CPT® Code 51555

Partial cystectomy is a surgical procedure that involves the removal of a portion of the bladder, typically performed to address localized malignant neoplasms, or tumors, within the bladder. This procedure is indicated when the cancer is confined to a specific area, allowing for the excision of the tumor while preserving as much of the bladder as possible. The surgery is initiated by exposing the bladder through a low midline or transverse suprapubic incision, which provides access to the bladder for the surgeon. Depending on the location of the tumor, different approaches are utilized; for instance, tumors located in the posterior bladder are accessed intraperitoneally, while those situated in the dome or anterior bladder are approached extraperitoneally. During the procedure, if necessary, a pelvic lymph node dissection may be performed to assess the spread of cancer. The bladder is then mobilized, and stay sutures are placed at a distance from the lesion to facilitate a clear view of the area being treated. The bladder is incised between these stay sutures, allowing for an enlargement of the incision to enhance visualization of the lesion. The surgeon excises the affected portion of the bladder along with surrounding perivesical fat and peritoneum, ensuring that a margin of healthy tissue is included to minimize the risk of cancer recurrence. After the excision, the bladder wall is meticulously closed in layers, including the submucosa and muscle, to restore the integrity of the bladder. This procedure is classified as complicated when it involves factors such as previous bladder surgeries, radiation treatment affecting the lower abdomen or bladder, or when the lesions are in difficult-to-access locations, necessitating a more intricate surgical approach.