CPT® Code 38100

A total splenectomy, designated by CPT® code 38100, is a surgical procedure that involves the complete removal of the spleen. This procedure is typically indicated in cases where the spleen is significantly enlarged, ruptured, or affected by disease. The surgery begins with an incision in the abdomen, allowing the surgeon to access and expose the spleen. Once exposed, the spleen is carefully mobilized and displaced medially to provide a clear view of the surrounding ligaments, specifically the splenorenal, splenocolic, and gastrosplenic ligaments. In situations where the spleen is enlarged or ruptured, the surgeon first locates and ligates the splenic artery to minimize the risk of hemorrhage and to facilitate the removal of the spleen. If the spleen is not significantly compromised, the ligaments are ligated and divided before the splenic artery is tied off. Following this, both the splenic artery and vein are visualized, ligated, and divided to ensure complete detachment of the spleen from its vascular supply. After the spleen is removed, the surgical site is meticulously inspected for any signs of bleeding, particularly in the splenic pedicle and retroperitoneal space. Any bleeding that is identified is controlled using electrocautery or by suturing blood vessels. Finally, the wound is irrigated to prevent infection, and the abdomen is closed. This procedure is distinct from a partial splenectomy, which involves the removal of only a portion of the spleen, and an en bloc total splenectomy, which is performed in conjunction with other surgical procedures for extensive disease. The total splenectomy is a critical intervention that can significantly impact a patient's health, particularly in managing conditions related to splenic dysfunction or trauma.