CPT® Code 45116

The CPT® Code 45116 refers to a surgical procedure known as a partial proctectomy with anastomosis performed exclusively through a transsacral approach, specifically the Kraske type. This technique is characterized by the patient being positioned prone in a jack-knife position, which facilitates access to the rectum through the lower back. The procedure begins with an incision made at the midline of the back, starting approximately 2 cm above the anal verge and extending upwards for about 8-10 cm. This incision allows for the excision of the coccyx and resection of the two lower sacral segments, providing the necessary exposure to the distal segment of the rectum. Once the rectum is adequately mobilized, it is divided both above and below the diseased or injured segment, which is then removed. The remaining proximal and distal segments of the rectum are subsequently anastomosed in an end-to-end fashion, ensuring continuity of the bowel. After the anastomosis is completed, drains are placed to manage any potential fluid accumulation, and the transsacral incision is closed. This procedure is rarely performed due to its complexity and the specific indications that necessitate its use, making it a specialized surgical intervention within the field of colorectal surgery.