Revision of colostomy; simple (release of superficial scar) (separate procedure)
CPT4 code
Name of the Procedure:
Revision of colostomy; simple (release of superficial scar)
Common name(s): Simple Colostomy Revision
Summary
A simple colostomy revision is a surgical procedure performed to release superficial scars that are causing complications or discomfort around a colostomy site. It's a relatively minor procedure aimed at improving the function and comfort of the stoma.
Purpose
This procedure addresses issues related to superficial scar tissue formation around a colostomy. The expected outcome is the relief of discomfort, improved stoma function, and prevention of further complications such as blockage or irritation.
Indications
- Discomfort or pain around the colostomy site
- Difficulty in colostomy appliance fitting
- Partial blockage or constriction of the stoma
- Visible scar tissue causing irritation or infections
Preparation
- Fasting for a certain number of hours as advised by the healthcare provider
- Possible adjustments or temporary discontinuation of certain medications
- Completion of pre-surgical assessments such as blood tests or imaging studies
Procedure Description
- The patient is given local anesthesia to numb the area around the colostomy.
- The surgeon makes a small incision around the stoma to access the scar tissue.
- Superficial scar tissue is carefully released or removed to alleviate any constriction or discomfort.
- The area is then closed with sutures, and a dressing is applied.
- The fitting of the colostomy appliance is checked to ensure proper alignment and comfort.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
This procedure is usually performed in an outpatient surgical center or hospital.
Personnel
- Surgeon
- Surgical nurse
- Anesthesiologist (if necessary, although typically local anesthesia suffices)
Risks and Complications
- Infection
- Bleeding
- Pain at the incision site
- Recurrence of scar tissue
- Allergic reaction to local anesthesia
- Reduced stoma function or new blockages (rare)
Benefits
- Relief from discomfort and pain
- Improved stoma function and appliance fit
- Prevention of further complications
- Immediate improvement in most cases
Recovery
- Patients can usually go home the same day.
- Follow instructions regarding stoma care and dressing changes.
- Avoid heavy lifting or strenuous activities for a few weeks.
- Follow-up appointments to monitor healing and stoma function.
- Pain management with prescribed medications.
Alternatives
- Non-surgical methods like stoma dilation or adjustment of colostomy appliances.
- More extensive surgical revision if simple release is insufficient.
- Conservative management with dietary adjustments and careful monitoring.
Patient Experience
Patients might feel some discomfort or minor pain during and after the procedure, which can be managed with local anesthesia and pain medications. The area may be swollen or sore for a few days, but normal activities can generally be resumed within a week, with specific restrictions as advised by the healthcare provider.