39560 Resection, diaphragm; with simple repair (eg, primary suture)

Name of the Procedure:

Resection of the Diaphragm with Simple Repair (e.g., Primary Suture)

Summary

This surgical procedure involves the removal of a section of the diaphragm, followed by a repair using basic suturing techniques. The diaphragm is a vital muscle that helps in breathing, and resection is typically performed to remove damaged or diseased tissue.

Purpose

The procedure addresses conditions where a portion of the diaphragm is compromised due to tumors, trauma, infection, or congenital defects. The primary goals are to restore normal diaphragmatic function and improve breathing.

Indications

• Tumors or cancerous growths on the diaphragm
• Traumatic injury to the diaphragm
• Diaphragmatic hernias
• Infection or abscess in the diaphragm
• Congenital abnormalities affecting diaphragm structure

Preparation

• Patients may need to fast for 8-12 hours prior to surgery.
• Certain medications may need to be adjusted or stopped.
• Diagnostic tests such as imaging studies (e.g., CT scan, MRI) and pulmonary function tests are often required to assess the diaphragm and plan the procedure.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made to access the diaphragm.
3. The diseased or damaged section of the diaphragm is identified and removed.
4. The remaining edges of the diaphragm are brought together and stitched with sutures to ensure a proper seal.
5. The surgical site is inspected for completeness and to ensure there is no bleeding.
6. The incision is closed using sutures or staples, and a dressing is applied.

Duration

The procedure typically takes between 1 to 3 hours, depending on the complexity and extent of the tissue to be resected.

Setting

The procedure is performed in a hospital operating room under sterile conditions.

Personnel

• Thoracic surgeon or surgical specialist
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the incision site
• Bleeding or hemorrhage
• Injury to surrounding organs (e.g., lungs, liver)
• Difficulty breathing or respiratory complications
• Risk of recurrence if underlying condition persists

Benefits

• Relief of symptoms such as difficulty breathing
• Removal of diseased or cancerous tissue
• Improved diaphragmatic function
• Enhanced overall respiratory health

Recovery

• Post-operative hospitalization for monitoring (typically 2-5 days)
• Pain management with medications
• Breathing exercises and physiotherapy to strengthen the diaphragm
• Restrictions on heavy lifting and strenuous activity for several weeks
• Follow-up appointments to monitor healing and function

Alternatives

• Non-surgical management (e.g., observation, medication)
• Less invasive surgical options such as minimally invasive or laparoscopic procedures
• Palliative care (for terminal conditions where surgery is not a viable option)

Patient Experience

The patient will be under anesthesia during the procedure and will not feel pain. Post-operatively, there may be discomfort and pain managed with medications. Breathing exercises and physiotherapy may be necessary to aid recovery and restore diaphragmatic function. The patient might feel tired and will need to follow specific care instructions for optimal recovery.