CPT® Code 38120

A laparoscopic splenectomy, as described by CPT® Code 38120, is a minimally invasive surgical procedure aimed at the removal of the spleen. This procedure utilizes laparoscopy, which involves the use of a laparoscope—a thin, lighted tube equipped with a camera—to visualize the abdominal cavity. The operation begins with the placement of trocars, which are specialized instruments that create small incisions in the abdominal wall. Through these incisions, a pneumoperitoneum, or gas inflation of the abdominal cavity, is established to provide a working space for the surgeon. The laparoscope is then inserted to allow for exploration of the abdominal cavity. During the procedure, a retractor is used to lift the inferior aspect of the spleen, facilitating access to the surrounding structures. The splenorenal and splenocolic ligaments, which are connective tissues that anchor the spleen, are carefully divided to free the spleen from its attachments. The dissection continues in a superior and lateral direction to fully expose the posterior aspect of the splenic hilum, which is the area where blood vessels and lymphatics enter and exit the spleen. Once the spleen is completely mobilized, a surgical stapler is employed to transect the splenic hilum, effectively cutting off its blood supply. As needed, the short gastric vessels, which supply blood to the upper part of the stomach and the spleen, are also divided. After detaching the spleen, the procedure involves enlarging the incision made by the most lateral trocar to accommodate a larger trocar for specimen retrieval. A specimen retrieval bag is then inserted through this enlarged trocar site to safely contain the spleen, which is sectioned into smaller pieces for removal. Following the extraction of the spleen, a drain may be placed in the abdominal cavity to prevent fluid accumulation. The surgical instruments are then removed, the abdomen is deflated, and the trocars are taken out. Finally, the incisions are closed, completing the laparoscopic splenectomy.