# Filshie clip removals



## pygreen (Jul 26, 2011)

Need help coding this OP report Please.

Pre and Post Operative diagnosis:  Pelvic Pain

Procedure:  Diagnostic laparoscopy,  Removal of bilateral Filshie Clips

Description of Procedure:  Patient taken to OP, placed under general anesthesia, Position in dorsolithotomy position in the Allen stirrups.  Prepped and Draped in normal sterile fashion.  A bivalve spectulum was inserted into the vagina, and the anterior lip of the cervix was grasped with the Allis clamp.  The cervix was dilated sufficiently to accommodate a Kronner uterine manipulator.  The urinary bladder was then drained with a straight catheter.  A 5 mm bladeless trocar was inserted directly, with intraabdominal placement immediately confirmed with the laparoscope, as well as the absence of any apparent injury.  The patient was placed in Trendelenburg, and bilaterally 5 mm lower quadrant ports were inserted using bladeless trocars under direct visualization.  All trocar sites were injected with 0.25% Marcaine prior to incision.  The pelvis was inspected and was found to be grossly normal.  The Filshie clips were easily identified and excised using the PlasmaKinetic forceps by transecting the tube immediately adjacent to each side of the Filshie clip.  The clips were removed.  The fallopian tubes were hemostatic.  The carbon dixiode gas was evacuated.  The trocars were removed.  The trocar sites were hemostatic.  The skin incisions were closed using 4-0 Moncryl in subcuticular fashion, with Dermabond applied to the skin.  The uterine manipulator was removed, and the procedure was completed.  Counts were correct.  The patient awakened and taked to the recovery room in stable condition.

Thanks for any assistance with this.


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