CPT® Code 54690

Laparoscopic orchiectomy is a minimally invasive surgical procedure that involves the removal of one or both testicles through small incisions in the abdomen. The procedure is performed with the patient positioned supine, often in a Trendelenburg position, which helps to facilitate access to the abdominal cavity. Prior to the surgery, a Foley catheter is typically placed transurethrally to assist with bladder management during the procedure. The surgical approach begins with a small U-shaped incision at the umbilicus, allowing for the introduction of a Veress needle into the peritoneal cavity after dissecting through the anterior rectus fascia. This technique creates a pneumoperitoneum, which is essential for providing the necessary working space within the abdomen by insufflating carbon dioxide (CO2). Once the abdominal cavity is inflated, a laparoscope is inserted through the umbilical incision, and additional trocars are placed along the mid-clavicular line to facilitate the use of laparoscopic instruments. The surgeon then identifies and inspects the abdominal organs before proceeding to grasp and dissect the testis from the surrounding tissue. The spermatic cord, which includes the spermatic vessels and vas deferens, is carefully clipped and cut, allowing for the removal of the testis through the ports. After the procedure, the laparoscopic instruments are withdrawn, CO2 is evacuated from the abdominal cavity, and the fascia is closed with sutures, followed by the closure of the skin. This technique is favored for its reduced recovery time and minimized postoperative pain compared to traditional open orchiectomy methods.