CPT® Code 50045

Nephrotomy, specifically referred to as an open nephrotomy, is a surgical procedure that involves making an incision in the kidney to allow for internal exploration. This procedure is typically indicated when there is a need to investigate or address various conditions affecting the kidney. The process begins with a skin incision made directly over the kidney, followed by careful dissection of the surrounding soft tissues. In some cases, it may be necessary to remove part of the lower rib(s) to gain adequate access to the kidney. Once the incision is made, Gerota's fascia, which is the connective tissue surrounding the kidney, is incised, and the perirenal fat is meticulously dissected away to expose the kidney. During the procedure, blood vessels are identified and controlled by placing a loop around each vessel to prevent excessive bleeding. The kidney is then fully exposed, allowing for a thorough visual examination. A small incision is made in the kidney itself to facilitate exploration, and the edges of this incision are retracted to provide a clear view of the internal structures. After the exploration is completed, a drainage catheter or tube may be placed through the skin to assist with any necessary drainage, and this is secured in position. The procedure concludes with the closure of Gerota's fascia, the removal of the vessel loops, and the layered closure of the skin incision, ensuring proper healing and minimizing the risk of complications.