reduced risk of infection
• Improved nutrient absorption and digestion
• Typically quicker recovery and less pain compared to open surgery

Recovery

• Post-procedure hospital stay of 3-7 days
• Gradual return to normal diet
• Instructions for wound care and activity restrictions
• Follow-up appointments to monitor healing and function

Alternatives

• Open surgery for enterostomy closure, which involves a larger incision and longer recovery.
• Non-surgical management if the enterostomy-related complications are manageable without resection.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-surgery, patients might experience discomfort or pain at the incision sites, managed with medication. Recovery involves gradual dietary changes and limited physical activity to ensure proper healing.