CPT® Code 43338

Add-On Code

Esophageal lengthening procedure (eg, Collis gastroplasty or wedge gastroplasty) (List separately in addition to code for primary procedure)

The esophageal lengthening procedure, as described by CPT® Code 43338, refers to surgical techniques such as Collis gastroplasty or wedge gastroplasty that are performed to extend the length of the esophagus. This procedure is typically indicated during a separate open surgical intervention for a hiatal hernia. The primary goal of the esophageal lengthening is to facilitate the proper alignment and function of the esophagus in relation to the stomach, particularly when addressing complications associated with gastroesophageal reflux disease (GERD) or other anatomical abnormalities. During the procedure, careful dissection is performed to remove the gastroesophageal fat pad while preserving the vagal nerves, which are crucial for maintaining gastrointestinal motility and function. The use of a dilator, or bougie, is essential for guiding the surgical instruments and ensuring the correct positioning of the esophagus and stomach. The procedure culminates in the creation of a neoesophagus, which is a newly formed segment of the esophagus, and a new angle of His, which is the angle formed between the esophagus and the stomach. This surgical intervention is performed in conjunction with a primary procedure, often involving fundoplication, to secure the esophagus and prevent reflux, thereby enhancing the overall effectiveness of the surgical treatment for hiatal hernia and related conditions.