CPT® Code 43320

Esophagogastrostomy, also referred to as cardioplasty, is a surgical procedure that involves the creation of a connection between the esophagus and the stomach. This procedure can be performed with or without additional surgical interventions such as vagotomy, which involves cutting the vagus nerve to reduce stomach acid production, and pyloroplasty, which is the surgical widening of the pylorus to facilitate gastric drainage. The approach to this surgery can be either transabdominal, which involves accessing the abdominal cavity, or transthoracic, which involves entering the thoracic cavity through the chest. In a transthoracic approach, a right posterior thoracotomy is typically utilized, allowing the surgeon to access the esophagus while minimizing disruption to the pleura, the membrane surrounding the lungs. Conversely, the transabdominal approach, also known as a transhiatal approach, involves making an incision in the upper abdomen to explore the peritoneal cavity and mobilize the stomach at the gastroesophageal junction. This procedure is indicated for various conditions affecting the esophagus and stomach, and it requires careful dissection and manipulation of surrounding structures to ensure a successful anastomosis between the esophagus and the newly created gastric tube.