CPT® Code 43288

Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, thoracoscopic, laparoscopic and cervical incision esophagectomy, McKeown esophagectomy, tri-incisional esophagectomy)

The procedure described by CPT® Code 43288 refers to a total or near total esophagectomy, which is a surgical operation involving the removal of a significant portion of the esophagus. This procedure is performed using thoracoscopic techniques, which involve the use of a thoracoscope to access the thoracic cavity, allowing for minimally invasive surgery. The esophagus is mobilized in the upper, middle, and lower mediastinal regions, which are the spaces in the chest that contain the esophagus, trachea, heart, and major blood vessels. Additionally, a separate laparoscopic proximal gastrectomy may be performed, which involves the removal of the upper part of the stomach, and if indicated, a laparoscopic pyloric drainage procedure may also be included. The surgery may culminate in an open cervical pharyngogastrostomy or esophagogastrostomy, which are procedures that connect the remaining esophagus or the gastric conduit to the pharynx, allowing for the passage of food. This complex surgical intervention is typically indicated for patients with locally advanced esophageal cancers located in the mid to distal sections of the esophagus. The procedure requires careful positioning of the patient, typically in a left lateral position, and involves multiple surgical steps to ensure the safe and effective removal of the esophagus and reconstruction of the digestive tract. The use of thoracoscopic and laparoscopic techniques aims to minimize recovery time and postoperative complications compared to traditional open surgery.