KBean2018
Guru
Hello has anyone come across this type of procedure? I am leaning towards 43241 (Esophagogastrduodenoscopy,flexible,transoral;with insertion of intraluminal tube or catheter)
With the patient under general anesthesia in the supine position and with a laparoscopic procedure ongoing, endoscopy instrumentation was properly positioned. The Olympus video upper endoscope was inserted into the oropharynx and maneuvered around the endotracheal tube into the esophagus. The scope was able to pass through the GE junction. Upon entering a small proximal gastric pouch, a non-strictured anastomosis was identified. In conjunction with the operating surgeons, air was insufflated while the repaired anastomosis was placed under saline, without evidence of any leak. The scope was passed into the jejunum that was slightly dilated and with a large amount of liquid bilious material that was suctioned completely. At the request of the operating surgeon, we placed a 12 French nasogastric tube endoscopically across the anastomosis to help decompress the small bowel and proximal gastric remnant. This was performed by placement of a 0.35 Glidewire through the Olympus endoscope and into the jejunum. The scope was removed over the wire and the nasogastric tube was passed over the wire into position. It was then capped and taped to the endotracheal tube
With the patient under general anesthesia in the supine position and with a laparoscopic procedure ongoing, endoscopy instrumentation was properly positioned. The Olympus video upper endoscope was inserted into the oropharynx and maneuvered around the endotracheal tube into the esophagus. The scope was able to pass through the GE junction. Upon entering a small proximal gastric pouch, a non-strictured anastomosis was identified. In conjunction with the operating surgeons, air was insufflated while the repaired anastomosis was placed under saline, without evidence of any leak. The scope was passed into the jejunum that was slightly dilated and with a large amount of liquid bilious material that was suctioned completely. At the request of the operating surgeon, we placed a 12 French nasogastric tube endoscopically across the anastomosis to help decompress the small bowel and proximal gastric remnant. This was performed by placement of a 0.35 Glidewire through the Olympus endoscope and into the jejunum. The scope was removed over the wire and the nasogastric tube was passed over the wire into position. It was then capped and taped to the endotracheal tube