CPT® Code 38573

Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed

The procedure described by CPT® Code 38573 involves a laparoscopic surgical approach to perform a bilateral total pelvic lymphadenectomy, which is the removal of lymph nodes from both sides of the pelvis. This procedure may also include sampling of the para-aortic lymph nodes, which are located near the aorta, as well as various other interventions such as peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings. The laparoscopic technique is minimally invasive, utilizing small incisions to access the abdominal cavity, which allows for reduced recovery time and less postoperative pain compared to traditional open surgery. The surgeon begins by creating a small incision below the umbilicus to insert a trocar, through which a laparoscope is introduced to visualize the internal structures. Additional incisions are made to insert surgical instruments necessary for the procedure. The surgeon carefully inspects the peritoneal cavity for signs of metastatic disease, ensuring to preserve critical anatomical structures such as the genitofemoral nerve and psoas muscle. The fatty tissue surrounding the common iliac vessels is meticulously stripped to access and excise the lymph nodes bilaterally. The excised lymph nodes, along with surrounding tissue, are placed in an endobag for removal through a larger incision. The procedure may also involve taking biopsies of the para-aortic lymph nodes, which are then sent for frozen section analysis. If necessary, involved para-aortic lymph nodes are excised and removed in a similar manner. This comprehensive approach allows for thorough evaluation and treatment of potential malignancies in the pelvic and abdominal regions.