CPT® Code 43287

Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic esophagogastrostomy (ie, laparoscopic thoracoscopic esophagectomy, Ivor Lewis esophagectomy)

The CPT® Code 43287 refers to a complex surgical procedure known as a distal two-thirds esophagectomy, which is performed using laparoscopic techniques. This procedure involves the removal of the distal two-thirds of the esophagus, which is the muscular tube that connects the throat to the stomach, and is typically indicated for patients suffering from esophageal disease or resectable malignant tumors located in the middle to lower third of the esophagus and the gastroesophageal junction. The surgery is characterized by the laparoscopic mobilization of both the abdominal and lower mediastinal esophagus, as well as a proximal gastrectomy, which is the surgical removal of the upper portion of the stomach. If necessary, a laparoscopic pyloric drainage procedure may also be performed during this operation. In addition to the laparoscopic approach, the procedure includes a separate thoracoscopic mobilization of the middle and upper mediastinal esophagus, which involves accessing the esophagus through the chest cavity. This is followed by a thoracic esophagogastrostomy, where the remaining esophagus is connected to the gastric conduit that has been created from the stomach. The use of laparoscopic and thoracoscopic techniques allows for minimally invasive access, which can lead to reduced recovery times and less postoperative pain compared to traditional open surgery. Overall, this procedure is a critical intervention for managing significant esophageal conditions and requires a high level of surgical expertise.