CPT® Code 39530

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The procedure described by CPT® Code 39530 involves the surgical repair of a diaphragmatic hernia, specifically an esophageal hiatal hernia, utilizing a combined thoracoabdominal approach. This type of hernia occurs when the esophageal hiatus, the opening in the diaphragm through which the esophagus passes from the chest into the abdomen, becomes enlarged. This enlargement allows a portion of the upper stomach to protrude into the chest cavity, which can lead to various complications. The combined thoracoabdominal approach is particularly indicated for patients who have previously undergone diaphragmatic hernia surgery or for those presenting with an irreducible hernia, which cannot be pushed back into the abdomen. The surgical technique involves both a left posterolateral thoracotomy, which provides access to the esophagus, and an upper abdominal incision, which allows for direct access to the diaphragm and stomach. This dual approach facilitates simultaneous dissection in both the upper abdomen and left chest, enabling the surgeon to effectively excise the hernia sac and address any associated anatomical issues. The procedure is comprehensive, addressing not only the hernia itself but also any potential complications such as strictures at the esophagogastric junction, ensuring a thorough and effective repair.