CPT® Code 44146

The CPT® Code 44146 refers to a surgical procedure known as a partial colectomy with coloproctostomy, which includes the creation of a colostomy. This procedure involves the surgical removal of a portion of the colon, followed by the construction of an anastomosis, which is the connection of the remaining segments of the colon. The term 'coloproctostomy' indicates that the anastomosis is made between the colon and the rectum, specifically in the low pelvic region. The procedure is typically performed through a midline incision in the abdomen, allowing the surgeon to access the abdominal cavity for inspection and intervention. During the operation, the superior rectal vessels are identified, dissected, ligated, and divided to facilitate the mobilization of the rectum and the affected segment of the colon. The diseased portion of the colon is then removed, and the remaining segments are sutured together to restore continuity of the gastrointestinal tract. Additionally, a diverting colostomy is created, which involves making an incision in the lower abdomen, usually on the right side, to bring a portion of the colon through the abdominal wall, forming a stoma. This stoma is then secured to the skin, and a colostomy appliance is applied to manage waste. The procedure is comprehensive, requiring careful attention to detail to ensure proper healing and function post-surgery.