49323 Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity

Name of the Procedure:

Laparoscopy, Surgical; with Drainage of Lymphocele to Peritoneal Cavity
Common Name(s): Laparoscopic Lymphocele Drainage

Summary

Laparoscopic lymphocele drainage is a minimally invasive surgical procedure used to remove excess lymphatic fluid from a lymphocele, a fluid-filled sac caused by a leakage of lymph, into the peritoneal cavity.

Purpose

Lymphoceles can cause pain, swelling, and infection if left untreated. The procedure aims to drain this fluid to alleviate symptoms, prevent complications, and restore normal body function.

Indications

• Presence of a lymphocele causing pain or discomfort.
• Infection within the lymphocele.
• Lymphocele causing obstruction or pressure on nearby organs.
• Persistent or recurrent lymphoceles that have not responded to conservative treatment.

Preparation

• The patient may need to fast for 8 hours before the procedure.
• Medication adjustments may be necessary, including anticoagulants.
• Pre-procedure assessments might include blood tests, imaging studies, and medical history review.

Procedure Description

1. Anesthesia: The patient is given general anesthesia.
2. Incisions: Small incisions are made in the abdomen.
3. Insertion of Trocar: A trocar (a specialized surgical instrument) and a camera are inserted through the incisions.
4. Visual Inspection: The surgeon uses the camera to locate the lymphocele.
5. Drainage: A drainage tube is inserted into the lymphocele, allowing fluid to be transferred to the peritoneal cavity.
6. Closure: The incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Performed in a hospital or specialized surgical center.

Personnel

• Surgeons (typically specialized in laparoscopic surgery)
• Surgical nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding organs
• Adhesions or scar tissue formation
• Anesthetic complications
• Risk of lymphocele recurrence

Benefits

• Relief from pain and discomfort caused by lymphoceles
• Reduced risk of infection and other complications
• Improved quality of life post-procedure
• Typically minimal scarring due to small incisions
• Quick recovery time compared to open surgery

Recovery

• Patients may stay in the hospital for 1-2 days.
• Post-procedure instructions include managing incision sites, activity restrictions, and signs of complications.
• Normal activities can often be resumed within 1-2 weeks, subject to surgeon's advice.

Alternatives

• Aspiration (needle drainage) of the lymphocele
• Sclerotherapy (injection of a sclerosing agent to collapse the lymphocele)
• Conservative management, including watchful waiting Pros and cons: Less invasive alternatives might be less effective or result in recurrence, whereas open surgery has a longer recovery time but may provide a more definitive solution.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel pain. Post-procedure, some discomfort, pain at incision sites, and bloating can be expected, managed with pain medication and rest. Most patients experience significant symptom relief within a few weeks.