daniel
True Blue
A physician performs a SPY elite perfusion angiography study of flaps 15860 with Panniculecetomy 15830.
How is this reported? And is the SPY elite perfusion inclusive?
Main question, should this SPY perfusion be looked at as inclusive.
OPERATION PERFORMED: 1. Panniculecetomy 2. SPY elite perfusion angiography study of flaps. FINDINGS: 1. Significant overhang, and non healing wound removed en bloc with pannus. Pannus weight removed 4077 grams. 2. SPY elite perfusion angiography study for flap viability, demonstrating all area viable at completion, inferior portion of umbilicus was non-viable and excised. Procedure in detail: The patient was met in pre-operative holding, and his identity and procedure were confirmed. He was appropriately marked and was then taken to the operating room and placed in supine position. General anesthesia was induced with endotracheal intubation. The patient was prepped and draped in the usual sterile fashion and a time-out was performed. The surgical site was marked to layout a plan for removal and closure of the skin. A Fleur-de-lis incision was then made encompassing the entire pannus. The umbilicus was cut out from the surrounding tissue. The dissection was carried down to the level of the fascia, and was lifted off the fascia. The midline hernia repair was encountered and found to be intact. No fascia violation or disturbance was made. The dissection continued until the entire area was removed. Hemostasis was checked in the wound. Flaps were raised in order to decrease tension down to re-approximation area. Perfusion study was carried out after hemostasis and flap creation. The entire area was viable, except a 1.5 cm area at the inferior portion of the umbilicus. This was excised and the ubilicus was sewn with 2-0 Vicryl for reconstitution. Completion SPY showed excellent perfusion. Before closure, two 19 F round blake drains were placed under the flaps, exiting one from the right and the other from the left. The umbilicus was transposed to the superior portion of the fleur-de-lis, and the wound closure was undertaken with 3-0 Vicryl deep dermal sutures. The skin was approximated with running 4-0 Monocryl Stratafix suture. The wound was covered dermabond prineo. The patient tolerated the procedure well and was transferred to recovery in stable condition. Instrument sponge and needle counts were correct at the conclusion.
How is this reported? And is the SPY elite perfusion inclusive?
Main question, should this SPY perfusion be looked at as inclusive.
OPERATION PERFORMED: 1. Panniculecetomy 2. SPY elite perfusion angiography study of flaps. FINDINGS: 1. Significant overhang, and non healing wound removed en bloc with pannus. Pannus weight removed 4077 grams. 2. SPY elite perfusion angiography study for flap viability, demonstrating all area viable at completion, inferior portion of umbilicus was non-viable and excised. Procedure in detail: The patient was met in pre-operative holding, and his identity and procedure were confirmed. He was appropriately marked and was then taken to the operating room and placed in supine position. General anesthesia was induced with endotracheal intubation. The patient was prepped and draped in the usual sterile fashion and a time-out was performed. The surgical site was marked to layout a plan for removal and closure of the skin. A Fleur-de-lis incision was then made encompassing the entire pannus. The umbilicus was cut out from the surrounding tissue. The dissection was carried down to the level of the fascia, and was lifted off the fascia. The midline hernia repair was encountered and found to be intact. No fascia violation or disturbance was made. The dissection continued until the entire area was removed. Hemostasis was checked in the wound. Flaps were raised in order to decrease tension down to re-approximation area. Perfusion study was carried out after hemostasis and flap creation. The entire area was viable, except a 1.5 cm area at the inferior portion of the umbilicus. This was excised and the ubilicus was sewn with 2-0 Vicryl for reconstitution. Completion SPY showed excellent perfusion. Before closure, two 19 F round blake drains were placed under the flaps, exiting one from the right and the other from the left. The umbilicus was transposed to the superior portion of the fleur-de-lis, and the wound closure was undertaken with 3-0 Vicryl deep dermal sutures. The skin was approximated with running 4-0 Monocryl Stratafix suture. The wound was covered dermabond prineo. The patient tolerated the procedure well and was transferred to recovery in stable condition. Instrument sponge and needle counts were correct at the conclusion.