CPT® Code 44615

Intestinal stricturoplasty, as defined by CPT® Code 44615, is a surgical procedure aimed at alleviating intestinal obstruction caused by strictures, particularly in patients suffering from long-standing Crohn's disease. This procedure is specifically indicated for short strictures, typically measuring less than 10 cm, where the narrowed segment of the small intestine is surgically treated to restore normal function. The process begins with an incision in the abdomen to access the affected area of the small bowel. During the procedure, a longitudinal incision, known as an enterotomy, is made along the anti-mesenteric border of the narrowed segment. This incision is extended into the adjacent normal diameter intestine to ensure adequate access for repair. The intestinal mucosa is meticulously examined throughout the length of the stricture to rule out any signs of malignancy or other pathological conditions, with biopsies taken as necessary for further evaluation. Following the examination, the enterotomy is closed using sutures or staples in a transverse manner, which effectively increases the diameter of the strictured segment, thereby relieving the obstruction. In cases where the stricture measures between 10 to 20 cm, a different technique known as Finney stricturoplasty is employed, which involves folding the strictured segment into a U-shape and securing it with seromuscular sutures. This method also includes a longitudinal incision around the suture line for inspection and potential biopsy, followed by careful closure of the intestinal wall to restore its integrity. Overall, stricturoplasty is a critical intervention for managing intestinal strictures, aimed at preserving bowel function and preventing further complications associated with Crohn's disease.