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Resection Transverse Colon to No Qualifier with No Device, Via Natural or Artificial Opening With Percutaneous Endoscopic Assistance Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | D Gastrointestinal System |
| Operation | T Resection |
| Body Part | L Transverse Colon |
| Approach | F Via Natural or Artificial Opening With Percutaneous Endoscopic Assistance |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection describes the surgical removal of an entire gastrointestinal organ or a clearly defined anatomic segment of one, without putting anything in its place. Common examples include total gastrectomy for stomach cancer, complete removal of the appendix, and total colectomy for severe ulcerative colitis, where the entire designated body part as defined by the coding system is taken out rather than just a portion of it.
Surgeons choose resection when disease, most often cancer, severe inflammatory conditions, or irreversible ischemic damage, affects an entire organ or a segment that the classification treats as a whole unit, such as the cecum or the sigmoid colon. The remaining ends of the digestive tract are typically reconnected in the same operation, restoring continuity, though in some cases a stoma is created instead when reconnection is not immediately safe.
Anatomy & Axis Detail
Transverse Colon
The transverse colon crosses the upper abdomen from the hepatic to the splenic flexure and is the most mobile portion of the large intestine, suspended by the transverse mesocolon and attached to the stomach via the gastrocolic ligament. Resection of this segment is performed for transverse colon carcinoma, a large polyp, or ischemic injury, and because of its mobility and dual blood supply from the middle colic artery, segmental transverse colectomy is technically feasible without requiring resection of the adjacent flexures. Its close relationship to the stomach and greater omentum means the gastrocolic ligament often must be divided during mobilization, and surgeons must take care to avoid injury to the omental and gastroepiploic vessels. The operative note should confirm the resection is confined to the transverse segment rather than extending into a flexure requiring a more extensive colectomy.
Approach: Via Natural or Artificial Opening With Percutaneous Endoscopic Assistance
This hybrid approach combines entry through a natural or artificial opening with simultaneous percutaneous endoscopic access used to assist the procedure, such as a laparoscopically assisted vaginal hysterectomy where a scope placed through the abdominal wall guides work done through the vagina. It is reserved for procedures genuinely needing both routes together, setting it apart from either route used alone.
Coding & Documentation
The key documentation requirement is that the entire body part, as defined by the specific GI body part value, was removed, not merely a partial excision of tissue from within it. When only part of a segment is taken, such as a wedge of stomach tissue, the correct root operation is Excision rather than Resection, which is one of the most common assignment errors in this family. Coders must also identify whether an anastomosis, stoma, or other reconstruction was performed and code that separately from the resection itself, since the two are distinct steps. Clear identification of the specific segment removed, such as right colon versus left colon versus total colon, is essential because each maps to a different body part value.