CPT® Code 45303

A rigid proctosigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the rectum and sigmoid colon using a rigid scope. This procedure is specifically performed with the addition of dilation techniques to address strictures, which are narrowings of the rectal or sigmoid colon lumen. Strictures can arise from various underlying conditions, including complications from previous surgeries, radiation therapy, or inflammatory diseases affecting the intestines. During the procedure, an obturator is first inserted into the scope, which is then introduced into the anus and advanced approximately 5 centimeters into the rectum. After the obturator is removed, the eyepiece is attached to allow for direct visualization. The scope is carefully advanced to the site of the stricture, utilizing air insufflation to separate the mucosal folds for better visibility. A guidewire is then introduced under direct visualization, positioned just proximal to the stricture. Following this, a balloon catheter is passed over the guidewire and placed within the stricture. The balloon is inflated to dilate the narrowed area, held in place for a brief period, and subsequently deflated and removed. Alternatively, a bougie, which is a flexible cylindrical instrument, may be employed to stretch the stricture. After dilation, the area is thoroughly inspected with the scope to confirm the success of the dilation and to check for any potential injuries to the rectum or sigmoid colon that may have occurred during the procedure.