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Laparoscopy, surgical; partial nephrectomy

CPT4 code

Name of the Procedure:

Laparoscopy, surgical; partial nephrectomy

  • Common Name: Laparoscopic Partial Nephrectomy
  • Medical Term: Minimally Invasive Partial Nephrectomy

Summary

Laparoscopic partial nephrectomy is a minimally invasive surgical procedure used to remove a portion of the kidney. This technique uses small incisions and a camera to guide the surgery, minimizing recovery time and reducing scarring compared to traditional open surgery.

Purpose

This procedure is typically performed to remove a tumor or damaged tissue while preserving as much of the healthy kidney as possible. The goal is to treat kidney cancer, benign kidney tumors, or localized kidney damage, enabling the kidney to function properly.

Indications

  • Kidney tumors (both malignant and benign)
  • Localized kidney damage or cysts
  • Patient has sufficient healthy kidney tissue that allows for partial removal
  • An alternative to total nephrectomy (total removal of a kidney)

Preparation

  • Fasting for 8 hours prior to surgery
  • Discontinuing certain medications as advised by the physician
  • Pre-operative tests like blood work, urine analysis, and imaging studies (CT scan, MRI)

Procedure Description

  1. The patient is placed under general anesthesia.
  2. Small incisions are made in the abdominal area.
  3. A laparoscope (a thin tube with a camera) and surgical instruments are inserted through these incisions.
  4. The surgeon views the inside of the abdomen on a monitor and carefully removes the diseased portion of the kidney.
  5. The incisions are closed with sutures or staples.
  6. The tissue removed is sent to a lab for pathological analysis.

Duration

The procedure typically takes 3 to 4 hours.

Setting

  • Hospital operating room
  • Specialized surgical center

Personnel

  • Urologist or general surgeon specialized in laparoscopic procedures
  • Anesthesiologist
  • Surgical nurses
  • Surgical technologist

Risks and Complications

  • Infection
  • Bleeding
  • Injury to surrounding organs or tissues
  • Blood clots
  • Anesthesia-related complications
  • Possible incomplete removal of the tumor
  • Urine leakage from the kidney

Benefits

  • Reduced recovery time compared to open surgery
  • Smaller incisions leading to less pain and scarring
  • Preservation of kidney function
  • Shorter hospital stay

Recovery

  • Hospital stay of 1-2 days depending on the patient's condition
  • Pain management with prescribed medications
  • Gradual return to normal activities within 2-4 weeks
  • Follow-up appointments to monitor kidney function and overall health
  • Avoiding heavy lifting and strenuous activity for several weeks

Alternatives

  • Open partial nephrectomy: more invasive with longer recovery time
  • Total nephrectomy: complete removal of the kidney, higher impact on kidney function
  • Ablation techniques (radiofrequency or cryoablation): non-surgical options for small tumors
  • Active surveillance for small, slow-growing tumors

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, there may be mild to moderate pain managed with medication. Patients typically experience some discomfort around the incision sites, mild abdominal pain, and possible bloating. Full recovery may take a few weeks, during which the patient should follow care instructions and attend follow-up appointments.

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