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Dilation of rectal stricture (separate procedure) under anesthesia other than local

CPT4 code

Name of the Procedure:

Dilation of Rectal Stricture (Separate Procedure) under Anesthesia other than Local

Summary

This procedure involves the widening of a narrowed section of the rectum (stricture) to allow for easier passage of stool. It is performed under anesthesia to ensure patient comfort.

Purpose

The procedure addresses rectal strictures, which can cause pain and difficulty during bowel movements. The goal is to widen the narrowed area, relieve symptoms, and improve bowel function.

Indications

  • Chronic constipation with inability to pass stool
  • Painful bowel movements
  • Incomplete evacuation of stool
  • Diagnosed rectal stricture through diagnostic imaging or colonoscopy

Preparation

  • Fasting for several hours before the procedure
  • Adjustments in medication as advised by the healthcare provider
  • Pre-procedure diagnostic tests like colonoscopy or imaging studies to confirm the stricture

Procedure Description

  1. Patient is placed under general or regional anesthesia.
  2. A lubricated instrument called a dilator is gently inserted into the rectum.
  3. The dilator is gradually expanded to stretch the narrowed area.
  4. The process may be repeated several times with increasingly larger dilators.
  5. The procedure concludes once adequate dilation is achieved.

Tools: Graduated rectal dilators

Anesthesia: General or regional anesthesia

Duration

Typically, the procedure takes 15-30 minutes.

Setting

Hospital or surgical center

Personnel

  • Surgeon (usually a colorectal specialist)
  • Anesthesiologist
  • Surgical nurses

Risks and Complications

  • Bleeding
  • Infection
  • Perforation of the rectum
  • Temporary pain or discomfort post-procedure
  • Risk of re-narrowing (recurrence) of the stricture

Benefits

  • Relief from symptoms associated with rectal stricture
  • Improved bowel movements and quality of life
  • Immediate symptom relief in most cases

Recovery

  • Observation for a few hours post-procedure to monitor for complications
  • Instructions on diet and activity levels
  • Pain management typically with mild analgesics
  • Follow-up appointments to assess healing and prevent recurrence

Alternatives

  • Conservative management with stool softeners and dietary changes
  • Endoscopic balloon dilation
  • Surgical resection of the stricture in severe cases
  • Comparison: Alternatives might be less invasive but could offer varying degrees of symptom relief and might not be as effective in severe cases.

Patient Experience

During the procedure: No pain due to anesthesia. After the procedure: Mild discomfort or bloating might be experienced. Pain management will be provided to ensure comfort.

Patients will have follow-up care to ensure proper healing and monitor for potential complications.

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