CPT® Code 51596

Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder

The procedure described by CPT® Code 51596 involves a complete cystectomy, which is the surgical removal of the bladder, performed in conjunction with the creation of a continent urinary diversion. This type of diversion allows the patient to void normally through the urethra, distinguishing it from other urinary diversion methods. In some cases, a stoma may be created that includes a valve mechanism, utilizing intussuscepted colon to prevent urine leakage. This allows the patient to manage urine elimination by periodically catheterizing the pouch. The surgical approach typically involves a midline incision in the abdomen, through which the bladder is accessed and removed. The procedure requires careful dissection and mobilization of the bladder and ureters, ensuring that the surrounding structures are preserved as much as possible. Following the removal of the bladder, a segment of either small or large intestine is selected to construct a neobladder, which serves as a new reservoir for urine. This segment is meticulously prepared and shaped into a pouch, allowing for the proper connection to the ureters and, in some cases, the urethra or a stoma. The entire process is complex and requires precise surgical techniques to ensure successful outcomes and minimize complications.