Sunnycd wrote:What is the CPT code of the expected surgery: CPT 44626 or CPT 44625 - it can make a difference in long-term quality of life (QOL) considerations.
I understand the difference, but how would that make a difference in QOL? Instinctively, I know 44625 would be neater and less complicated, since colon to colon vs. colon to rectum.What method will be used to connect the descending colon to the rectal stump? Hand stitches? Stapler? What kind of stapler? Can the stapler cause damage and injury to nearby organs while it is being used?
Most articles I read suggest that staplers are preferable and safer to hand stitching. Is this what you find?
I think 44625 would be better because more of the rectum would be retained, but this is only a guess. I'm not sure.
There are different kinds of staplers. If a trans-anal stapler is used, it might cause bruising or tearing of tissues while it is being jockeyed into position, like damage to sphincter muscles. But again, this is only a guess. But trans-anal staplers might not be used if they are not long enough for connecting the end of a 20 cm rectal stump. Other staplers have other kinds of problems, I suspect. Staplers are generally single-fire, single-use devices that cannot be cleaned and used by another patient, I think. After my ileostomy reversal I was given my stapler because I had paid for it and it could not be used again. It was a huge contraption and I couldn't understand how such a big thing could be manipulated properly in a small pelvic space. I think that current stapling procedures have less than 5% failure rate, but I'm not sure. Only the surgeons would know how much trouble they have in getting a stapler to work properly.