Name of the Procedure:

Common Name: Retrieval Device Insertion
Technical/Medical Term: Insertable Retrieval Device for Fractured Medical Devices (HCPCS: C1773)

Summary

The procedure involves inserting a specialized device to retrieve fractured or broken medical devices that remain inside the body. This is often necessary when a medical device, like a catheter or stent, breaks and fragments inside the body, requiring careful removal to prevent further complications.

Purpose

The procedure addresses the issue of broken or fractured medical devices inside the body which could cause damage or infection if left unattended. The goal is to safely and effectively remove the broken fragments to restore normal body function and avoid potential complications.

Indications

• Fractured or broken medical devices inside the body (e.g., catheters, stents, guidewires)
• Symptoms of device fragmentation such as pain, infection, or impaired function
• Radiological evidence of device fragment presence
• Patients at risk of complications from retained device fragments

Preparation

• Patients may be instructed to fast for a certain period prior to the procedure.
• Specific medication adjustments may be required, such as stopping blood thinners.
• Pre-procedure diagnostic tests might include imaging studies (e.g., X-ray, MRI) to locate the fragments accurately.

Procedure Description

1. The patient will be positioned appropriately, and the site of insertion will be sterilized.
2. Local or general anesthesia may be administered depending on the complexity of the procedure.
3. A specialized retrieval device is inserted through a small incision or through an existing access point.
4. Using imaging guidance (e.g., fluoroscopy), the device is navigated to the location of the fragments.
5. The fractured pieces are carefully captured using the retrieval device and removed from the body.
6. The site of insertion is then closed and bandaged.

Duration

The procedure typically takes between 30 minutes to 2 hours, depending on the location and complexity of the fragments.

Setting

The procedure is usually performed in a hospital interventional radiology suite, outpatient clinic, or surgical center equipped with the necessary imaging technology.

Personnel

• Interventional Radiologist or Surgeon
• Nurses or Technicians
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Common risks: bleeding, infection, bruising at the insertion site
• Rare risks: damage to surrounding tissues or organs, incomplete retrieval requiring additional procedures
• Complications are managed with appropriate medical interventions and monitoring.

Benefits

• Successful removal of hazardous fragmented devices
• Relief from pain or symptoms caused by retained fragments
• Prevention of potential complications like infection or further tissue damage
• Benefits are often realized immediately after the procedure is completed.

Recovery

• Post-procedure care includes monitoring for any immediate complications and managing pain at the incision site.
• Instructions might include avoiding strenuous activities for a few days.
• Recovery time typically ranges from a few days to a week.
• Follow-up appointments are scheduled to ensure proper healing and device fragment removal confirmation.

Alternatives

• Conservative management, regularly monitoring the fragment
• Surgery to remove the fragment, which might involve more significant risks and recovery time
• Endoscopic procedures, if fragments are accessible via natural body openings
• Pros of the retrieval device insertion include less invasiveness and quicker recovery compared to surgical options.

Patient Experience

• During the procedure, patients are usually under local or general anesthesia and should feel minimal discomfort.
• Post-procedure, there may be some pain or tenderness at the insertion site, usually managed with prescribed pain relievers.
• Most patients are able to return to normal activities relatively quickly, with specific instructions from their healthcare provider.