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Repair, diaphragmatic hernia (other than neonatal), traumatic; acute

CPT4 code

Name of the Procedure:

Repair of Diaphragmatic Hernia (Other than Neonatal), Traumatic; Acute

Summary

This surgical procedure involves repairing a diaphragmatic hernia that occurs due to trauma. A diaphragmatic hernia is a tear in the diaphragm that allows abdominal organs to move into the chest cavity. The surgery aims to relocate these organs back to their correct position and mend the diaphragm.

Purpose

The procedure addresses a diaphragmatic hernia caused by traumatic injury. The goal is to restore normal anatomy by fixing the tear in the diaphragm and repositioning any displaced organs. Expected outcomes include improved respiratory function and prevention of future complications.

Indications

  • Traumatic injury resulting in diaphragmatic tear
  • Difficulty breathing or respiratory distress
  • X-ray or CT scan showing abdominal organs in the chest cavity
  • Sharp chest or abdominal pain

Preparation

  • Fasting for at least 8 hours before surgery
  • Preoperative blood tests and imaging studies such as an X-ray or CT scan
  • Review of current medications with doctors, some may need to be paused

Procedure Description

  1. Patient receives general anesthesia to be asleep during the surgery.
  2. An incision is made in the abdomen or chest.
  3. Displaced abdominal organs are carefully relocated to their original positions.
  4. The tear in the diaphragm is repaired using sutures or a mesh patch.
  5. The incision is closed with sutures or surgical staples.
  6. A drain may be placed to remove excess fluid.

Duration

The procedure typically takes 2 to 4 hours.

Setting

It is performed in a hospital operating room.

Personnel

  • Surgeon
  • Anesthesiologist
  • Surgical nurses
  • Operating room technicians

Risks and Complications

  • Infection
  • Bleeding
  • Damage to surrounding organs
  • Recurrence of hernia
  • Complications from anesthesia
  • Respiratory issues post-surgery

Benefits

  • Relief of symptoms such as pain and breathing difficulties
  • Prevention of serious complications like organ strangulation
  • Improved overall lung function
  • Enhanced quality of life

Recovery

  • Hospital stay for 5 to 7 days
  • Pain management with prescribed medications
  • Avoid heavy lifting for 4 to 6 weeks
  • Follow-up appointments for monitoring recovery and removing stitches or staples

Alternatives

  • Conservative management (watchful waiting, pain relief)
  • Minimally invasive procedures like laparoscopic surgery
    • Pros: Less scarring, quicker recovery
    • Cons: May not be suitable for all patients or severe cases

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, they can expect to feel some pain and discomfort, which will be managed with medications. Breathing exercises, physical therapy, and rest will be important aspects of recovery.

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