27065 Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed

Name of the Procedure:

Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed.

Summary

This surgical procedure involves removing a benign (non-cancerous) bone cyst or tumor from specific pelvic and femur regions. The targeted regions include the wing of the ilium (part of the hip bone), the symphysis pubis (the joint between the left and right pubic bones), or the greater trochanter (the bony prominence near the top of the femur). In some cases, an autograft (a bone graft using the patient's own tissue) may be performed to aid healing.

Purpose

The procedure addresses benign bone cysts or tumors that may cause pain, deformity, or impair function. The goals are to alleviate symptoms, improve function, and prevent potential complications such as fractures or joint issues.

Indications

• Persistent pain in the affected area
• Visible deformity or swelling
• Functional impairment or movement restrictions
• Risk of fracture due to weakened bone structure
• Failure of non-surgical treatments

Preparation

• Fasting for at least 6-8 hours before surgery
• Adjusting or stopping certain medications as advised by the doctor
• Blood tests, imaging studies (X-rays, MRI, or CT scans) to evaluate the cyst or tumor

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A surgical incision is made over the affected bone area.
3. Excision: The surgeon carefully removes the bone cyst or tumor.
4. Autograft (if needed): Bone from another part of the patient's body may be grafted to fill the void and promote healing.
5. Closure: The incision is closed with sutures or staples.
6. Dressing and Bandaging: The area is cleaned, dressed, and bandaged to prevent infection.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity and extent of the cyst or tumor.

Setting

The procedure is usually performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Fracture of the bone
• Non-union or poor healing of the bone graft
• Adverse reactions to anesthesia

Benefits

• Relief from pain and discomfort
• Restoration of normal function and mobility
• Reduced risk of bone fractures or further complications

Recovery

• Pain management with prescribed medications
• Rest and limited weight-bearing on the affected area
• Physical therapy to restore strength and mobility
• Follow-up appointments to monitor healing
• Full recovery may take several weeks to months, depending on the extent of surgery and individual healing rates

Alternatives

• Observation and monitoring for slow-growing or asymptomatic cysts or tumors
• Medications or injections for pain management
• Less invasive procedures like needle aspiration or curettage
• The choice of alternative treatments depends on the size, location, and effect on bone function

Patient Experience

During the procedure, the patient will be under general anesthesia and unaware of the surgery. Afterward, they may experience pain and swelling at the surgical site, managed with medications. Most patients gradually regain function and experience significant pain relief as the area heals. Following post-operative instructions and attending follow-up appointments are crucial for optimal recovery.