Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral
CPT4 code
Name of the Procedure:
Thoracoscopy, surgical; with therapeutic wedge resection (e.g., mass, nodule), initial unilateral
Summary
A thoracoscopy with therapeutic wedge resection involves using a small camera and instruments inserted through tiny incisions in the chest to remove a portion of lung tissue, often for treating or diagnosing nodules or masses. It allows the surgeon to view the chest cavity and perform necessary interventions with minimal invasion.
Purpose
This procedure addresses conditions like lung nodules or masses that might be cancerous or causing symptoms. The goal is to remove the suspicious or problematic tissue for treatment or biopsy, potentially preventing the spread of disease or relieving symptoms.
Indications
- Presence of lung nodules or masses.
- Persistent lung issues not explained by other conditions.
- Diagnostic needs where other methods failed.
- Patient suitability for minimally invasive surgery rather than open surgery.
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments or discontinuation of certain medications such as blood thinners.
- Pre-operative assessments including blood tests, imaging studies (e.g., CT scan), and pulmonary function tests.
Procedure Description
- The patient is given general anesthesia.
- Small incisions are made in the chest to insert a thoracoscope (a thin, tubular instrument with a camera).
- The chest cavity is examined, and specialized surgical instruments are used to perform a wedge resection—removing a small, wedge-shaped portion of the lung.
- The resected tissue is then sent for pathological analysis if necessary.
- The thoracoscope and instruments are withdrawn, and the incisions are closed with sutures or staples.
Duration
The procedure typically takes 1 to 2 hours.
Setting
This is performed in a hospital or a surgical center equipped with the necessary technology and facilities.
Personnel
- Surgeons (particularly thoracic surgeons)
- Nurses
- Anesthesiologists
- Surgical technologists
Risks and Complications
- Infection at the incision site.
- Bleeding
- Air leaks from the lung
- Pain or discomfort
- Rarely, complications related to anesthesia such as allergic reactions or breathing difficulties.
Benefits
- Minimally invasive with quicker recovery than open surgery.
- Potentially effective in treating or diagnosing lung conditions.
- Can minimize disease progression if cancerous tissue is removed.
Recovery
- Post-operative monitoring in the hospital.
- Pain management with medications.
- Instructions on wound care and activity restrictions.
- Generally, a few weeks to recover with follow-up appointments to monitor progress and to review biopsy results if applicable.
Alternatives
- Open thoracotomy: more invasive but may be necessary for larger or more complex resections.
- Non-surgical therapies: such as radiotherapy or chemotherapy, depending on the underlying condition.
- Less invasive biopsy techniques: like needle biopsy for diagnostic purposes though less comprehensive.
Patient Experience
- During the procedure, the patient is under general anesthesia and will not feel anything.
- Post-procedure, there may be discomfort and pain managed with medications.
- Some soreness and restrictions on activity as they recover, with guidance provided to ensure a smooth recovery.