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Biopsy of stomach, by laparotomy

CPT4 code

Name of the Procedure:

Biopsy of Stomach by Laparotomy
Common Names: Stomach Biopsy, Laparotomy-Based Gastric Biopsy
Technical Terms: Gastric Biopsy via Laparotomy, Surgical Stomach Biopsy

Summary

A biopsy of the stomach by laparotomy is a surgical procedure where a sample of tissue from the stomach is removed through an incision in the abdomen. This allows the doctor to examine the tissue under a microscope to diagnose or rule out certain medical conditions.

Purpose

This procedure helps diagnose diseases of the stomach, including cancers, ulcers, and other abnormalities. The goals are to identify the cause of symptoms, determine the extent and nature of a disease, and formulate an effective treatment plan.

Indications

  • Unexplained stomach pain
  • Suspicion of stomach cancer
  • Persistent nausea or vomiting
  • Unexplained weight loss
  • Gastrointestinal bleeding
  • Abnormal imaging or endoscopy results

Preparation

  • Fasting for at least 8 hours before the procedure.
  • Adjusting or stopping certain medications as advised by the doctor.
  • Undergoing pre-operative diagnostic tests such as blood tests, imaging studies, and pre-anesthesia assessments.

Procedure Description

  1. The patient is given general anesthesia to ensure they are asleep and pain-free.
  2. A surgical incision is made in the abdomen to access the stomach.
  3. The surgeon identifies the area of the stomach from which the biopsy will be taken.
  4. A small tissue sample is removed from the stomach.
  5. The tissue sample is sent to a laboratory for microscopic examination.
  6. The surgical incision is closed with sutures or staples.
  7. The patient is monitored in the recovery area until fully awake and stable.

Duration

The procedure typically takes about 1 to 2 hours, although this can vary depending on the complexity of the case.

Setting

Performed in a hospital setting, usually in an operating room.

Personnel

  • Surgeon
  • Anesthesiologist
  • Surgical nurses
  • Operating room technician
  • Pathologist (for examination of the biopsy)

Risks and Complications

  • Infection at the incision site
  • Bleeding
  • Adverse reaction to anesthesia
  • Injury to surrounding organs
  • Post-operative pain and discomfort
  • Rarely, complications like hernias or adhesions may develop

Benefits

  • Accurate diagnosis of stomach conditions
  • Identification of malignancies or benign abnormalities
  • Formulation of an effective treatment plan
  • Potential to alleviate symptoms once the underlying issue is identified

Recovery

  • Hospital stay for 1-2 days for monitoring.
  • Pain management with prescribed medications.
  • Gradual reintroduction of regular activities, typically within 2-4 weeks.
  • Follow-up appointments to monitor healing and discuss biopsy results.

Alternatives

  • Endoscopic biopsy (less invasive but may not always suffice)
  • Imaging tests (less diagnostic accuracy compared to biopsy)
  • Non-surgical management and observation (appropriate in certain cases)

Patient Experience

During the procedure, the patient will feel no pain due to general anesthesia. Post-operatively, there may be some pain and discomfort at the incision site managed with medications. Patients can expect some restrictions on physical activity as they recover and should follow specific dietary and care instructions to ensure proper healing.

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