CPT® Code 37145

The procedure described by CPT® Code 37145 involves a surgical technique known as venous anastomosis, specifically an open renoportal anastomosis. This procedure is also commonly referred to as a renoportal or portorenal shunt. It is a specialized surgical intervention that creates a connection between the portal vein and the renal vein, allowing for the diversion of blood flow. The renoportal shunt is utilized in specific clinical scenarios, although it is considered a rare procedure. The surgical approach requires an incision in the abdomen to access the necessary anatomical structures. The hepatoduodenal ligament is identified to facilitate exposure of the portal vein, which runs from the hilum of the liver to the pancreas. In cases where further exposure of the portal vein is necessary, the surgeon may divide the gastroduodenal and right gastric branches. Ultimately, the selected renal vein is carefully exposed, and the portal vein is anastomosed to the renal vein, establishing the desired venous connection. This procedure is typically performed in a controlled surgical environment and requires a thorough understanding of the vascular anatomy involved.