Ileostomy or jejunostomy, non-tube
CPT4 code
Name of the Procedure:
Ileostomy or Jejunostomy (non-tube)
Summary
An ileostomy or jejunostomy is a surgical procedure in which a hole, called a stoma, is created in the abdomen to allow waste to pass out of the body bypassing the lower gastrointestinal tract. The stoma is connected to the ileum or jejunum, parts of the small intestine.
Purpose
The procedure is designed to divert bowel contents away from diseased, damaged, or missing sections of the digestive system. This helps manage conditions like inflammatory bowel disease, bowel obstruction, or colorectal cancer. The goal is to improve quality of life and manage symptoms effectively.
Indications
- Inflammatory Bowel Disease (e.g., Crohn's Disease, Ulcerative Colitis)
- Colorectal cancer
- Fecal incontinence
- Bowel obstruction
- Birth defects involving the gastrointestinal tract
- Trauma to the intestines
Preparation
- Inform the patient of the need for fasting, usually starting the night before.
- Adjust or stop certain medications as advised by the physician.
- Conduct preoperative assessments including blood tests, imaging studies, and a thorough medical history.
- Bowel preparation may be required, involving the use of laxatives or enemas to clear the intestines.
Procedure Description
- Administer anesthesia to ensure the patient is asleep and pain-free.
- Make an incision in the abdomen to access the intestines.
- Select a suitable portion of the ileum or jejunum and bring it through an opening in the abdominal wall to create the stoma.
- Secure the intestine to the abdominal wall and close the surrounding skin.
- Attach an ostomy bag over the stoma to collect waste products.
Duration
The surgery typically takes around 2 to 3 hours.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Surgeon
- Anesthesiologist
- Operating room nurses
- Surgical technician
Risks and Complications
- Infection at the surgical site
- Bleeding
- Stoma blockage or retraction
- Skin irritation around the stoma
- Nutritional deficiencies
- Long-term changes in bowel habits
Benefits
- Improved management of underlying gastrointestinal conditions
- Relief from symptoms like pain, obstruction, or severe diarrhea
- Enhanced quality of life
Recovery
- Hospital stay for 3 to 7 days post-surgery
- Instructions for stoma care, including cleaning and changing the ostomy bag
- Dietary adjustments might be necessary
- Follow-up appointments for monitoring and managing any potential complications
- Patients can usually return to normal activities within 6 to 8 weeks
Alternatives
- Medical management (e.g., medications)
- Less invasive surgical methods, if applicable
- Endoscopic procedures for specific conditions
- Each alternative has its own risks and benefits and should be discussed with the healthcare provider
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel anything. Post-surgery, they may experience discomfort or pain, which will be managed with pain relief medications. There will be adjustments to living with a stoma, and patients will receive education and support to help them adapt comfortably.