Omental flap, intra-abdominal (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Omental Flap, Intra-Abdominal
Common name(s): Omental flap surgery
Summary
An omental flap surgery involves using a portion of the omentum—a layer of fatty tissue within the abdomen—to repair or reconstruct areas within the abdominal cavity. This tissue is rich in blood supply and helps promote healing.
Purpose
This procedure is often performed to address issues such as complex abdominal wounds, fistulas, or to cover and protect vital structures after other surgeries. The goals are to improve healing, reduce the risk of infection, and support abdominal reconstruction.
Indications
- Chronic or non-healing abdominal wounds
- Abdominal fistulas
- Reconstruction after tumor removal or trauma
- Support during complex abdominal surgery
- Certain cases of abdominal infections or abscesses
Preparation
- Patients may be required to fast for at least 8 hours prior to the surgery.
- Medication adjustments, such as discontinuation of blood thinners.
- Pre-operative imaging and lab tests may be necessary.
- Consultation with the surgical team to understand the procedure and risks.
Procedure Description
- An incision is made in the abdominal area to access the omentum.
- A portion of the omentum is carefully dissected and mobilized.
- The omental tissue is then transposed to the area needing repair or reinforcement.
- The omentum is secured in place, often with sutures.
- The abdominal incision is closed, and dressings are applied.
Tools and equipment used include surgical instruments for cutting and suturing, retractors, and sometimes laparoscopic tools. General anesthesia is typically administered for patient comfort.
Duration
The procedure usually takes between 2-4 hours, depending on the complexity.
Setting
Omental flap surgery is typically performed in a hospital or specialized surgical center.
Personnel
- Surgeon
- Surgical assistant
- Anesthesiologist
- Operating room nurses
- Scrub techs
Risks and Complications
- Infection
- Bleeding
- Anesthesia complications
- Delayed wound healing
- Tissue necrosis
- Hernia formation
Benefits
- Enhanced healing of chronic wounds
- Reduced infection rates
- Improved structural support within the abdomen
- Faster recovery of abdominal function
Recovery
- Patients may need to stay in the hospital for several days post-surgery.
- Pain management typically includes analgesics.
- Gradual return to normal diet and activities.
- Follow-up visits for wound assessments and suture removal.
- Avoid strenuous activities for at least 4-6 weeks.
Alternatives
- Secondary intention wound healing
- Skin grafts
- Synthetic mesh placement
- Each alternative has its pros and cons, often depending on the wound's size, location, and the patient’s overall health.
Patient Experience
Patients may feel groggy from anesthesia and experience moderate pain, which is managed with medication. There might be some restriction in movement initially, and assistance may be required for daily activities. Most patients will notice significant improvement in healing within several weeks. Comfort measures include pain management, wound care education, and emotional support from healthcare providers.