CPT® Code 45395

The CPT® Code 45395 refers to a surgical procedure known as a complete proctectomy, which is performed using laparoscopic techniques. This procedure involves the removal of the rectum and surrounding tissues, and it is combined with the creation of a colostomy. The term "laparoscopy" indicates that the surgery is conducted through small incisions in the abdomen, utilizing a camera and specialized instruments to minimize trauma to the body compared to traditional open surgery. The procedure begins with the establishment of pneumoperitoneum, which is the introduction of gas into the abdominal cavity to create space for the surgeon to work. Following this, additional incisions are made to allow for the insertion of trocars, which are instruments that facilitate the introduction of surgical tools into the abdominal cavity. During the proctectomy, the sigmoid colon is carefully mobilized and retracted to expose the rectum, which is then detached from its attachments in the pelvic and abdominal regions. The inferior mesenteric artery and vein, which supply blood to the colon, are identified, ligated, and transected to ensure complete removal of the rectum. The procedure culminates with the creation of a colostomy, where a portion of the colon is brought out through the abdominal wall to form a stoma, allowing for waste to exit the body into a colostomy bag. This procedure is typically indicated for conditions such as rectal cancer, severe inflammatory bowel disease, or other significant rectal pathologies that necessitate the removal of the rectum and the establishment of an alternative route for waste elimination.