Revision of ileostomy; simple (release of superficial scar) (separate procedure)
CPT4 code
Name of the Procedure:
Revision of ileostomy; simple (release of superficial scar)
Summary
The revision of an ileostomy involves the surgical release of superficial scar tissue around the ileostomy site. This procedure helps to alleviate any discomfort or complications caused by the scar tissue without making significant changes to the ileostomy itself.
Purpose
This procedure addresses complications due to scar tissue formation at the ileostomy site. The goal is to relieve discomfort, improve the function of the ileostomy, and prevent further complications such as infections or blockages.
Indications
This procedure is typically indicated for patients experiencing:
- Pain or discomfort around the ileostomy site
- Difficulty in maintaining an ileostomy appliance due to scar tissue
- Recurrent infections or skin irritation around the ileostomy site
- Decreased ileostomy function due to scarring
Preparation
Patients may need to:
- Fast for a specified period before the procedure (usually overnight)
- Adjust medications as directed by their healthcare provider
- Undergo pre-procedure assessments such as blood tests or imaging studies
Procedure Description
- The patient is positioned comfortably, and the ileostomy site is cleaned and sterilized.
- Local or general anesthesia is administered, depending on the patient’s needs and the physician’s recommendation.
- The surgeon makes a small incision at the site of the scar tissue.
- Scar tissue around the ileostomy is carefully released and removed as necessary.
The site is then cleaned, and the incision is closed with sutures or steri-strips.
Tools used may include scalpel, scissors, forceps, and suturing materials.
Duration
The procedure typically takes about 30 minutes to 1 hour.
Setting
The procedure is usually performed in an outpatient clinic or a surgical center.
Personnel
- Surgeon
- Surgical nurse
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
Common risks include:
- Pain or discomfort at the incision site
- Infection
- Bleeding
Rare complications may include:
- Adverse reaction to anesthesia
- Damage to surrounding tissues
Most complications can be managed with prompt medical attention.
Benefits
The primary benefit is the alleviation of pain and discomfort caused by scar tissue. Improved ileostomy function and easier maintenance of the appliance can also be expected, with benefits typically realized soon after recovery.
Recovery
Post-procedure care includes:
- Keeping the incision site clean and dry
- Following any specific instructions regarding medication or dressing changes
- Avoiding strenuous activities for a few days Recovery time is generally short, with most patients resuming normal activities within a week. Follow-up appointments will be scheduled to monitor healing.
Alternatives
Alternative treatments may include:
- Non-surgical methods like physical therapy or topical treatments for minor scar tissue
- More extensive surgical revisions if superficial release is insufficient
Each option has its own set of risks and benefits, which should be discussed with the healthcare provider.
Patient Experience
During the procedure, patients will be under local or general anesthesia, ensuring minimal discomfort. Post-procedure, there might be some pain or tenderness at the incision site, which can be managed with pain medications. Most patients experience significant relief from symptoms shortly after recovery.