CPT® Code 32654

Thoracoscopy, surgical; with control of traumatic hemorrhage, is a minimally invasive procedure aimed at managing significant bleeding within the thoracic cavity. This procedure is commonly known as video-assisted thoracoscopic surgery (VATS). It involves the use of a thoracoscope, a specialized instrument equipped with a camera, which allows the surgeon to visualize the thoracic cavity without the need for large incisions. The procedure typically begins with a small incision made in the posterolateral area of the chest, usually between the fifth or sixth ribs, just below the scapula. This incision allows for the insertion of a trocar, through which the thoracoscope is introduced. Once inside, the surgeon can aspirate blood and fluid from the thorax, facilitating a thorough exploration of the thoracic cavity to identify any potential injuries to the cardiovascular system or other structures that may necessitate a more invasive approach, such as thoracotomy. In cases of blunt trauma, the source of bleeding is often traced back to injuries involving the intercostal vessels or lung lacerations, while perforating trauma may lead to damage in the mediastinum or other thoracic tissues. To effectively control the bleeding, the surgeon may utilize diathermy, clips, or staples, and may place chest tubes as required to ensure proper drainage. The procedure concludes with the closure of the incisions, promoting recovery and minimizing complications.