Forum - Questions & Answers
Sleeve resection of prolasped colotomy
Not sure where to go with this one.
Pt had a prolaspse of colostomy with intussusception with necrosis of prolapsed segment.
Patient underwent a sleeve resection of prolasped segment of colostomy, external
approach.
Any ideas?
Re: Sleeve resection of prolapsed colostomy
not sure without an op, but consider 44340, 44345, or 44346 for "revision of a colostomy". Did he take down the colostomy, excise the necrotic part and put it back together? If so, at the same site, or a new colostomy site? If those codes dont seem right, give a little more info, I'd be happy to look at it again.
Re: Prolasped of colostomy
Here is part of the note
"The prolasped segment of colon wa addressed with a GIA staple load. The staple load ws placed down the lumen of the prolapsed segment with one half of the stapler in the lumen and the other half of the stapler outside the lumen such that the sleeve of prolapsed colon was divided longitudinally down the barrel. The opposite limb of colon was kept safe and univolved. The opposite limb of colon was palpated and noted to be well clear and uninvolved with the operative area. Nonetheless, the longitudinal stapling contined throught three load of the GIA blue staple load until such time as the portio of colon divided showed no necrosis and normal capillarly oozing of blood. The same blue GIA stapler load was then used in a circumferential fashion to proceed around the sleeve of the prolapsted colon.
This was accomplished in multiple firings of the blue staple load with ultimately a sleeve resection, which had been divided longitudinally. The specimen was passed off the field for perm pathology labeled prolapsed colon. The remaining staple line was inspected and nicely viable. The colon easily reduced. The ostomy was then observed with no signs of any concerning bleeding. The ostomy appliance was then replaced.
Thanks for your help
sleeve resection prolasped colon
An takers on this one?
Thanks
resection
Sleeve resection via Laparoscope? Gastric Sleeve Resection (Vertical Sleeve Gastrectomy - VSG). This is difficult without more information.
sleeve resection for prolaspe of colostomy
No scope was used. This was an external sleeve resection.