CPT® Code 57307

The CPT® Code 57307 refers to the surgical procedure for the closure of a rectovaginal fistula using an abdominal approach, which is typically indicated when the fistula is situated high in the rectum. Rectovaginal fistulas are abnormal connections between the rectum and the vagina, often resulting from conditions such as malignant neoplasms or complications arising from radiation therapy. The procedure involves making an incision in the lower abdomen to access the affected area. During the surgery, the rectovaginal septum is carefully dissected to identify the fistula. Once located, the fistula is divided, and the openings in both the rectum and vagina are meticulously closed with sutures to restore normal anatomy. In addition to the closure of the fistula, this specific code also includes the performance of a concomitant colostomy. This entails making a second incision in the abdomen to create an opening for the colostomy. The section of the intestine that is to be diverted is transected, and the distal segment is closed off. The proximal segment is then brought out through the skin to form a stoma, which is sutured to the skin, allowing for the placement of a colostomy bag over the stoma. This comprehensive approach addresses both the closure of the fistula and the necessary diversion of intestinal contents, ensuring effective management of the patient's condition.