28045 Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm

Name of the Procedure:

Excision, Tumor, Soft Tissue of Foot or Toe, Subfascial (e.g., Intramuscular); Less than 1.5 cm

Summary

This procedure involves the surgical removal of a tumor located within the soft tissues of the foot or toe, specifically situated beneath the fascia (a layer of connective tissue) and potentially within muscle tissue. The tumor being excised is less than 1.5 centimeters in size.

Purpose

The purpose of this procedure is to remove a potentially harmful or symptomatic tumor from the soft tissue of the foot or toe. It aims to alleviate pain, prevent tumor growth, and allow for a biopsy to determine if the tumor is benign or malignant.

Indications

• Presence of a palpable mass or lump in the foot or toe
• Pain or discomfort in the area
• Swelling or inflammation
• Suspicious imaging findings
• Biopsy indicating need for tumor removal

Preparation

• Patients may need to fast for several hours prior to surgery.
• Adjustments to current medications, especially blood thinners, as instructed by the doctor.
• Preoperative diagnostic tests such as MRI or ultrasound to assess the tumor.

Procedure Description

1. The patient is positioned appropriately, and the area is cleaned and sterilized.
2. Local or general anesthesia is administered based on the case specifics.
3. The surgeon makes an incision over the site of the tumor.
4. Underlying muscles and tissues are carefully separated to access the tumor.
5. The tumor is excised along with a small margin of healthy tissue to ensure complete removal.
6. The incision is closed using sutures or surgical staples.
7. A sterile dressing is applied to the wound.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and size of the tumor.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic or general surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)
• Surgical technologist

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Scarring
• Nerve damage or numbness
• Recurrence of the tumor
• Reaction to anesthesia

Benefits

• Relief from pain and discomfort
• Prevention of further tumor growth or complications
• Obtaining a biopsy for accurate diagnosis
• Improved foot function and mobility

Recovery

• Patients are typically able to go home the same day.
• Instructions will include keeping the surgical site clean and dry.
• Pain management may involve prescribed medications.
• Limited weight-bearing on the affected foot for a period.
• Follow-up appointments to monitor healing and remove stitches if necessary.
• Full recovery may take a few weeks.

Alternatives

• Observation with regular monitoring if the tumor is asymptomatic and benign.
• Needle biopsy to diagnose without complete excision.
• Radiation or chemotherapy for malignant tumors, potentially in combination with surgery.

Patient Experience

During the procedure, the patient will not feel pain due to anesthesia. Postoperatively, some discomfort or pain at the incision site is expected, which can be managed with prescribed pain relief measures. Swelling and limited mobility are common in the healing phase, with most patients returning to normal activities within a few weeks after the procedure.