CPT® Code 44156

The CPT® Code 44156 refers to a total colectomy performed through an abdominal approach, which includes the removal of the entire colon along with a proctectomy, and the creation of a continent ileostomy. This surgical procedure is indicated for patients with various conditions affecting the colon and rectum, necessitating the complete removal of these structures. The term 'continent ileostomy' signifies that a surgically constructed internal pouch is created to collect stool, allowing for controlled evacuation by the patient. The procedure begins with a midline abdominal incision, through which the abdominal cavity is accessed and inspected. The entire colon is mobilized by carefully dividing its attachments and separating it from surrounding structures. The mesentery, which is the tissue that supports the colon, is also divided to facilitate the removal of the colon. Following the mobilization, the rectum is addressed, involving the identification and dissection of the superior rectal vessels, which are then ligated and divided. The procedure culminates in the creation of a reservoir from a segment of the ileum, which is designed to function as a storage pouch for fecal matter, allowing the patient to manage bowel movements more effectively. This complex surgical intervention requires meticulous technique and careful postoperative management to ensure optimal recovery and function of the newly created ileostomy.