Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)
CPT4 code
Name of the Procedure:
Resection of the Diaphragm with Complex Repair (e.g., Prosthetic Material, Local Muscle Flap)
Summary
Resection of the diaphragm with complex repair is a surgical procedure where a portion of the diaphragm is removed and then repaired using advanced techniques such as prosthetic materials or muscle flaps. This procedure is typically performed to remove diseased or damaged parts of the diaphragm and restore normal function.
Purpose
The procedure addresses conditions such as diaphragmatic tumors, traumatic injuries, or congenital defects that impair the diaphragm's function. The goal is to remove the affected tissue and repair the diaphragm to restore its integrity and functionality, ensuring proper respiratory mechanics.
Indications
- Diaphragmatic tumors or masses
- Severe trauma or injury to the diaphragm
- Large diaphragmatic hernias
- Congenital diaphragmatic abnormalities
- Diaphragmatic weakening due to previous surgeries
Specific symptoms warranting the procedure include trouble breathing, chest pain, or a noticeable bulge in the abdomen or chest.
Preparation
- Patients may be instructed to fast for 8-12 hours prior to the procedure.
- Certain medications, particularly blood thinners, may need to be paused.
- Pre-operative diagnostic tests might include imaging studies like CT scans or MRIs, blood tests, and a respiratory function test.
Procedure Description
- Administration of general anesthesia to ensure the patient is asleep and pain-free.
- An incision is made in the chest or abdomen to access the diaphragm.
- The affected portion of the diaphragm is carefully resected (removed).
- The diaphragm is then reconstructed using a prosthetic mesh, local muscle flap, or other advanced repair techniques.
- The incision is closed with sutures or staples.
- A temporary chest drain might be placed to remove excess fluid.
Duration
The procedure typically takes 2-4 hours, depending on the complexity.
Setting
This surgery is performed in a hospital operating room.
Personnel
- Thoracic or general surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
- Respiratory therapist (in some cases)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Respiratory complications
- Adverse reactions to anesthesia
- In rare cases, organ damage or failure of the repair
Benefits
- Removal of diseased or damaged tissue leading to improved diaphragm function
- Enhanced respiratory capacity and reduced symptoms
- Improved quality of life following recovery
Recovery
- Patients typically stay in the hospital for several days for monitoring.
- Pain management will be provided through medications.
- Instructions may include breathing exercises, wound care, and activity restrictions.
- Full recovery could take several weeks to months, with regular follow-up appointments to monitor progress.
Alternatives
- Non-surgical treatments such as observation or medical management (for non-malignant or non-life-threatening conditions).
- Minimally invasive procedures like laparoscopic repair for smaller defects.
- Pros and cons should be discussed with the healthcare provider based on individual cases.
Patient Experience
- During the procedure, the patient will be under general anesthesia and will not feel anything.
- Post-procedure, some pain and discomfort at the incision site are normal but will be managed with pain medication.
- Breathing might initially feel challenging, but respiratory exercises and therapies will aid in recovery.
- Emotional support and reassurance from health care professionals will be provided throughout the hospital stay and recovery period.