CPT® Code 44144

The procedure described by CPT® Code 44144 involves a partial colectomy, which is the surgical removal of a segment of the colon, also known as the large intestine. This operation is performed to address various conditions affecting the colon, such as tumors, inflammatory bowel disease, or other significant pathologies. During this procedure, two distinct openings, referred to as stomas, are created. The first stoma is either a colostomy or an ileostomy, which serves as an outlet for stool to exit the body, bypassing the affected portion of the colon. The second stoma is a mucofistula, which is designed to drain mucus from the rectum. This type of procedure is often referred to as a double-barrel colostomy due to the presence of two separate stomas. The surgical technique involves mobilizing the segment of colon that is to be removed by carefully dividing the embryonic fusion planes and the peritoneum, ensuring that the blood supply to the remaining bowel is preserved. The mesentery, which is the tissue that attaches the intestines to the abdominal wall, is also divided. After the diseased or damaged segment of the colon is excised, the colostomy or ileostomy is created through a small incision in the skin at the designated site. This incision is extended through the subcutaneous tissue until the anterior rectus fascia is reached, which is then opened with care to protect the underlying muscle and its blood supply. The rectus fibers are separated using blunt dissection, allowing access to the peritoneal cavity. An opening of adequate size is made for the stoma, and the proximal segment of the colon or ileum is brought through this opening, ideally via a peritoneal tunnel to minimize the risk of postoperative complications such as stoma obstruction. The colon or cecum is then everted and sutured to the skin to secure the stoma in place. The second stoma for the mucofistula is created in a similar manner, utilizing the distal segment of the colon that remains attached to the rectum to facilitate mucus drainage.