Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)
CPT4 code
Name of the Procedure:
Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection
Summary
This procedure involves placing a mesh or prosthetic material to repair an incisional or ventral hernia (a type of abdominal hernia) or to close an area debrided due to a severe soft tissue infection. The mesh reinforces the abdominal wall, providing additional support and reducing the risk of recurrence.
Purpose
The procedure addresses weaknesses or defects in the abdominal wall, often caused by previous surgeries or infections. The main goal is to provide long-term support to the affected area, ensuring proper healing and preventing the hernia or infection from recurring.
Indications
- Presence of an incisional or ventral hernia.
- Necrotizing soft tissue infection requiring debridement.
- Patients experiencing pain, discomfort, or complications related to an abdominal wall defect.
- Previous attempts at hernia repair that have failed.
Preparation
- Fasting for a certain period before the procedure, usually 6-8 hours.
- Adjustments to medications, particularly blood thinners or anti-inflammatory drugs.
- Preoperative imaging studies like CT scans or ultrasounds.
- Blood tests and other routine assessments to ensure the patient’s suitability for surgery.
Procedure Description
- The patient is positioned and sterile draping is applied.
- General anesthesia is administered to ensure the patient is asleep and pain-free during the procedure.
- A surgical incision is made at the site of the hernia or infection.
- The herniated tissue is pushed back into place, and any infected tissue is carefully removed (debridement).
- A mesh or prosthetic material is positioned over or within the defect to provide reinforcement.
- The mesh is secured with sutures, tacks, or other fixation devices.
- The incision is closed using sutures or staples.
Duration
The procedure typically takes about 1 to 3 hours, depending on the complexity of the case.
Setting
The procedure is typically performed in a hospital operating room.
Personnel
- Surgeon specializing in general or abdominal surgery.
- Surgical nurses and technicians.
- Anesthesiologist or nurse anesthetist.
Risks and Complications
- Infection at the surgical site.
- Bleeding or blood clots.
- Recurrence of the hernia or infection.
- Mesh-related complications such as rejection or migration.
- Adverse reactions to anesthesia.
Benefits
- Strengthening of the abdominal wall and reduction in hernia recurrence.
- Improved recovery from necrotizing soft tissue infection.
- Relief from pain and other symptoms associated with hernias and infections.
- Enhanced quality of life and physical function.
Recovery
- Hospital stay of 1-3 days post-surgery, depending on the patient’s condition.
- Instructions for wound care and activity restrictions.
- Pain management through prescribed medications.
- Gradual return to normal activities over 4-6 weeks.
- Follow-up appointments for monitoring and stitch removal.
Alternatives
- Non-surgical management with watchful waiting and lifestyle modifications (e.g., weight loss, avoiding heavy lifting).
- Laparoscopic hernia repair as a less invasive surgical option.
- Use of natural tissue for repair in cases unsuitable for mesh.
Patient Experience
- Patients can expect to feel some pain and discomfort at the surgical site, which will be managed with medications.
- Sensation of tightness or pulling in the abdominal area.
- Gradual improvement in symptoms within the first few weeks post-surgery.
- Guidance and support from healthcare providers for optimal recovery.