CPT® Code 47130

The procedure described by CPT® Code 47130 refers to a total right lobectomy, which is a surgical operation involving the resection of the right lobe of the liver. This complex procedure is typically performed to address various hepatic conditions, including tumors, cysts, or other liver diseases that necessitate the removal of a significant portion of the liver. The surgery begins with an incision in the right subcostal area, which may extend into the left subcostal region or upward toward the xiphoid process, allowing access to the liver. During the operation, the surgeon carefully transects the right rectus muscle and splits the oblique muscles to gain entry to the abdominal cavity. The medial portion of the left rectus muscle may also be transected to facilitate the mobilization of the right lobe of the liver toward the left side of the body. The procedure involves meticulous dissection and identification of critical vascular structures, including the cystic artery and duct, which are ligated and divided to prevent bleeding. The right main hepatic artery is then identified and protected during the dissection, which continues superiorly and posteriorly while ensuring the portal vein remains intact. The right main hepatic duct is also carefully dissected free to allow for the complete removal of the right lobe. The hepatic vein is transected, and the liver capsule is incised to access the liver parenchyma, which is then transected to excise the right lobe. In some cases, the hepatic parenchyma may be transected in the interlobar plane before the right lobe is removed. After the excision, the incision is closed over drains, ensuring that any bleeding is controlled and the wound is properly irrigated to promote healing.