maryir
Networker
Please see bolded/underlined area - I believe this can be coded but have no idea which code to use - any assistance would be appreciated.
We then turned our attention to the left lingular nodule. This was quite
deep within the lingular lobe and required anatomic segmentectomy. We
first dissected out the fissure and easily saw the pulmonary artery branch
going into the lingula. This was ligated with a silk tie and a clip. We
then dissected out the lingular vein, assuring that the upper veins were
preserved and took this with an endoscopic linear stapler vascular load.
We then dissected out the left lingular bronchus and took this with an
endoscopic linear stapler, black load, after assuring through inflating the
lung that only the lingula was taken. We then stapled across the
parenchyma, dividing the lingula and the other segments of the left upper
lobe. This afforded us a very good margin, at least several centimeters
with the tumor. We stapled across this using an endoscopic linear stapler,
black load.
While doing this, it was noted that there was an aberrant lingular artery
coming under the pulmonary veins and then going into the lingula. This was
noted and stapled with an endoscopic linear stapler, vascular load. The
specimen was then removed. The chest was irrigated copiously and
hemostasis was achieved.[/B]
We placed a #32 straight chest tube into the apex of the chest and inflated the lung under direct vision.
We then turned our attention to the left lingular nodule. This was quite
deep within the lingular lobe and required anatomic segmentectomy. We
first dissected out the fissure and easily saw the pulmonary artery branch
going into the lingula. This was ligated with a silk tie and a clip. We
then dissected out the lingular vein, assuring that the upper veins were
preserved and took this with an endoscopic linear stapler vascular load.
We then dissected out the left lingular bronchus and took this with an
endoscopic linear stapler, black load, after assuring through inflating the
lung that only the lingula was taken. We then stapled across the
parenchyma, dividing the lingula and the other segments of the left upper
lobe. This afforded us a very good margin, at least several centimeters
with the tumor. We stapled across this using an endoscopic linear stapler,
black load.
While doing this, it was noted that there was an aberrant lingular artery
coming under the pulmonary veins and then going into the lingula. This was
noted and stapled with an endoscopic linear stapler, vascular load. The
specimen was then removed. The chest was irrigated copiously and
hemostasis was achieved.[/B]
We placed a #32 straight chest tube into the apex of the chest and inflated the lung under direct vision.