Help w/ code please,
Procedure: The patient was transferred to the Operative Suite,
placed in the supine position on the operating table. After
administration of interscalene block and general anesthesia, she
was transitioned to the right lateral decubitus position.
Examination under examination revealed 2+ sulcus, as well as
anterior and posterior instability. The left upper extremity
was then prepped and draped in the usual sterile fashion and
suspended with 12 pounds of weight from the shoulder traction
system. Posterior glenohumeral portal was established, followed
by an anterior superior portal in the rotator interval, followed
by an anterior inferior portal. Diagnostic arthroscopy was
initiated. There was increased capsular volume. I was easily
able to drive the arthroscope into the inferior capsular pouch.
I then roughened the anterior inferior glenohumeral ligament
with a rasp and placed a plication stitch in the anterior
inferior glenohumeral ligament, thus shifting the capsule
medially and superiorly. I then placed the arthroscope in the
anterior portal and I performed a similar plication stitch in
the posterior inferior glenohumeral ligament. This
significantly decreased the inferior capsular volume. I then
placed the arthroscope in the posterior portal and placed two
stitches in the rotator interval. The arthroscope was then
returned to the anterior portal and I actually closed my
posterior portal with a PDS stitch. The subacromial space was
entered and a bursectomy was performed. I identified the
rotator interval stitches and tied them from the subacromial
space, thus completing the rotator interval closure. All
arthroscopic instruments were removed, portals were closed with
interrupted 4-0 nylon. A bulky sterile dressing was applied and
the patient was then extubated and transferred to PACU in stable
condition.
Procedure: The patient was transferred to the Operative Suite,
placed in the supine position on the operating table. After
administration of interscalene block and general anesthesia, she
was transitioned to the right lateral decubitus position.
Examination under examination revealed 2+ sulcus, as well as
anterior and posterior instability. The left upper extremity
was then prepped and draped in the usual sterile fashion and
suspended with 12 pounds of weight from the shoulder traction
system. Posterior glenohumeral portal was established, followed
by an anterior superior portal in the rotator interval, followed
by an anterior inferior portal. Diagnostic arthroscopy was
initiated. There was increased capsular volume. I was easily
able to drive the arthroscope into the inferior capsular pouch.
I then roughened the anterior inferior glenohumeral ligament
with a rasp and placed a plication stitch in the anterior
inferior glenohumeral ligament, thus shifting the capsule
medially and superiorly. I then placed the arthroscope in the
anterior portal and I performed a similar plication stitch in
the posterior inferior glenohumeral ligament. This
significantly decreased the inferior capsular volume. I then
placed the arthroscope in the posterior portal and placed two
stitches in the rotator interval. The arthroscope was then
returned to the anterior portal and I actually closed my
posterior portal with a PDS stitch. The subacromial space was
entered and a bursectomy was performed. I identified the
rotator interval stitches and tied them from the subacromial
space, thus completing the rotator interval closure. All
arthroscopic instruments were removed, portals were closed with
interrupted 4-0 nylon. A bulky sterile dressing was applied and
the patient was then extubated and transferred to PACU in stable
condition.