CPT® Code 43117

Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (Ivor Lewis)

The CPT® Code 43117 refers to a surgical procedure known as a partial esophagectomy, specifically targeting the distal two-thirds of the esophagus. This complex operation is performed through a thoracotomy, which involves making an incision in the chest, and a separate abdominal incision. The procedure may be conducted with or without a proximal gastrectomy, which is the surgical removal of the upper portion of the stomach, and may also include a pyloroplasty, a procedure that widens the opening of the pylorus to facilitate gastric drainage. The Ivor Lewis technique is commonly employed in this surgery, which is characterized by the creation of a thoracic esophagogastrostomy, where the remaining esophagus is connected to a gastric tube formed from the stomach. This procedure is typically indicated for patients with malignancies affecting the esophagus, necessitating the removal of the diseased tissue while ensuring the continuity of the gastrointestinal tract. The operation involves meticulous dissection and resection of the esophagus and potentially affected stomach tissue, followed by reconstruction to restore normal digestive function.