43610 Excision, local; ulcer or benign tumor of stomach

Name of the Procedure:

Excision, local; ulcer or benign tumor of stomach (Gastrotomy with Local Tumor or Ulcer Excision)

Summary

This procedure involves the surgical removal of a localized ulcer or benign tumor from the stomach. The goal is to eliminate the abnormal tissue while preserving the healthy portions of the stomach.

Purpose

The procedure addresses the presence of localized ulcers or benign tumors in the stomach. The goals are to relieve symptoms, prevent complications, and ensure the condition doesn't progress to a more serious state.

Indications

• Persistent stomach pain or discomfort
• Non-responsive to medication for ulcers
• Suspicious benign tumors found via imaging or endoscopy
• Persistent bleeding or obstruction in the stomach
• Pre-malignant conditions

Preparation

• Fasting for at least 8 hours prior to surgery
• Thorough medical evaluation, including blood tests and imaging (CT scan, MRI, or endoscopy)
• Possible adjustment of medications (e.g., blood thinners)

Procedure Description

1. Anesthesia: Administered general anesthesia to ensure the patient is asleep and pain-free.
2. Incision: A small incision is made in the abdomen to access the stomach.
3. Excision: Using surgical instruments, the surgeon carefully identifies and removes the ulcer or benign tumor.
4. Closure: The stomach tissue is then closed with sutures, and the abdominal incision is also sutured.
5. Monitoring: The patient is monitored for any immediate complications.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity and size of the ulcer or tumor.

Setting

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

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common risks: Infection, bleeding, adverse reaction to anesthesia
• Rare complications: Injury to surrounding organs, delayed gastric emptying, leakage from the suture line, development of a new ulcer in the future

Benefits

• Relief from symptoms such as pain, bleeding, and discomfort
• Prevention of potential complications such as ulcer perforation or malignancy
• Improved quality of life, typically realized a few weeks post-operatively

Recovery

• Initial hospital stay: 2-5 days post-surgery for monitoring
• Focus on a liquid or soft diet progressing to regular foods as tolerated
• Avoid strenuous activities for a few weeks
• Follow-up appointments to monitor healing and remove sutures if necessary

Alternatives

• Medication management (e.g., proton pump inhibitors, H2 blockers)
• Non-surgical endoscopic treatment
• Pros and cons: Medications might alleviate symptoms but may not resolve the underlying issue and can lead to recurrence; endoscopic treatments are less invasive but may not be suitable for larger tumors or deeper ulcers.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel anything. Post-procedure, patients can expect some abdominal discomfort, which can be managed with prescribed pain medications. They may experience temporary digestive changes as they heal. Concerns about pain and diet will be addressed by the healthcare team to ensure a comfortable recovery.