CPT® Code 43210

Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed

Esophagogastroduodenoscopy, flexible, transoral, with esophagogastric fundoplasty, is a minimally invasive surgical procedure designed to reconstruct a defective gastroesophageal valve. This procedure is particularly relevant for patients suffering from gastroesophageal reflux disease (GERD), which may be exacerbated by the presence of a hiatal hernia. The technique involves the use of a specialized endoscope that is inserted through the mouth and navigated down the esophagus into the stomach. This endoscope is equipped with various tools, including an invaginator, tissue mold, chassis, helical retractor, stylet, and fasteners, which facilitate the reconstruction of the gastroesophageal junction. During the procedure, the stomach is inflated to allow for better visualization and manipulation of the tissues. The invaginator plays a crucial role in retracting the surrounding tissue, which aids in reducing any hernia present and ensures the proper positioning of the fundoplication. The procedure culminates in the creation of a tight, omega-shaped valve that effectively prevents the backflow of stomach contents into the esophagus, thereby alleviating symptoms associated with GERD. Additionally, the procedure may include an examination of the duodenum to assess any further gastrointestinal issues. The careful inspection of the surgical site for bleeding before the removal of the endoscope is a critical step in ensuring patient safety and procedural success.