Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication
CPT4 code
Name of the Procedure:
Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum, including surgical thoracoscopy; decortication.
Summary
This procedure involves providing anesthesia for surgeries on the chest area, specifically targeting the lungs, pleura, diaphragm, and mediastinum. It includes the use of surgical thoracoscopy and decortication (removal of the fibrous layer covering the lung). Anesthesia ensures the patient is pain-free and unconscious during these complex surgical operations.
Purpose
The primary purpose is to manage pain and discomfort during thoracic surgeries. These surgeries address conditions such as lung cancer, pleural diseases, diaphragmatic issues, and mediastinal tumors. The goal is to remove or repair diseased tissue, improve lung function, and enhance overall patient outcomes.
Indications
- Lung cancer or tumors
- Pleural effusions or infections
- Diaphragmatic paralysis or hernia
- Mediastinal masses or tumors
- Empyema (collection of pus in the pleural cavity) Patients who exhibit significant symptoms of these conditions or who have not responded to other treatments would be candidates for this procedure.
Preparation
- Patients may need to fast for at least 8 hours before surgery.
- Adjustments in medications, particularly blood thinners or diabetes medications, as advised by the doctor.
- Preoperative tests including blood work, chest X-rays, ECG, and pulmonary function tests to assess overall fitness for surgery and anesthesia.
Procedure Description
- Preoperative Assessment: An anesthesiologist will evaluate the patient's medical history and test results to devise an anesthesia plan.
- Induction of Anesthesia: The patient is administered general anesthesia to induce unconsciousness.
- Intubation: A breathing tube is placed in the trachea to assist with ventilation during surgery.
- Maintenance of Anesthesia: Continuous administration of anesthetic medications to keep the patient unconscious and pain-free.
- Monitoring: Vital signs, oxygen levels, and anesthesia depth are closely monitored throughout the procedure.
- Post-Surgical Care: After surgery, the patient is gradually awakened from anesthesia and closely monitored in the recovery room.
Duration
The duration varies depending on the complexity of the surgery but typically lasts between 3 to 6 hours.
Setting
The procedure is performed in a hospital's operating room or a specialized surgical center.
Personnel
- Surgeons specialized in thoracic surgeries
- Anesthesiologists
- Operating room nurses
- Surgical technologists
- Respiratory therapists
Risks and Complications
- Common risks: Nausea, vomiting, sore throat, and minor allergic reactions.
- Rare risks: Anesthesia awareness, heart complications, lung infections, blood clots, and nerve damage.
- Serious complications: Respiratory failure, cardiac arrest, and adverse reactions to anesthetic drugs. These are managed by the surgical and anesthesia teams.
Benefits
- Pain-free and unconscious state during surgery ensuring patient comfort.
- Enables successful completion of complex thoracic surgeries.
- Immediate relief from symptoms and improved lung function are typically observed post-surgery.
Recovery
- Close monitoring in a recovery room for several hours post-surgery.
- Pain management with medications.
- Breathing exercises and physical therapy might be recommended to aid recovery.
- Full recovery can range from a few weeks to several months, depending on the extent of the surgery.
- Follow-up appointments for progress evaluation and management of any complications.
Alternatives
- Non-surgical treatments (e.g., medication, physical therapy) for less severe conditions.
- Less invasive procedures like needle biopsies or bronchoscopies in specific cases.
- Each alternative has its own risks and benefits, discussed with the healthcare provider.
Patient Experience
- Patients will feel no pain during the procedure due to general anesthesia.
- Postoperatively, patients might experience grogginess, discomfort at the surgery site, and pain, which are managed with medications and care strategies.
- Gradual resumption of normal activities guided by the healthcare team.