CPT® Code 43832

The procedure described by CPT® Code 43832 refers to an open gastrostomy with the construction of a gastric tube, specifically known as the Janeway procedure. This surgical intervention is performed to create an opening in the stomach that allows for the placement of a gastric tube, which is essential for providing nutrition directly to the stomach in patients who cannot eat by mouth. The procedure involves a series of meticulous steps, beginning with a small incision in the midline of the upper abdomen, which allows access to the abdominal cavity. The surgeon carefully incises the peritoneum and opens the abdominal cavity, addressing any adhesions that may be present. Once the stomach is accessed, the anterior aspect is grasped, and purse-string sutures are placed around the planned incision site. This technique is crucial for creating a secure opening in the stomach wall. The serosa is incised, and a portion of the inner mucosal layer is excised to facilitate the insertion of a balloon catheter. The catheter is then positioned within the stomach, and the balloon is inflated to maintain its placement. The procedure continues with the externalization of the catheter through a stab incision in the abdomen, where it is anchored to the abdominal wall. The construction of the gastric tube involves creating a stomach flap that is everted and sutured to the abdominal wall, ensuring that there is no undue tension on the stomach. This careful manipulation is vital for the successful placement of the gastrostomy tube, which is ultimately inserted into the abdomen to provide a means of nutritional support. The entire process requires precision and attention to detail to ensure proper healing and function of the gastrostomy site.