CPT® Code 44186

The procedure described by CPT® Code 44186 refers to a laparoscopic surgical technique for creating a jejunostomy, which is an opening into the jejunum, a part of the small intestine. This procedure is typically performed to facilitate decompression of the bowel or to provide a means for feeding patients who are unable to take food orally. The laparoscopic approach involves making small incisions in the abdominal wall, which minimizes trauma compared to traditional open surgery. The process begins with the establishment of pneumoperitoneum, allowing the surgeon to visualize the abdominal cavity using a laparoscope. Following this, additional incisions are made to insert trocars, which are instruments that allow for the introduction of surgical tools into the abdomen. The surgeon inspects the abdominal cavity for any adhesions, which may need to be lysed or cut away to ensure proper access to the jejunum. Once the jejunum is identified, a small incision is made on the left side of the upper abdominal wall, through which a guidewire is inserted and advanced into the jejunum under laparoscopic guidance. A jejunostomy tube is then placed over this guidewire, allowing for feeding or decompression. The tube is secured in place with internal and external devices to prevent dislodgment. This minimally invasive technique is advantageous as it typically results in reduced recovery time and less postoperative pain compared to open surgical methods.