CPT® Code 44213

Add-On Code

Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)

Laparoscopic mobilization, also referred to as take-down of the splenic flexure, is a surgical procedure that is performed using minimally invasive techniques. This procedure is specifically conducted in conjunction with a partial colectomy, which is a surgical operation that involves the removal of a portion of the colon. The term "take-down" refers to the process of mobilizing the splenic flexure, which is the bend of the colon located near the spleen, to facilitate the resection of the affected segment of the colon. This mobilization is crucial as it allows for the exteriorization of the colon segment that is to be removed and ensures that the remaining segments of the colon can be reconnected without tension, a process known as anastomosis. During the procedure, the inferior mesenteric vein is divided, and the mesentery, which is the tissue that attaches the colon to the abdominal wall, is carefully dissected away from Gerota's fascia, the connective tissue surrounding the kidneys. Additionally, a small opening is created in the mesentery of the transverse colon to enable gas to enter and distend the lesser sac, enhancing visualization of the surgical field. The detachment of the mesentery of the splenic flexure from the pancreas, along with the separation of the colon from the omentum and the left abdominal gutter, completes the mobilization process, setting the stage for the subsequent steps of the partial colectomy.