CPT® Code 54520

A simple orchiectomy, also known as orchidectomy, is a surgical procedure that involves the removal of one testis. This procedure can be performed using two different surgical approaches: the scrotal approach or the inguinal approach. In the scrotal approach, the surgeon makes an incision along the median raphe of the scrotum, which is the line that divides the scrotal sac. This incision allows access to the underlying tissues, including the dartos fascia and cremasteric fibers, to reach the tunica vaginalis, which encases the testis. The gubernacular attachments, which are fibrous structures that help anchor the testis, are then ligated and divided to facilitate the removal of the testis through the scrotal incision. Alternatively, the inguinal approach involves making a 4-6 cm incision above the pubic bone, parallel to the inguinal ligament. This incision allows the surgeon to access the inguinal canal and spermatic cord. The external oblique muscle is incised to expose the internal structures, and the testis is carefully manipulated out of the scrotum through the inguinal canal. Once the testis is removed, the spermatic cord is clamped and divided, and the vas deferens and blood vessels are ligated to ensure complete removal. In some cases, a testicular prosthesis may be implanted during the same surgical session to provide cosmetic restoration of the scrotal appearance. The procedure concludes with the inspection of the scrotal structures, irrigation of the wound with saline, and closure of the surgical site in layers to promote healing. This procedure is typically indicated for various medical conditions affecting the testis, including malignancies, trauma, or other pathological conditions requiring removal of the testis.