Name of the Procedure:

Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm

Summary

In this procedure, a surgeon removes a tumor located within the soft tissue of the abdominal wall, specifically beneath the fascia and possibly within the muscle. The tumor is less than 5 centimeters in size.

Purpose

Medical Condition or Problem:

This procedure is done to remove benign or malignant tumors in the soft tissue of the abdominal wall to prevent growth, alleviate symptoms, and reduce the risk of cancer spread.

Goals or Expected Outcomes:

Removal of the tumor with clean margins, relief from pain or discomfort, prevention of tumor recurrence, and improved functional outcomes.

Indications

Symptoms or Conditions:

• Presence of a palpable mass in the abdominal wall
• Pain or discomfort associated with the tumor
• Suspicious imaging findings suggesting malignancy or rapid tumor growth
• Biopsy-confirmed diagnosis of a malignant or bothersome benign tumor

Patient Criteria:

• Tumor size is less than 5 cm
• Tumor is located subfascially or within the muscle
• Patient is in overall good health to handle surgery

Preparation

Pre-Procedure Instructions:

• Fasting for at least 8 hours prior to the surgery
• Adjustments or temporary discontinuation of certain medications as advised by the doctor
• Preoperative imaging studies such as an MRI or CT scan to delineate tumor boundaries

Diagnostic Tests:

• Blood tests to check overall health and fitness for surgery
• Biopsy of the tumor to determine its nature

Procedure Description

1. Anesthesia: Patient receives general anesthesia to ensure they are asleep and pain-free throughout the procedure.
2. Incision: The surgeon makes an incision over the site of the tumor.
3. Exposure: The fascia and muscle are carefully exposed to view the tumor.
4. Excision: The tumor is excised along with a margin of healthy tissue to ensure complete removal. Special surgical tools like scalpels, forceps, and electrocautery may be used.
5. Closure: The muscle and fascia are stitched back, followed by the skin incision.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is generally performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon: Performs the excision
• Anesthesiologist: Manages anesthesia and patient comfort
• Surgical Nurses: Assist during the procedure

Risks and Complications

Common Risks:

• Infection at the site of surgery
• Bleeding or hematoma formation
• Pain at the incision site

Rare Risks:

• Damage to nearby organs or structures
• Recurrence of the tumor
• Adverse reaction to anesthesia

Benefits

• Removal of the tumor
• Relief from symptoms and discomfort
• Reduced risk of tumor-related complications or malignancy spread
• Improved quality of life

Recovery

Post-Procedure Care:

• Pain management with prescribed medications
• Care of the surgical incision including keeping it clean and dry
• Avoiding strenuous activities for 4-6 weeks

Recovery Time:

• Most patients can return to normal activities within 4-6 weeks
• Follow-up appointments to monitor healing and check for any complications

Alternatives

Other Treatment Options:

• Watchful waiting with regular monitoring if the tumor is benign and asymptomatic
• Radiotherapy or chemotherapy for malignant tumors
• Minimally invasive procedures or ablation techniques

Pros and Cons of Alternatives:

• Watchful Waiting: No surgical risks, but potential for tumor growth.
• Radiotherapy/Chemotherapy: Non-surgical options, but potential side effects and less immediate results.
• Minimally Invasive Procedures: Less scarring and faster recovery, but may not be suitable for all tumor types.

Patient Experience

During the Procedure:

• The patient will be under general anesthesia and will not feel anything.

After the Procedure:

• Mild to moderate pain managed with medication
• Some swelling or bruising around the incision site
• Gradual return to normal activities with adherence to post-op guidelines
• Regular check-ups to ensure proper healing and tumor absence.

Pain management includes prescription medications and guidance on comfort measures like using ice packs and wearing loose-fitting clothing.