CPT® Code 19367

The procedure described by CPT® Code 19367 involves breast reconstruction utilizing a single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap. This surgical technique is designed to restore the shape and appearance of the breast following mastectomy, which may be performed either immediately after the mastectomy or at a later date, depending on the patient's treatment plan. The TRAM flap is composed of skin, fat, and muscle tissue that is harvested from the abdominal area and then transplanted to the chest to create a new breast mound. The procedure begins with the patient standing, allowing for precise marking of the abdomen to optimize the flap's vascular supply. An incision is made along these markings, carefully dissecting down to the aponeurotic plane of the abdominal muscles. The surgical team takes special care to preserve the superior epigastric artery, which is crucial for maintaining blood flow to the flap. The dissection continues to ensure that the flap is adequately sized and shaped for successful transplantation, while also minimizing disruption to the abdominal muscles to preserve function. The final steps involve securing the flap in place on the chest, ensuring proper blood flow, and closing the incisions in a manner that promotes healing and aesthetic outcomes.