CPT® Code 43622

The procedure described by CPT® Code 43622 refers to a total gastrectomy with the formation of an intestinal pouch. This surgical intervention involves the complete removal of the stomach, which is accessed through an upper midline abdominal incision. The procedure begins with an exploration of the abdominal cavity to assess the surrounding structures. The stomach is then mobilized, and clamps are strategically placed above the gastroesophageal junction and below the gastroduodenal junction to facilitate the transection of the esophagus and duodenum. Following the removal of the stomach, the surgical focus shifts to the creation of an intestinal pouch. This involves mobilizing a long segment of the small intestine, which is then folded back on itself in a specific configuration, either S or J-shaped. This segment is incised and sutured to form a reservoir or pouch. The final step of the procedure includes anastomosing the newly created pouch to the esophagus and the remaining segment of the small bowel, ensuring continuity of the gastrointestinal tract. This complex surgical procedure is typically indicated for various conditions affecting the stomach, necessitating its complete removal and reconstruction of the digestive pathway.