CPT® Code 43830

The CPT® Code 43830 refers to an open gastrostomy procedure performed without the construction of a gastric tube, specifically known as the Stamm procedure. This surgical intervention is indicated for patients requiring long-term nutritional support through direct access to the stomach. The procedure begins with a small incision made in the midline of the upper abdomen, allowing the surgeon to access the peritoneal cavity. The peritoneum is carefully grasped and incised to open the abdominal cavity, where any adhesions along the inner abdominal wall are lysed to facilitate the procedure. The anterior aspect of the stomach is then grasped, and two concentric purse-string sutures are placed around the planned incision site on the stomach. Following this, the serosa of the stomach is incised at the center of the purse-string sutures, and a small portion of the inner mucosal layer is excised to create an opening. This opening is dilated to accommodate the insertion of a balloon catheter, which is then placed into the stomach. The balloon is inflated, and traction is applied to the external catheter to position the balloon against the stomach wall. The purse-string sutures are securely tied around the catheter to maintain its position. The stomach is then positioned against the abdominal wall, and the site for the abdominal incision is determined. A stab incision is made in the abdomen, allowing forceps to be inserted through the skin into the abdominal cavity to grasp and exteriorize the catheter. Finally, anchoring sutures are placed on the internal abdominal wall, and the abdominal incision is closed in layers. This procedure is classified as a separate procedure, emphasizing its distinct nature in the context of surgical interventions for gastrostomy placement.