37617 Ligation, major artery (eg, post-traumatic, rupture); abdomen

Name of the Procedure:

Ligation of a Major Artery in the Abdomen (Post-traumatic or Rupture)

Summary

In this procedure, a surgeon ties off a major artery within the abdomen to stop severe bleeding, typically after an injury or due to a rupture. This is often an emergency surgery aimed at saving the patient's life.

Purpose

• Medical Condition: This procedure addresses severe internal bleeding caused by trauma or arterial rupture in the abdomen.
• Goals/Outcomes: The primary goal is to control hemorrhage, stabilize the patient's condition, and prevent further blood loss or shock.

Indications

• Massive internal bleeding in the abdominal cavity.
• Rupture of a major abdominal artery.
• Trauma to the abdomen causing arterial damage.
• Signs of hemorrhagic shock, such as rapid heartbeat, low blood pressure, and pallor.

Preparation

• Pre-Procedure Instructions: Fasting is required for several hours before surgery.
• Medication Adjustments: Blood-thinning medications may need to be paused under medical advice.
• Diagnostic Tests: Imaging studies like CT scans or ultrasound to locate the bleeding and assess damage.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the abdomen to access the bleeding artery.
3. The surgeon identifies the damaged artery and uses a special surgical clamp and sutures to tie off or "ligate" the artery.
4. Hemostasis is ensured, and the wound is cleaned and closed.
5. The patient is monitored closely for stabilization.

Tools/Equipment: Surgical clamps, sutures, scalpel, imaging devices. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and free of pain during the procedure.

Duration

The procedure typically takes around 1-3 hours, depending on the complexity and extent of the injury.

Setting

The surgery is performed in a hospital operating room, often in an emergency or trauma center setting.

Personnel

• Surgeon: Performs the ligation.
• Anesthesiologist: Manages anesthesia.
• Surgical Nurses: Assist with the procedure.
• Radiologist: May be involved for imaging guidance.

Risks and Complications

• Common Risks: Infection, blood clots, and bleeding.
• Rare Risks: Damage to surrounding organs, failure to control bleeding, and adverse reactions to anesthesia.

Benefits

• Expected Benefits: Immediate control of bleeding, stabilization of the patient's condition, and preservation of life.
• Realization Time: Benefits are typically realized immediately post-surgery as bleeding is controlled.

Recovery

• Post-Procedure Care: Close monitoring in an intensive care unit (ICU), pain management, and possibly blood transfusions if necessary.
• Recovery Time: Initial recovery in the hospital usually lasts 1-2 weeks, with several weeks of rest and limited activity at home.
• Follow-Up: Regular follow-up appointments to monitor healing and check for complications.

Alternatives

• Other Options: Endovascular repair (minimally invasive), embolization (blocking the artery with coils or particles).
• Pros and Cons: Less invasive alternatives may have faster recovery times but may not be feasible or as effective in emergency situations.

Patient Experience

• During the Procedure: The patient will be under general anesthesia and should not feel any pain or discomfort.
• After the Procedure: Pain at the incision site, temporary soreness, and limited mobility. Pain management includes medications and supportive care for comfort.