35221 Repair blood vessel, direct; intra-abdominal

Name of the Procedure:

Repair blood vessel, direct; intra-abdominal (Commonly referred to as Intra-abdominal vessel repair)

Summary

Intra-abdominal vessel repair is a surgical procedure to fix damaged or ruptured blood vessels located within the abdominal cavity. This is typically performed through an open surgery method, where surgeons directly access the affected blood vessel to repair it.

Purpose

This procedure addresses blood vessel damage in the abdomen, which may result from trauma, aneurysms, or other medical conditions causing vessel rupture or obstruction. The primary goal is to restore normal blood flow and prevent potentially life-threatening complications like internal bleeding or ischemia in the affected organs.

Indications

• Trauma to the abdominal area causing vessel damage.
• Abdominal aortic aneurysm.
• Acute mesenteric ischemia due to arterial blockage.
• Splenic artery aneurysm.
• Certain congenital vascular conditions.
• Severe arterial bleeding within the abdomen.

Preparation

• Patients may be instructed to fast for at least 8 hours before the surgery.
• Certain medications, especially blood thinners, might need to be adjusted or stopped.
• Preoperative blood tests, imaging studies like CT scans or ultrasounds, and a physical examination are typically required.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made in the abdominal wall to access the affected area.
3. Identification: The damaged vessel is located.
4. Repair: Surgeons use sutures, grafts, or synthetic materials to repair or replace the damaged section of the blood vessel.
5. Closing: The incision is sutured closed, and sterile dressings are applied.

Specialized surgical tools like scalpels, clamps, and vascular sutures are used. Imaging technologies may also assist in guiding the repair process.

Duration

The procedure generally takes 2-4 hours, depending on the extent of the damage and complexity of the repair.

Setting

This surgery is typically performed in a hospital's operating room.

Personnel

• Surgeon specialized in vascular or general surgery.
• Anesthesiologist.
• Surgical nurses.
• Possibly a radiologic technologist if imaging guidance is needed.

Risks and Complications

• Infection at the surgical site.
• Bleeding and hematoma formation.
• Blood clots (thrombosis).
• Damage to surrounding organs or tissues.
• Anesthesia-related complications.
• Re-rupture or re-bleeding from the repaired vessel.

Benefits

• Restores normal blood flow and prevents life-threatening complications.
• Alleviates symptoms such as pain, swelling, or organ dysfunction.
• Immediate reduction in the risk of further hemorrhage.

Recovery

• Hospital stay of 5-7 days post-surgery.
• Monitoring for signs of infection or complications.
• Gradual return to normal activities over 4-6 weeks.
• Follow-up appointments for imaging and clinical assessments.
• Instructions to avoid heavy lifting or strenuous activities for several weeks.

Alternatives

• Endovascular repair (less invasive but not suitable for all patients).
• Medication management for smaller, less critical vessel damage.
• Non-surgical observation for contained vessel injuries.

Pros and cons should be discussed with the healthcare provider to determine the most appropriate treatment.

Patient Experience

• General anesthesia ensures no pain during the procedure.
• Post-operative pain managed with medications.
• Initial discomfort and pain at the incision site, improving over days to weeks.
• Support from medical staff ensures a comfortable recovery environment.