CPT® Code 50605

Ureterotomy for insertion of an indwelling stent is a surgical procedure that involves making an incision in the ureter to facilitate the placement of a stent. This procedure is typically indicated when there is a stricture or other abnormality in the ureter that obstructs the normal flow of urine. The term 'ureterotomy' refers to the surgical incision made in the ureter, which is the tube that carries urine from the kidney to the bladder. During the procedure, the surgeon makes an incision in the abdomen, which may be located over the upper, middle, or lower ureter, depending on the specific location of the obstruction. The abdominal wall muscles are carefully divided, and the peritoneum, which is the lining of the abdominal cavity, is pushed aside to access the ureter. Once the ureter is identified, it is meticulously dissected free from surrounding tissues, including the serosa and periureteral fat. The ureter is then incised to allow for exploration and treatment of the stricture. A soft Penrose drainage or suction tube is placed above the stricture site to facilitate drainage and flushing of the ureter with an irrigation solution. Following this, a double J stent is inserted at the site of the stricture to maintain patency and ensure proper urine flow. The ureterotomy site may be left open with a drainage tube in place to allow for continued drainage, and finally, the abdominal and skin incisions are closed around the drain to complete the procedure.