43500 Gastrotomy; with exploration or foreign body removal

Name of the Procedure:

Gastrotomy; with Exploration or Foreign Body Removal

Summary

A gastrotomy is a surgical procedure in which an incision is made into the stomach. This procedure is often used to explore the stomach for diagnostic purposes or to remove foreign objects that have been ingested.

Purpose

The primary goal of a gastrotomy is to remove foreign bodies that may have been accidentally ingested and cannot be retrieved endoscopically. This helps prevent complications such as blockages, infections, or damage to the stomach lining.

Indications

• Ingested foreign objects causing blockage or injury
• Failure of endoscopic retrieval of the foreign object
• Symptoms such as severe abdominal pain, vomiting, or bleeding
• Large or sharp objects posing a risk of perforation

Preparation

• Fasting for at least 8 hours prior to the procedure
• Discontinuing any blood-thinning medications as advised by the doctor
• Preoperative imaging studies like X-rays or CT scans to locate the foreign body
• Complete blood counts and other laboratory tests

Procedure Description

1. Anesthesia: The patient is given general anesthesia to ensure they are unconscious and pain-free.
2. Incision: A sterile incision is made in the abdomen to access the stomach.
3. Exploration: The surgeon explores the stomach to locate the foreign body.
4. Removal: Once located, the object is carefully removed.
5. Closure: The incision in the stomach and the abdominal wall are sutured closed.
6. Post-op Care: The patient is monitored as anesthesia wears off, and vital signs are checked.

Duration

The procedure typically takes about 1-2 hours, but this may vary depending on the complexity of the case.

Setting

A gastrotomy is performed in a hospital operating room.

Personnel

• General Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Infection at the incision site
• Bleeding
• Damage to surrounding tissues or organs
• Leakage of stomach contents into the abdominal cavity
• Reactions to anesthesia

Benefits

• Effective removal of foreign objects
• Relief from symptoms and prevention of further complications
• Immediate resolution of obstruction or injury

Recovery

• Hospital stay for 2-5 days for monitoring and recovery
• Gradual reintroduction of food and fluids
• Pain management with prescribed medications
• Avoid strenuous activities for 4-6 weeks
• Follow-up appointments to monitor healing

Alternatives

• Endoscopic retrieval (if feasible)
• Observation in cases where the foreign body may pass naturally
• Pros: Less invasive options like endoscopy may be possible
• Cons: Alternatives may not be effective for large, sharp, or complicated cases

Patient Experience

• Patients will be under general anesthesia and not feel anything during the procedure.
• Post-operatively, there may be some pain and discomfort managed with pain medications.
• Full recovery can take a few weeks, during which activity may be limited.
• Proper care of the incision site is essential to prevent infection.