CPT® Code 38571

The procedure described by CPT® Code 38571 involves a laparoscopic surgical technique for performing a bilateral total pelvic lymphadenectomy. This procedure is typically indicated for patients with certain malignancies, where the removal of lymph nodes is necessary to assess or treat cancer spread. The term "laparoscopy" refers to a minimally invasive surgical approach that utilizes small incisions and specialized instruments, including a laparoscope, which is a camera that allows the surgeon to visualize the internal structures of the abdomen and pelvis. During the procedure, the surgeon makes a small incision just below the umbilicus to insert a trocar, which facilitates the establishment of pneumoperitoneum, a condition where gas is introduced into the abdominal cavity to create space for surgical manipulation. Once the laparoscope is introduced through the umbilical port, additional incisions are made to insert other trocars for surgical instruments. The surgeon inspects the peritoneal cavity and explores the abdomen and pelvis for any signs of metastatic disease. Care is taken to preserve critical anatomical structures, such as the genitofemoral nerve and the psoas muscle, while fatty tissue is carefully stripped from the common iliac vessels and along the internal and external iliac vessels. The procedure culminates in the excision of the iliac, hypogastric, and obturator lymph nodes bilaterally, which are then placed in an endobag for removal through an enlarged incision. Additionally, the procedure may involve the exposure and biopsy of para-aortic lymph nodes, with any involved nodes being excised and removed in a similar manner. This comprehensive approach allows for thorough evaluation and treatment of potential lymphatic spread of cancer.