CPT® Code 43651

A laparoscopic surgical procedure known as transection of the vagus nerves, or truncal vagotomy, involves the cutting of the vagus nerve, which is the tenth cranial nerve. This nerve originates from the brainstem and extends through the neck, thorax, and abdomen, branching out to innervate various parts of the stomach and upper digestive tract. The primary purpose of performing a vagotomy is to reduce excessive acid production in the stomach, thereby helping to prevent the formation of peptic ulcers. Although vagotomy was once a common surgical intervention for ulcer treatment, its frequency has diminished significantly due to the effectiveness of pharmacological therapies available today. During the procedure, a small incision is made in the upper abdomen, through which a trocar is inserted to establish pneumoperitoneum, allowing for the introduction of a laparoscope. Additional incisions are made to facilitate the use of surgical instruments. The vagus nerve is carefully identified and separated from surrounding tissues. In the context of CPT® Code 43651, a truncal vagotomy is specifically performed, which involves the division of the main vagal trunks. This contrasts with selective or highly selective vagotomy procedures, which target specific branches of the vagus nerve. After the surgical intervention is completed, all instruments and the laparoscope are removed, air is released from the abdominal cavity, and the incisions are closed to complete the process.