hnybee101
New
can someone help me with this?? I am new to Trauma surgery coding:
The old Wound VAC was removed and at this point we performed a feeding jejunostomy tube placement with a Malecot 28. We went through the left upper quadrant, down into the abdominal cavity using Bovie electrocautery and hemostat. The Malecot was placed through the subcutaneous tissue, all the way down to the abdominal cavity in this way. The ligament of Treitz was localized and was placed a feeding jejunostomy tube 30 cm away from the ligament of Treitz. We did this in a whistle format, imbricating the feeding tube onto the small bowel for at least 10 cm and then entering the small bowel with a pursestring suture using 2-0 stick tie silk. After formal imbrication and placement inside the lumen of the bowel, the feeding tube was advanced 20 cm distally. At this point, we secured the small bowel to the
lateral abdominal wall with interrupted 2-0 stick ties and we put a piece of omentum around the fitting entry site in order to provide the best seal with a 2-0 stick tie. At this point, we continued the abdominal washout. We did component separations all the way down to the linea semilunaris bilaterally.We placed 2 JP under the flaps. We did irrigation with Pulsavac and antibiotics. We obtained good hemostasis with Bovie electrocautery and then, after good mobilization, we closed the skin using #1 nylon interrupted stitches. After closing the abdominal wall, the patient's abdomen was cleaned and covered with 4x4s and tape. The Malecot drain to the jejunum was placed to gravity in a:confused Foley bag. The patient tolerated the procedure well.
The old Wound VAC was removed and at this point we performed a feeding jejunostomy tube placement with a Malecot 28. We went through the left upper quadrant, down into the abdominal cavity using Bovie electrocautery and hemostat. The Malecot was placed through the subcutaneous tissue, all the way down to the abdominal cavity in this way. The ligament of Treitz was localized and was placed a feeding jejunostomy tube 30 cm away from the ligament of Treitz. We did this in a whistle format, imbricating the feeding tube onto the small bowel for at least 10 cm and then entering the small bowel with a pursestring suture using 2-0 stick tie silk. After formal imbrication and placement inside the lumen of the bowel, the feeding tube was advanced 20 cm distally. At this point, we secured the small bowel to the
lateral abdominal wall with interrupted 2-0 stick ties and we put a piece of omentum around the fitting entry site in order to provide the best seal with a 2-0 stick tie. At this point, we continued the abdominal washout. We did component separations all the way down to the linea semilunaris bilaterally.We placed 2 JP under the flaps. We did irrigation with Pulsavac and antibiotics. We obtained good hemostasis with Bovie electrocautery and then, after good mobilization, we closed the skin using #1 nylon interrupted stitches. After closing the abdominal wall, the patient's abdomen was cleaned and covered with 4x4s and tape. The Malecot drain to the jejunum was placed to gravity in a:confused Foley bag. The patient tolerated the procedure well.