CPT® Code 45108

Anorectal myomectomy, as defined by CPT® Code 45108, is a surgical procedure aimed at excising a segment of the muscular layer of the rectum and a portion of the internal anal sphincter. This intervention is primarily indicated for the treatment of Hirschsprung's disease, a congenital condition characterized by the absence of ganglion cells in the distal colon, leading to severe functional bowel obstruction. The absence of these nerve cells disrupts normal bowel motility, resulting in significant challenges for affected individuals. During the procedure, the anus is carefully dilated using specialized narrow retractors to facilitate access. A transverse incision is then made in the posterior wall of the anal mucosa, positioned just above the mucocutaneous junction. This incision allows for the elevation of the mucosa, enabling the surgeon to excise a strip of the muscularis measuring between 6 to 10 centimeters, along with a portion of the internal sphincter. Following the excision, the overlying mucosa is meticulously closed, often over a small drain to manage any potential fluid accumulation. This procedure is critical in alleviating the symptoms associated with Hirschsprung's disease and restoring normal bowel function.