CPT® Code 43116

Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction

The CPT® Code 43116 refers to a surgical procedure known as a partial esophagectomy, specifically performed in the cervical region. This complex operation involves the removal of a portion of the esophagus and the use of a free intestinal graft, which is typically a segment of the jejunum, to reconstruct the esophagus. The procedure is characterized by several key components: obtaining the intestinal graft, performing microvascular anastomosis, and reconstructing the intestines. The cervical esophagectomy is primarily indicated for patients with malignant neoplasms confined to the cervical area, although it may also be utilized in cases of benign strictures of the esophagus. During the procedure, an incision is made in the neck, usually on the left side, allowing access to the internal jugular vein and carotid artery, which are carefully retracted to expose the cervical esophagus. A second incision is made in the abdomen to harvest the intestinal graft, where a segment of the jejunum is identified and prepared for removal. The surgical team meticulously dissects the blood vessels supplying the jejunal segment, ensuring that the graft can be properly vascularized once placed in the neck. The procedure requires precise coordination among the surgical team, which may include a general surgeon, a head and neck surgeon, and a microvascular surgeon, to ensure successful graft placement and anastomosis. Overall, this procedure is a critical intervention for restoring esophageal continuity in patients with significant esophageal pathology.