CPT® Code 45562

The procedure described by CPT® Code 45562 involves the exploration and repair of a rectal injury, along with the placement of presacral drains. This procedure is typically indicated in cases of penetrating injuries to the rectum, where the integrity of the rectal wall is compromised. During the operation, the abdomen is surgically opened to allow for direct visualization and assessment of the injury. Once the rectal injury is identified, the surgeon takes steps to control any bleeding that may be present. The next critical step involves the repair of the rectal wound, which is accomplished using sutures to restore the normal anatomy and function of the rectum. In certain cases, depending on the severity and nature of the injury, a colostomy may be necessary to divert stool away from the rectum temporarily. This diversion is crucial for allowing the rectal repair to heal without the stress of stool passage. If a colostomy is performed, it is typically created in the sigmoid colon, and various techniques may be employed, including loop colostomy, loop with distal closure, or an end colostomy with a mucous fistula. Following the repair of the rectal injury and any necessary colostomy creation, presacral drains are placed to facilitate the drainage of any potential fluid accumulation in the presacral space. The placement of these drains is achieved through a curvilinear incision made between the coccyx and the posterior margin of the anus, which is then extended through the endopelvic fascia. Blunt dissection is utilized to access the presacral space, allowing the surgeon to reach the site of the rectal injury. A drain is inserted to the level of the injury and secured to the perianal skin to ensure proper drainage and minimize the risk of complications.