CPT® Code 35636

A splenorenal bypass graft using other than vein is a surgical procedure designed to create a new pathway for blood flow around a diseased or obstructed segment of the renal artery, which supplies blood to the kidney. This procedure is particularly important when the renal artery is compromised, as it can lead to reduced blood flow and potential kidney damage. The surgery involves making an incision in the abdomen to access the necessary vascular structures. During the operation, the surgeon evaluates the celiac axis, which includes the hepatic, left gastric, and splenic arteries, to ensure proper identification and isolation of the splenic artery. The descending duodenum is mobilized to provide better access to the inferior vena cava and renal vein, which are critical landmarks in this procedure. A synthetic graft, rather than a vein, is used to create the bypass, which is essential for restoring adequate blood flow to the kidney. The graft is meticulously sutured in an end-to-side configuration to both the splenic artery and the renal artery, allowing blood to bypass the obstructed area. After the graft is in place, vascular clamps are released, and the blood flow through the graft is assessed using Doppler ultrasound to confirm the success of the procedure.