49325 Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed

Name of the Procedure:

Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed

Summary

This procedure involves the use of a laparoscope (a small camera) to examine the abdominal cavity and surgically revise a previously placed cannula or catheter. If there is any obstructive material within the catheter, it is removed during the procedure.

Purpose

This procedure addresses issues related to previously placed intraperitoneal cannulas or catheters, such as blockages or malposition. The goal is to restore the function of these devices and ensure they are correctly positioned within the abdominal cavity.

Indications

• Blockage or obstruction of an intraperitoneal catheter
• Displacement or malfunction of a previously placed cannula or catheter
• Symptoms such as abdominal pain, swelling, or infection at the catheter site
• Diagnostic imaging indicating catheter issues

Preparation

• Patients may be instructed to fast for 6-8 hours before the procedure.
• Medications may need to be adjusted or paused, particularly blood thinners.
• Pre-procedure diagnostic tests, such as blood tests, imaging (CT scan, ultrasound), or infection screenings, might be required.

Procedure Description

1. The patient is positioned and given general anesthesia for sedation.
2. Small incisions are made in the abdominal area.
3. A laparoscope is inserted through one of the incisions to provide a visual guide.
4. Surgical instruments are used to access the previously placed cannula or catheter.
5. The catheter or cannula is revised or repositioned as needed.
6. Any obstructive material within the catheter is removed.
7. The surgical site is inspected for complications.
8. Incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes 1-2 hours, depending on the complexity.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon (usually a general surgeon or a specialist)
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection at the incision site or within the abdominal cavity
• Bleeding or hematoma
• Damage to surrounding organs or tissues
• Anesthesia-related complications
• Postoperative pain or discomfort
• Possible need for additional surgery if complications arise

Benefits

• Restoration of catheter function
• Relief from symptoms associated with catheter blockage or malfunction
• Reduced risk of infection and other complications related to a faulty catheter
• Improved overall patient comfort and quality of life

Recovery

• Patients may need to stay in the hospital for observation for a day or two.
• Pain management typically involves prescribed analgesics.
• Patients are advised to avoid strenuous activities for a few weeks.
• Follow-up appointments are scheduled to monitor recovery and catheter function.

Alternatives

• Non-surgical management, such as clearing the obstruction with medication
• Replacement of the catheter without laparoscopy
• Imaging-guided repositioning
• Each alternative varies in terms of invasiveness, effectiveness, and recovery time.

Patient Experience

Patients may feel soreness at the incision sites and some abdominal discomfort post-surgery. Pain is usually managed with medications. Recovery involves gradual resumption of normal activities, with care taken to avoid straining the surgical area. Regular follow-ups ensure the catheter remains functional and complications are promptly addressed.