Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site
CPT4 code
Name of the Procedure:
Pathology Consultation During Surgery; Cytologic Examination (e.g., touch prep, squash prep)
Summary
This procedure involves the rapid examination of cells taken from a surgical site while the surgery is ongoing. Techniques like touch prep or squash prep are used to prepare cell samples for immediate microscopic examination by a pathologist.
Purpose
This procedure aims to provide rapid diagnostic information during surgery to guide the surgeon. It can confirm if a tumor is malignant or benign, check if the surgical margins are clear of disease, and help decide the next steps in the surgery.
Indications
- Suspicion of malignancy during surgery
- Need to determine tumor type quickly
- Ensuring complete removal of cancerous tissue
- Immediate tissue diagnosis to guide surgical decisions
Patient criteria:
- Undergoing surgery where rapid diagnosis can influence the surgical outcome
- Suspected cancer or unclear tissue pathology that needs quick evaluation
Preparation
- Patient undergoes standard surgical preparation, which could include fasting and medication adjustments.
- Pre-surgical imaging or biopsy might be done to guide the surgery.
Procedure Description
- A sample of tissue is taken from the surgical site.
- The tissue is gently touched or squashed onto a glass slide (touch/squash prep).
- The slide is quickly stained to highlight cellular details.
- A pathologist examines the slides under a microscope in the operating room or a nearby lab.
- The pathologist communicates the findings to the surgical team.
Tools and equipment:
- Glass slides, staining solutions, microscope.
Anesthesia:
- General or regional anesthesia as part of the ongoing surgery.
Duration
The cytologic examination itself takes approximately 15-30 minutes.
Setting
Performed in an operating room with immediate access to a pathology lab.
Personnel
- Surgeons
- Surgical nurses
- Pathologist
- Anesthesiologists (if applicable)
Risks and Complications
- Minimal risks directly related to the cytology procedure itself.
- Standard surgical risks include infection, bleeding, and anesthesia complications.
Benefits
- Rapid diagnosis can guide immediate surgical decision-making.
- Helps in achieving clear surgical margins, reducing the need for repeat surgeries.
- Can provide peace of mind by confirming diagnoses quickly.
Recovery
- No specific recovery process related to the cytologic examination.
- Recovery follows the standard post-surgical care plan.
- Follow-up appointments to discuss pathology results and next steps.
Alternatives
- Frozen section analysis, which is another rapid diagnostic procedure but involves freezing and slicing tissue.
- Waiting for postoperative pathology results, which can delay further treatment plans.
Patient Experience
- The patient will be under anesthesia during the procedure.
- Post-surgery, the patient might not directly experience the cytologic examination but will benefit from the immediate diagnostic information it provides.
- Pain management will follow standard postoperative care practices.