CPT® Code 44139

Add-On Code

Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)

A mobilization (take-down) of the splenic flexure is a surgical procedure that is performed in conjunction with a partial colectomy, which is a surgical resection of a portion of the colon. The splenic flexure, also known as the left colic flexure, is the anatomical bend in the large intestine located at the junction where the transverse colon transitions into the descending colon. This area is significant due to its multiple attachments to surrounding structures, including the splenocolic ligament, which connects the spleen to the colon, and the renocolic ligament, which is a fusion area between the retroperitoneal fascia and the mesentery of the left colon. The purpose of the take-down procedure is to mobilize the splenic flexure, allowing for a tension-free anastomosis, which is the surgical connection between two segments of the intestine, or to facilitate the externalization of the remaining intestine. The approach to the splenic flexure is typically inferior, requiring the retraction of the sigmoid colon to gain access. The procedure involves careful dissection of the retroperitoneal fascia and division of the splenocolic ligament using electrocautery, followed by the dissection of the omentum from the splenic flexure. This meticulous mobilization is crucial for ensuring that the subsequent partial colectomy can be performed effectively, allowing for optimal healing and function of the gastrointestinal tract.