toria11
Guru
I'm having trouble distinguishing when to use 51845 and 57288.. The provider states this was the "Raz procedure" but what exactly am I looking for to distinguish this from 57288? Thank you!
Procedure Performed
Raz procedure with mid urethral insight 2 urethral sling
Type of Anesthesia
General
Indications
Stress incontinence severe
Technique/Description of Procedure
Patient was placed in the dorsal lithotomy position prepped and draped in the usual manner a 16 Foley catheter was placed in her bladder. She then had 2 Allis clamps placed 1 cm below and lateral to the urethral orifice. Patient then had 2 parallel incisions made 1 cm lateral to the urethra in carried down to the bladder neck. The the superior portion was isolated has a 2 cm insight to sling area. We then created a flap inferiorly. Once this was done we entered the retropubic space on each side through the incision using Metzenbaum scissors. We then placed a finger into free adhesions. Two puncture wounds were then made superiorly. On the right-hand side we passed the rods needle under fingertip control out through the vaginal in system. We then perform cystoscopy to confirm that there was no bladder injury. The inside 2 sling then had a 0 Prolene placed in it from superior to inferior. They were then placed in the rods needle and transferred superiorly on the right-hand side similar procedure was then performed on the left-hand side. Cystoscopy was also performed. Once this was done we then closed the vaginal incision using the flap of tissue using a running 2 0 Vicryl suture. Once this was done we placed the cystoscope in the bladder and elevated the sling and tied the suture so that it was elevated but not obstructing. . Cystoscopy confirmed that there was no obstruction. We then placed a vaginal pack and closed the puncture wounds with staples Foley catheter was replaced. We tested her with a full bladder and a not demonstrate any incontinence. Patient was then transferred recovery in stable condition
Procedure Performed
Raz procedure with mid urethral insight 2 urethral sling
Type of Anesthesia
General
Indications
Stress incontinence severe
Technique/Description of Procedure
Patient was placed in the dorsal lithotomy position prepped and draped in the usual manner a 16 Foley catheter was placed in her bladder. She then had 2 Allis clamps placed 1 cm below and lateral to the urethral orifice. Patient then had 2 parallel incisions made 1 cm lateral to the urethra in carried down to the bladder neck. The the superior portion was isolated has a 2 cm insight to sling area. We then created a flap inferiorly. Once this was done we entered the retropubic space on each side through the incision using Metzenbaum scissors. We then placed a finger into free adhesions. Two puncture wounds were then made superiorly. On the right-hand side we passed the rods needle under fingertip control out through the vaginal in system. We then perform cystoscopy to confirm that there was no bladder injury. The inside 2 sling then had a 0 Prolene placed in it from superior to inferior. They were then placed in the rods needle and transferred superiorly on the right-hand side similar procedure was then performed on the left-hand side. Cystoscopy was also performed. Once this was done we then closed the vaginal incision using the flap of tissue using a running 2 0 Vicryl suture. Once this was done we placed the cystoscope in the bladder and elevated the sling and tied the suture so that it was elevated but not obstructing. . Cystoscopy confirmed that there was no obstruction. We then placed a vaginal pack and closed the puncture wounds with staples Foley catheter was replaced. We tested her with a full bladder and a not demonstrate any incontinence. Patient was then transferred recovery in stable condition
plus rods aren't used in 57288.