Orchiectomy, radical, for tumor; inguinal approach
CPT4 code
Name of the Procedure:
Radical Orchiectomy, Inguinal Approach
Common names: Testicle removal surgery for cancer, Testicular cancer surgery
Summary
A radical orchiectomy is a surgical procedure in which one or both testicles are removed through an incision in the groin. This approach is often used when a tumor is present and allows the surgeon to remove the testicle and spermatic cord for thorough examination and treatment.
Purpose
The primary purpose of a radical orchiectomy is to treat testicular cancer. By removing the affected testicle and spermatic cord, the procedure aims to prevent the spread of cancer and accurately stage the disease, which helps guide further treatment.
Indications
- Presence of a testicular tumor or mass
- Diagnosis of testicular cancer
- Acute symptoms such as severe pain or swelling in the testicle
- Elevated tumor markers indicating potential malignancy
Preparation
- Patients may need to fast (no food or drink) for at least 8 hours before the procedure.
- Adjustments to regular medications may be necessary, especially blood thinners.
- Pre-operative blood tests, imaging studies (like an ultrasound or CT scan), and physical exams will be conducted.
- Patients will receive specific instructions from their healthcare team regarding the day of surgery.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free during the surgery.
- Incision: A small incision is made in the groin area (inguinal region).
- Testicle Removal: The affected testicle and spermatic cord are carefully separated from surrounding tissues and removed.
- Closure: The incision is then closed with sutures or surgical staples, and a sterile dressing is applied.
- Pathology: The removed tissue is sent to a laboratory for pathological examination to determine the type and stage of cancer.
Duration
The procedure typically takes about 45 minutes to 1 hour, not including prep and recovery time.
Setting
Radical orchiectomy is commonly performed in a hospital or surgical center operating room.
Personnel
- Surgeons
- Surgical assistants
- Anesthesiologists
- Operating room nurses
- Pathologists (for tissue examination)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Reactions to anesthesia
- Damage to nearby structures (e.g., blood vessels, nerves)
- Scarring or changes in scrotal appearance
- Fertility issues if both testicles are removed
Benefits
- Removal of cancerous tissue, which can prevent the spread of cancer
- Accurate staging of testicular cancer for further treatment plans
- Alleviation of symptoms such as pain or swelling
Recovery
- Patients typically go home the same day or after an overnight stay.
- Pain management with prescribed medications.
- Instructions to avoid strenuous activities, heavy lifting, and sexual activity for a few weeks.
- Follow-up appointments to monitor the surgical site and discuss pathology results.
Alternatives
- Surveillance or watchful waiting for small, non-aggressive tumors.
- Chemotherapy or radiation therapy for certain types and stages of cancer.
- Less invasive procedures such as partial orchiectomy, though generally not recommended for malignant tumors.
Patient Experience
- Post-surgery, patients may experience pain and swelling in the groin area, which can be managed with pain relief medications.
- Sensations of discomfort during the healing process.
- Emotional or psychological impacts due to changes in body image or concerns about fertility and hormones.
- Regular follow-ups and supportive care for optimal recovery and cancer management.