45402 Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection

Name of the Procedure:

Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection

Summary

A laparoscopy for proctopexy with sigmoid resection is a minimally invasive surgical procedure aimed at correcting rectal prolapse. It involves fixing the rectum to its proper position and removing part of the sigmoid colon using small incisions and specialized instruments.

Purpose

This procedure addresses rectal prolapse, a condition where the rectum slips out of its normal position. The goal is to alleviate symptoms such as pain, discomfort, and incontinence, and to restore normal bowel function.

Indications

• Persistent rectal prolapse
• Rectal discomfort or pain
• Fecal incontinence or difficulty with bowel movements
• Failure of conservative treatments
• Patients in good health suitable for surgery

Preparation

• Fasting for at least 8 hours prior to surgery
• Adjustments or discontinuation of certain medications, as advised by the doctor
• Pre-operative diagnostic tests, including colonoscopy, blood tests, and imaging studies

Procedure Description

1. The patient is placed under general anesthesia.
2. Small incisions are made in the abdomen.
3. A laparoscope (a thin tube with a camera) and other surgical instruments are inserted.
4. The rectum is lifted and fixed into its correct position (proctopexy).
5. A portion of the sigmoid colon is removed (sigmoid resection) to prevent recurrence.
6. The incisions are closed with sutures or staples.
7. The patient is moved to a recovery area for observation.

Duration

The procedure typically takes 2 to 4 hours.

Setting

Performed in a hospital or surgical center with facilities for laparoscopy.

Personnel

• General surgeon or colorectal surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision sites
• Bleeding
• Damage to surrounding organs
• Anesthetic complications
• Recurrence of rectal prolapse
• Postoperative pain or adhesions

Benefits

• Relief from symptoms of rectal prolapse
• Improved bowel function
• Minimally invasive, which usually means less postoperative pain and quicker recovery

Recovery

• Hospital stay of 1 to 3 days
• Pain medication as needed
• Dietary restrictions and gradual return to normal diet
• Avoid heavy lifting and strenuous activities for several weeks
• Follow-up appointments to monitor healing

Alternatives

• Conservative treatments such as pelvic floor exercises or fiber supplements
• Open surgical repair
• Perineal rectosigmoidectomy Each alternative varies in its invasiveness, recovery time, and potential effectiveness.

Patient Experience

During the procedure, the patient is under general anesthesia and feels no pain. Post-procedure, the patient may experience discomfort at the incision sites, which is managed with prescribed pain relief. Full recovery often involves a period of restricted physical activity and close monitoring to ensure proper healing.