32667 Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)

Name of the Procedure:

Thoracoscopy, surgical; with therapeutic wedge resection (e.g., mass or nodule), each additional resection, ipsilateral

Common Names:

• Thoracoscopic wedge resection
• Video-assisted thoracic surgery (VATS) with wedge resection

Summary:

Thoracoscopy with therapeutic wedge resection is a minimally invasive surgical procedure used to remove small portions of the lung, typically to treat or diagnose abnormalities such as masses or nodules. The procedure uses small incisions and a thoracoscope (a type of specialized camera) to guide the surgery.

Purpose:

This procedure is used to remove abnormal growths, such as tumors or nodules, from the lung. It helps in diagnosing or treating conditions that affect lung function and may provide relief from symptoms or prevent the spread of disease.

Indications:

• Presence of lung nodules or masses suspected to be malignant or benign.
• Conditions such as lung cancer, metastatic cancer, or benign lung tumors.
• Patients who have been assessed and deemed suitable for minimally invasive surgery.

Preparation:

• Patients are typically advised to fast for at least 8 hours before the procedure.
• Any blood-thinning medications may need to be adjusted or paused.
• Preoperative assessments may include blood tests, imaging studies (e.g., CT scan), and evaluations by the anesthesia team.

Procedure Description:

1. The patient is placed under general anesthesia.
2. Small incisions are made in the chest wall.
3. A thoracoscope is inserted through one of the incisions to provide a visual guide.
4. Surgical instruments are inserted through the other incisions.
5. The surgeon locates and removes the abnormal lung tissue (wedge resection).
6. The tissue is sent for pathological examination if required.
7. The incisions are closed with sutures or staples.

Duration:

The procedure typically takes between 1 to 3 hours, depending on the complexity and the number of resections.

Setting:

• The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel:

• Thoracic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications:

• Common risks: Infection, bleeding, prolonged air leak.
• Rare risks: Injury to surrounding organs, respiratory complications, adverse reactions to anesthesia.

Benefits:

• Minimized invasiveness compared to traditional open surgery.
• Shorter recovery time and less postoperative pain.
• Effective removal of abnormal lung tissue, potentially improving health outcomes.

Recovery:

• Patients usually stay in the hospital for a few days following surgery.
• Pain management may include medications.
• Activity restrictions may be advised for several weeks.
• Follow-up appointments to monitor recovery and evaluate surgical outcomes.

Alternatives:

• Open surgical resection (more invasive, longer recovery).
• Non-surgical options like radiation or chemotherapy (depends on the condition being treated).
• Watchful waiting (monitoring the condition without immediate intervention).

Patient Experience:

• During the procedure: The patient will be under general anesthesia and will not feel anything.
• Post-procedure: Patients may experience discomfort or pain at the incision sites, managed with medications. Some shortness of breath or fatigue is common during recovery. Regular follow-ups will ensure proper healing and address any concerns.