CPT® Code 43045

The procedure described by CPT® Code 43045 refers to an esophagotomy performed via a thoracic approach, specifically involving the removal of a foreign body from the esophagus. In this surgical intervention, the esophagus is accessed through a right posterior thoracotomy, which is a surgical incision made in the back of the chest. This approach allows the surgeon to reach the esophagus while minimizing disruption to surrounding structures. The procedure begins with an incision in the skin, which is then extended through the underlying soft tissues. The scapula, or shoulder blade, is retracted to provide adequate access to the thoracic cavity without damaging the pleura, the membrane surrounding the lungs. Once the thorax is entered, retropleural dissection is performed, which involves carefully separating the tissues behind the pleura to gain access to the esophagus. The lung is retracted to further expose the esophagus, allowing the surgeon to locate the foreign body that is either incarcerated or impacted within the esophageal lumen. An incision is made in the esophagus at the site of the foreign body, enabling the surgeon to grasp the object with forceps and remove it carefully. After the foreign body is extracted, the esophagus is thoroughly inspected for any signs of tearing or injury, and repairs are made as necessary to ensure the integrity of the esophageal wall. Finally, the incision in the esophagus is closed, and the thoracic cavity is closed in a layered manner to promote proper healing and recovery.