Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
CPT4 code
Name of the Procedure:
Esophagogastroduodenoscopy (EGD), flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
Summary
An Esophagogastroduodenoscopy (EGD) is a diagnostic and therapeutic procedure where a flexible endoscope is inserted through the mouth to examine the esophagus, stomach, and the beginning of the small intestine (duodenum). When necessary, it allows for the removal of tumors, polyps, or other lesions using hot biopsy forceps.
Purpose
An EGD is performed to diagnose and treat conditions affecting the upper gastrointestinal (GI) tract. The specific goal of removing tumors, polyps, or lesions by hot biopsy forceps is to treat issues such as bleeding, obstruction, or potential malignancies.
Indications
- Persistent upper abdominal pain
- Unexplained weight loss
- Difficulty swallowing (dysphagia)
- Gastrointestinal bleeding
- Biopsy or removal of suspicious growths found in previous scans or tests
- Diagnostic evaluation of long-standing GERD
Preparation
- Fasting for at least 6-8 hours before the procedure
- Adjustments or temporary discontinuation of certain medications as instructed by a physician
- Blood tests or imaging studies to assess overall health and preparedness for the procedure
Procedure Description
- Sedation: The patient is given sedation or anesthesia for comfort.
- Insertion of Endoscope: A flexible endoscope with a camera is gently inserted through the mouth and guided down the esophagus to the stomach and duodenum.
- Visual Examination: The endoscopist examines the lining of the upper GI tract for any abnormalities.
- Removal with Hot Biopsy Forceps: If tumors, polyps, or lesions are found, hot biopsy forceps are used to grasp and remove these lesions. The heat cauterizes the area, reducing bleeding.
- Tissue Collection: Removed tissue may be collected for further pathological examination.
Duration
The procedure typically takes about 15-30 minutes but may vary depending on the complexity of the case.
Setting
EGD is usually performed in a hospital endoscopy unit, outpatient surgical center, or specialized endoscopy clinic.
Personnel
- Gastroenterologist or surgeon specialized in endoscopic procedures
- Nurses or clinical assistants
- Anesthesiologist or nurse anesthetist (if sedation is used)
Risks and Complications
- Bleeding at the site of removal
- Perforation of the esophagus, stomach, or duodenum (rare)
- Infections
- Adverse reactions to sedation or anesthesia
- Post-procedure pain or discomfort
Benefits
- Immediate removal of abnormal growths
- Relief from symptoms caused by the lesions, such as pain or bleeding
- Early detection and intervention of potentially cancerous growths
- Provides diagnostic information that can guide further treatments
Recovery
- Observational period immediately post-procedure for any immediate complications
- Instructions to rest and avoid certain activities for the first 24 hours
- Possible dietary and medication adjustments
- Follow-up appointment for results and further care planning
Alternatives
- Medical therapy for symptomatic relief (e.g., medications for GERD)
- Non-endoscopic imaging techniques like barium swallow or CT scans (diagnostic but not therapeutic)
- Surgical removal of lesions (in more complex cases)
Patient Experience
During the procedure, the patient may feel some pressure but should not feel pain due to sedation. Post-procedure, there might be a mild sore throat, bloating, or cramping. Pain management options and comfort measures include mild analgesics and rest.
This markdown provides a comprehensive yet straightforward description of the EGD procedure involving the removal of lesions using hot biopsy forceps, covering all essential aspects from preparation to recovery.