Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Suture of each additional major peripheral nerve
Summary
This procedure involves the surgical repair of a major peripheral nerve using sutures. It is typically performed as an additional step to the primary nerve repair surgery, helping to restore function and reduce symptoms resulting from nerve damage.
Purpose
This procedure aims to repair damaged peripheral nerves that are responsible for transmitting signals between the central nervous system and the rest of the body. The goal is to restore nerve function, relieve pain, and improve mobility or sensation in the affected area.
Indications
- Nerve transection or severe injury.
- Persistent or debilitating pain due to nerve damage.
- Loss of motor function or sensation in an extremity.
- Recovery from nerve-related surgeries where additional nerve repair is beneficial.
Preparation
- Patients may be instructed to fast for a certain period before the procedure.
- Any medications that could increase bleeding risk, such as blood thinners, may need to be adjusted.
- Preoperative diagnostic tests like electromyography (EMG) or nerve conduction studies may be required to assess the extent of nerve damage.
Procedure Description
- The patient is typically placed under general anesthesia to ensure comfort and immobility.
- The surgeon will make an incision over the affected nerve site.
- Using fine instruments and a microscope, the damaged nerve ends are carefully aligned.
- The nerve ends are then sutured together using very fine sutures, often with the aid of magnification to ensure precision.
- The surgical site is closed with sutures, and a sterile dressing is applied.
Duration
The procedure typically takes 1 to 3 hours, depending on the number and complexity of the nerves being repaired.
Setting
This procedure is usually performed in a hospital operating room or an advanced outpatient surgical center.
Personnel
- Surgeon specializing in nerve repair or microsurgery.
- Surgical assistant.
- Anesthesiologist or nurse anesthetist.
- Operating room nurses.
Risks and Complications
- Infection at the surgical site.
- Nerve damage or failure of the nerve to heal properly.
- Scarring or adhesion formation.
- Temporary or permanent loss of sensation or motor function in the affected area.
- Anesthesia-related complications.
Benefits
- Restored nerve function, potentially reducing pain and improving sensation and motor abilities.
- Enhanced quality of life and ability to perform daily activities.
- Benefits may be realized gradually over several weeks to months as nerve healing progresses.
Recovery
- Patients may need to keep the operated area immobilized for a period of time.
- Pain management may include medications and physical therapy.
- Avoiding specific activities that could strain the repaired nerve is crucial.
- Follow-up appointments will monitor the progression of nerve healing and function.
Alternatives
- Conservative treatment options such as physical therapy and pain management.
- Less invasive procedures like nerve grafting or transfer might be considered.
- The pros and cons of alternatives depend on the severity of the nerve damage and the specific case.
Patient Experience
- During the procedure, the patient will be under anesthesia and unaware of the surgery.
- Post-surgery, some pain and swelling at the incision site are typical, managed by pain medications prescribed by the healthcare provider.
- Gradual improvement in nerve function can be expected, with close monitoring and support from the medical team for optimal recovery.