Nerve pedicle transfer; first stage
CPT4 code
Name of the Procedure:
Nerve Pedicle Transfer; First Stage
Summary
Nerve pedicle transfer is a surgical procedure where a healthy nerve is rerouted to replace a damaged one. The first stage involves positioning the nerve "pedicle" near the area needing reinnervation. This helps to restore function and feeling to the affected area over time.
Purpose
Nerve pedicle transfer addresses nerve damage that leads to loss of muscle function or sensation. The goal is to promote nerve regeneration and restore movement or sensitivity in paralyzed or anesthetized areas.
Indications
- Severe nerve injury or damage
- Nerve palsy or paralysis
- Patients with muscle atrophy due to nerve damage
- Conditions where other surgical repairs are not viable
- Healthy donor nerve available for transfer
Preparation
- Fasting for at least 8 hours prior to surgery
- Discontinuation of blood thinners or other medications as directed
- Preoperative imaging or nerve conduction studies
- Adjustment of current medications under a doctor’s guidance
Procedure Description
- The patient receives general or regional anesthesia.
- The surgeon makes an incision near the donor nerve site.
- The selected nerve "pedicle" or a section of a healthy nerve is carefully dissected.
- This nerve pedicle is transferred and positioned adjacent to the target site.
- Incisions are closed, and the area is bandaged.
Tools include surgical scalpels, microscopes, and fine sutures. Anesthesia may be regional or general based on patient needs and surgeon preference.
Duration
Typically 2 to 4 hours, depending on the complexity of the transfer.
Setting
Usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Surgeon specialized in nerve repair
- Surgical nurses
- Anesthesiologist
- Operating room technicians
Risks and Complications
- Infection at surgical sites
- Nerve damage at the donor or recipient site
- Limited or no improvement in nerve function
- Scar tissue formation
- Pain or sensitivity at the surgical site
Benefits
- Potential restoration of movement or sensation
- Improvement in quality of life
- Functional use of previously paralyzed muscles
- Benefits may start to appear within several months, full effects could take a year or more
Recovery
- Pain management through prescribed medications
- Incision care as instructed
- Physical therapy to encourage nerve and muscle adaptation
- Recovery period typically lasts several weeks to months
- Regular follow-up appointments to monitor progress
Alternatives
- Physical therapy and rehabilitation without surgery
- Nerve grafts or other surgical nerve repair techniques
- Electrical stimulation therapies
- Each alternative has its own success rates and may depend on the extent of the injury
Patient Experience
Patients may feel sore and experience some discomfort during healing. Pain is usually managed with medications. Physical therapy will be critical for regaining function, and patient commitment is essential for the best outcomes.