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Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Thoracoscopy, Surgical with Diagnostic Wedge Resection Followed by Anatomic Lung Resection

Summary

Thoracoscopy is a minimally invasive surgical procedure that allows doctors to view the inside of the chest cavity and lungs. This procedure includes a diagnostic wedge resection to remove a small piece of lung tissue for examination, followed by a more extensive anatomic lung resection to remove a larger, more precise area of lung tissue.

Purpose

The procedure is commonly used to diagnose and treat lung conditions such as tumors, infections, or other abnormalities. The goals include confirming a diagnosis through biopsy and removing diseased lung tissue to improve lung function or prevent the spread of disease.

Indications

  • Symptoms such as persistent cough, unexplained weight loss, or respiratory difficulties.
  • Abnormal results from imaging tests like X-rays or CT scans showing lung nodules or masses.
  • Suspected lung cancer or other lung diseases requiring tissue diagnosis.

Preparation

  • Patients are usually required to fast for several hours before the procedure.
  • Medication adjustments, particularly those affecting blood clotting, may be necessary.
  • Preoperative assessments typically include imaging studies and pulmonary function tests.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. Small incisions are made in the chest wall.
  3. A thoracoscope (a thin tube with a camera) is inserted to view the chest cavity.
  4. Surgical instruments are used to perform a diagnostic wedge resection, removing a small piece of lung tissue.
  5. If abnormalities are found, an anatomic lung resection is performed to remove a larger, anatomically defined portion of the lung.
  6. Incisions are closed, and dressings are applied.

Duration

The procedure typically takes between 2 to 4 hours, depending on its complexity.

Setting

This operation is performed in a hospital, usually in a specialized surgical suite.

Personnel

  • Thoracic Surgeon
  • Anesthesiologist
  • Surgical Nurses
  • Surgical Technologists

Risks and Complications

  • Common risks include infection, bleeding, and air leaks.
  • Rare risks encompass reactions to anesthesia, prolonged air leaks, or damage to surrounding structures.
  • Management involves close postoperative monitoring and interventions as needed.

Benefits

  • Accurate diagnosis of lung conditions through biopsy.
  • Removal of diseased lung tissue can lead to improved breathing and symptom relief.
  • Potential cure or control of lung cancer if detected early.

Recovery

  • Hospital stay of a few days to a week.
  • Pain management with medications, including oral or intravenous analgesics.
  • Instructions for wound care, activity restrictions, and breathing exercises.
  • Follow-up visits for monitoring recovery and potential complications.

Alternatives

  • Non-surgical biopsy options like needle biopsy or bronchoscopy.
  • Less invasive treatments might be available, depending on the condition.
  • Pros: Less recovery time, fewer risks. Cons: May be less definitive or effective.

Patient Experience

  • The patient will be asleep during the procedure.
  • Postoperative discomfort is common, managed with pain medications.
  • Breathing exercises and physical activity are encouraged to aid recovery and prevent complications.
  • The patient may experience temporary limitations in activity and mobility.

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