CPT® Code 44211

Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when performed

The procedure described by CPT® Code 44211 involves a laparoscopic surgical technique for performing a total abdominal colectomy, which is the complete removal of the colon. This procedure is accompanied by a proctectomy, which entails the surgical removal of the rectum. A key component of this operation is the creation of an ileoanal anastomosis, where the ileum, the last part of the small intestine, is surgically connected to the anus. Additionally, an ileal reservoir, which can be shaped like an S or a J, is formed to serve as a storage pouch for stool, compensating for the absence of the large intestine. The procedure also includes the option of a loop ileostomy, where a loop of the ileum is brought out through the abdominal wall to create a temporary artificial opening for stool passage. This allows for the ileum to empty while the newly formed anal connection heals. The operation may also involve rectal mucosectomy, which is the removal of the mucosal lining of the rectum, if deemed necessary. The use of carbon dioxide gas for insufflation is a standard practice in laparoscopic surgeries, allowing for better visualization and access to the abdominal cavity through small incisions made in the abdomen. Overall, this complex surgical procedure is designed to restore bowel function and manage conditions affecting the colon and rectum.