Unless you present the OP notes ,we would not be able to proper openion or assign with more specification.
If you could, please do.
The internal iliac vessel ligation is not a part or component of GYN surgeries like hysterectomy, or OB surgery-Cesarean. The ligation of the iliac vessels are done for uncontrolled bleeding of the uterine vessels during/after surgery. It is purely surgeons' mandatory decision as a life saving measure. How this could be left incorporated with the regular intended procedure/ or not reported- whether the condition/the surgery warrants this procedure ,it needs to be reported definitely.
Surgeon making an injury is a very very rare one, but still it necessitates reporting -a life saving procedure. I do not know if there is some edits, though.
Which code would we assign, would depend upon the vein or artery (both has a separate code).
If you cannot get yet another document, the OP document would suffice so long it details the surgery.
Look for appropriate E code or V code that fits the surgical notes and the scenario.
Thank you .I hope it gives some hopes!