A patient had an incisional hernia times 2 and cholelithiasis. Here is the op report:
We made an incision over top of hernia. we dissected down around the hernia sac. The hernia sac was then opened and its contents were inspected. This was found to just be omentum. we did have to enlarge the fascial defect in order to reduce the omentum back down into the peritoneal cavity. Once this was done, we then placed 3 sutures to close the defect. Once insufflation was complete, full visual inspection of the anterior abdominal organs was performed. This revealed a very small hernia defect in the lower midline. we also identified the gallbladder was markedly dilated. We then elected to proceed with laparoscopic cholecystectomy.................................................we then removed the gallbladder through the umbilical incision. we then repaired the infraumbilical hernia using mesh. one this was complete, we then turned our attention to the smaller hernia defect in the lower abdomen. A horizontal incsion was made and this was carried down through the subq to the fascia. The defect was dissected free and the preperitoneal fiat which had herniated through was reduced back into the paritoneal cavity.
Is this truly a lap choecystectomy? And I can code for one hernia?? Is it truly an incisional? The dr put on his op report that it is two seperate incisions.
Thanks
Stacey
We made an incision over top of hernia. we dissected down around the hernia sac. The hernia sac was then opened and its contents were inspected. This was found to just be omentum. we did have to enlarge the fascial defect in order to reduce the omentum back down into the peritoneal cavity. Once this was done, we then placed 3 sutures to close the defect. Once insufflation was complete, full visual inspection of the anterior abdominal organs was performed. This revealed a very small hernia defect in the lower midline. we also identified the gallbladder was markedly dilated. We then elected to proceed with laparoscopic cholecystectomy.................................................we then removed the gallbladder through the umbilical incision. we then repaired the infraumbilical hernia using mesh. one this was complete, we then turned our attention to the smaller hernia defect in the lower abdomen. A horizontal incsion was made and this was carried down through the subq to the fascia. The defect was dissected free and the preperitoneal fiat which had herniated through was reduced back into the paritoneal cavity.
Is this truly a lap choecystectomy? And I can code for one hernia?? Is it truly an incisional? The dr put on his op report that it is two seperate incisions.
Thanks
Stacey