# please help-any suggestions on this?



## trose45116 (Jun 1, 2009)

any suggestions on this? i would think this would be another hernia repair code.


PREOPERATIVE DIAGNOSIS:  Recurrent right flank hernia.  


POSTOPERATIVE DIAGNOSIS:  Recurrent right flank hernia. 


PROCEDURE:  1.  Exploration of wound with removable mess. 

2.  Repair of hernia with a piece of Marlex mesh, measuring 3 x 4 cm. 


ANESTHESIA:  General.  

COMPLICATIONS:  None.  

SPECIMENS:  The scar tissue and old mesh plugs were excised and sent to Pathology.  

DISPOSITION:  He was taken to the recovery room in stable condition.  



INDICATIONS:  The patient is a 70-year-old gentleman who underwent a urologic procedure with a port hole site in the right flank area.  The patient developed a trocar site hernia.  He previously underwent a repair with a mesh plug, but unfortunately the area seemingly recurred.   I saw the patient and recommended he undergo redo hernia repair of the area.  The risks and benefits including infection, bleeding, recurrence, and injury to the bowel or bladder were discussed and consent obtained.  



DESCRIPTION OF PROCEDURE:  The patient was taken to the operating room and identified.  He was then appropriately sedated and placed under  Anesthesia's care.  The right flank was then prepped and draped.  An incision was made through the prior score down to the level of the previous hernia repair.  A large amount of scar tissue was noted.  It appeared that the mesh had become dislodged and pulled away from the fascia.  Therefore, the mesh plug was excised.  The hernia defect was then cleaned off in each direction, and then a piece of Marlex mesh was used to fix the defect.  It was anchored to the fascia with interrupted Ethibond sutures, and a tension-free repair was done.  The wound was then irrigated, injected with Marcaine, and the wound was closed in layers using a 3-0 and 4-0 Vicryl and sterile dressings were applied.  The patient tolerated this well and was taken to the recovery room in stable condition.


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## mbort (Jun 1, 2009)

sounds like a recurrent incisional hernia to me 

Mary, CPC, COSC


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## trose45116 (Jun 4, 2009)

Thanks thats what i thought, but wanted another input on this.


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