CPT® Code 44626

Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure)

The CPT® Code 44626 refers to the surgical procedure involving the closure of an enterostomy in either the large or small intestine, accompanied by resection and colorectal anastomosis. This procedure is particularly relevant in cases where a Hartmann type procedure has been performed, which typically involves the creation of a temporary colostomy. During this operation, the physician meticulously closes the enterostomy, which is an opening created in the abdominal wall for the intestine to exit the body. If there are any additional enterostomies, such as a duodenostomy or jejunostomy, these are also removed during the procedure. The process begins with the physician accessing the abdominal cavity, where they will identify and mobilize the rectal segment, which may be positioned low in the sacrum. The proximal segment of the colon, previously used to create the enterostomy, is then detached from the abdominal wall. Following this, both the proximal and distal segments of the intestine are resected as necessary to ensure healthy tissue is utilized for the anastomosis. The two segments are then sutured together to restore the continuity of the bowel, allowing for normal intestinal function. Additionally, drains may be placed in the abdominal cavity as required to manage any potential fluid accumulation, and the abdominal incision is subsequently closed. This comprehensive approach ensures that the integrity of the gastrointestinal tract is restored while addressing any complications that may arise from the initial procedure.