CPT® Code 49187

Excision or destruction, open, intra-abdominal (ie, peritoneal, mesenteric, retroperitoneal), primary or secondary tumor(s) or cyst(s), sum of the maximum length of tumor(s) or cyst(s); 5.1 to 10 cm

The procedure described by CPT® Code 49187 involves the open excision or destruction of intra-abdominal tumors or cysts, which can be either primary or secondary in nature. This surgical intervention is performed through an incision in the abdomen, allowing access to the peritoneal cavity. The tumors or cysts may be completely excised, meaning they are surgically removed in their entirety, or they may be destroyed using techniques such as electrocautery or laser ablation. The procedure begins with careful incision and elevation of the peritoneum, ensuring that surrounding organs, such as the bowel, are not injured during the process. Once the peritoneal cavity is accessed, any adhesions are dissected to expose the abdominal viscera fully. A thorough exploration of the abdominal cavity is conducted, both visually and through palpation, to identify all masses and abnormalities present. A self-retaining retractor is utilized to maintain visibility and access to the surgical site. The size, location, and extent of the primary mass are documented, and surrounding tissues are carefully manipulated to provide a clear view of the tumor. The excision or destruction of the tumor is performed with precision to avoid damaging blood vessels that supply adjacent organs. This meticulous approach is repeated for all identified tumors until they are either excised or destroyed. In cases involving retroperitoneal tumors, similar techniques are employed, with particular attention paid to protecting the kidneys, ureters, and renal vessels. After the procedure, the abdominal cavity is irrigated with an antibiotic solution, and a final inspection is conducted to check for any injuries before the surgical instruments are removed and the organs are returned to their anatomical positions. The omentum is then replaced over the abdominal contents, and drains may be placed as necessary before closing the fascia and other soft tissues.