54690 Laparoscopy, surgical; orchiectomy

Name of the Procedure:

Laparoscopy, surgical; orchiectomy
Common name: Laparoscopic Orchiectomy
Technical term: Minimally Invasive Orchiectomy

Summary

Laparoscopic orchiectomy is a minimally invasive surgical procedure to remove one or both testicles using small incisions and a camera to guide the surgery.

Purpose

This procedure is commonly performed to treat testicular cancer, severe trauma, or other testicular diseases. The primary goal is to remove the affected testicle(s) while minimizing tissue damage and promoting faster recovery.

Indications

• Testicular cancer
• Severe testicular trauma
• Persistent testicular pain
• Severe infection or abscess
• Male-to-female gender confirmation surgery

Preparation

• Patients are typically advised to fast for at least 8 hours before the procedure.
• Blood tests, imaging studies (e.g., ultrasound, CT scans), and medical evaluations may be required.
• Medications such as blood thinners might need to be adjusted or discontinued temporarily.

Procedure Description

1. Anesthesia is administered to ensure the patient remains unconscious and pain-free.
2. Several small incisions are made in the lower abdomen.
3. A laparoscope (a small camera) is inserted through one of the incisions.
4. Surgical instruments are inserted through the other incisions.
5. The testicle is carefully detached from surrounding tissues and blood vessels.
6. The detached testicle is then removed through one of the incisions.
7. The incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes 1-2 hours.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Urologist or general surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Adverse reactions to anesthesia
• Damage to surrounding tissues or organs
• Scrotal hematoma or swelling
• Emotional impact and potential hormonal changes (if both testicles are removed)

Benefits

• Effective removal of diseased or cancerous tissue
• Minimally invasive with smaller incisions and quicker recovery
• Reduced postoperative pain and shorter hospital stay

Recovery

• Patients may be required to stay in the hospital for a few hours to observe immediate recovery from anesthesia.
• Light activities can typically be resumed within a few days; however, strenuous activities should be avoided for several weeks.
• Follow-up appointments are necessary to monitor healing and any potential complications.
• Pain management typically involves prescribed analgesics.

Alternatives

• Open (traditional) orchiectomy: Requires larger incisions and a longer recovery.
• Radiation therapy: Non-surgical option primarily for certain types of testicular cancer.
• Chemotherapy: Typically used in conjunction with or as an alternative to surgery for cancer treatment.

Patient Experience

• During the procedure: The patient will be under general anesthesia and will not feel any discomfort.
• After the procedure: Expect some pain and swelling at the incision sites, managed with medication. Emotional support may be beneficial, especially if the surgery affects hormonal balance or body image.

Pain management involves prescribed medications and comfort measures to help ensure a smooth recovery.