sscott@hogonc.com
Networker
When a hemorrhoidopexy is performed with staples, you use 46947. What do you use if the provider did not use staples?
OPERATION:
1. Hemorrhoidectomy, one column.
2. Tag excision x2.
3. Left lateral sphincterotomy.
4. Hemorrhoidopexy x2.
SURGEON:
COMPLICATIONS: None.
After informed consent was obtained, the patient was brought to the
operating room, underwent general endotracheal anesthesia, placed in
a prone position, prone jackknife, prepped and draped. Lone Star
applied, Marcaine injected. Patient had a large posterior hemorrhoid with
tag and then some external tags on the right posterior and then
fissure in the posterior midline. The canal was very tight. I began
by performing a closed left lateral internal sphincterotomy with 11
blade. I then removed the posterior hemorrhoid with cautery and
LigaSure. I ligated it at its pedicle and then reapproximated the
defect with 3-0 Vicryl runner in a running locked continuous fashion
transitioning at the anal verge to continuous running. I then
buttressed the suture line in the rectum with 3-0 Vicryl pops
interrupted. I then performed a hemorrhoidopexy in the left lateral
by going 2 cm above the top of the hemorrhoid column, tying down,
then running to the dentate line and then tying back with good
repositioning of the anal canal and then over tying. I similarly
performed this in the right anterior. I then excised a right
posterior large tag which was excised with cautery. We then
reapproximated this defect in a continuous running fashion with 3-0
Vicryl runner. A bulky dressing was applied. Surgicel wick was
placed in the rectum. The patient tolerated the procedure, was taken
to recovery room in stable condition.
Thank you for any help!
OPERATION:
1. Hemorrhoidectomy, one column.
2. Tag excision x2.
3. Left lateral sphincterotomy.
4. Hemorrhoidopexy x2.
SURGEON:
COMPLICATIONS: None.
After informed consent was obtained, the patient was brought to the
operating room, underwent general endotracheal anesthesia, placed in
a prone position, prone jackknife, prepped and draped. Lone Star
applied, Marcaine injected. Patient had a large posterior hemorrhoid with
tag and then some external tags on the right posterior and then
fissure in the posterior midline. The canal was very tight. I began
by performing a closed left lateral internal sphincterotomy with 11
blade. I then removed the posterior hemorrhoid with cautery and
LigaSure. I ligated it at its pedicle and then reapproximated the
defect with 3-0 Vicryl runner in a running locked continuous fashion
transitioning at the anal verge to continuous running. I then
buttressed the suture line in the rectum with 3-0 Vicryl pops
interrupted. I then performed a hemorrhoidopexy in the left lateral
by going 2 cm above the top of the hemorrhoid column, tying down,
then running to the dentate line and then tying back with good
repositioning of the anal canal and then over tying. I similarly
performed this in the right anterior. I then excised a right
posterior large tag which was excised with cautery. We then
reapproximated this defect in a continuous running fashion with 3-0
Vicryl runner. A bulky dressing was applied. Surgicel wick was
placed in the rectum. The patient tolerated the procedure, was taken
to recovery room in stable condition.
Thank you for any help!