CPT® Code 43401

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The CPT® Code 43401 refers to the surgical procedure known as transection of the esophagus with repair, specifically performed for the treatment of esophageal varices. Esophageal varices are enlarged veins in the esophagus that can rupture and cause significant bleeding, often associated with liver disease. This procedure is typically indicated in cases where less invasive treatments, such as pharmacologic therapy or endoscopic interventions, have failed to control variceal bleeding. The approach to this surgery involves a right posterolateral thoracotomy, which is a surgical incision made in the chest to access the esophagus. The skin is incised, and the incision is extended through the soft tissues, allowing for the retraction of the scapula and entry into the thoracic cavity without damaging the pleura. In some cases, a transhiatal abdominal approach may be utilized instead. The procedure involves careful dissection to expose the distal third of the esophagus, where the varices are located. The surgeon then transects the esophagus using a staple gun, which effectively devascularizes the varices, thereby controlling the bleeding. Following the transection, the esophagus is repaired, and the surgical incisions are closed, marking the completion of the procedure.