Miko24
Guru
PROCEDURE
Left Inguinal Exploration, Ligation of Spermatic Cord, Washout and Approximation of Left Scrotal Laceration
INDICATIONS
Patient used a kitchen knife to lacerate the left scrotum and perform a traumatic left orchiectomy with continued bleeding necessitating OR for control of bleeding and exploration. He understood the risks, benefits, and alternatives and so was deemed to have capacity to provide consent. He received pre-procedural antibiotics and was marked for laterality per protocol.
DESCRIPTION OF PROCEDURE
After being transported to the operating room, the patient was placed in the supine position on the operating table. He was given excellent general anesthetic.
In preparation for the skin incision, the groin was shaved, and then the entire lower abdomen and external genitalia were prepped and draped in the standard fashion using Betadine solution.
I made an inguinal skin incision with a 10 blade after injection of local anesthesis. The underlying subcutaneous tissues and Scarpa fascia were divided throughout the length of the incision using electrocautery so as to expose the fascia of the external oblique muscle and external ring overlying the inguinal canal. I incised the fascia of the external oblique muscle over the inguinal canal and opened it from over the internal ring to the external ring. The ilioinguinal nerve was not able to be identified due due to inflammation and small amount of hematoma present.The fascial edges were retracted, superiorly and inferiorly, using a retractor.
The spermatic cord was then encircled with a 1/2-inch Penrose drain after mobilizing it out of the inguinal canal. It was compressed at the internal ring level. The cord was tied proximally with a 2-0 silk tie and distally with a 2-0 silk suture ligature.
The packing was then removed from the scrotal laceration where it was placed to tamponade bleeding. The bleeding had resolved a this point. The wound was washed out thoroughly. The edges were then approximated with 3-0 vicryl with space for drainage in attempt to pre-empt risk of infection.
External gloves were exchanged. The fascia of the external oblique muscle was closed with a running 2-0 PDS suture from over the internal ring to the external ring. The subcutaneous tissues were reapproximated using running 3-0 Vicryl suture. The wound edges were reapproximated using a running 4-0 monocryl subcuticular stitch. Dermabond was applied over the incision. Scrotal support was also put in place.
I am thinking 13131 but I am unsure if I should also charge the 55110
Thank you
Left Inguinal Exploration, Ligation of Spermatic Cord, Washout and Approximation of Left Scrotal Laceration
INDICATIONS
Patient used a kitchen knife to lacerate the left scrotum and perform a traumatic left orchiectomy with continued bleeding necessitating OR for control of bleeding and exploration. He understood the risks, benefits, and alternatives and so was deemed to have capacity to provide consent. He received pre-procedural antibiotics and was marked for laterality per protocol.
DESCRIPTION OF PROCEDURE
After being transported to the operating room, the patient was placed in the supine position on the operating table. He was given excellent general anesthetic.
In preparation for the skin incision, the groin was shaved, and then the entire lower abdomen and external genitalia were prepped and draped in the standard fashion using Betadine solution.
I made an inguinal skin incision with a 10 blade after injection of local anesthesis. The underlying subcutaneous tissues and Scarpa fascia were divided throughout the length of the incision using electrocautery so as to expose the fascia of the external oblique muscle and external ring overlying the inguinal canal. I incised the fascia of the external oblique muscle over the inguinal canal and opened it from over the internal ring to the external ring. The ilioinguinal nerve was not able to be identified due due to inflammation and small amount of hematoma present.The fascial edges were retracted, superiorly and inferiorly, using a retractor.
The spermatic cord was then encircled with a 1/2-inch Penrose drain after mobilizing it out of the inguinal canal. It was compressed at the internal ring level. The cord was tied proximally with a 2-0 silk tie and distally with a 2-0 silk suture ligature.
The packing was then removed from the scrotal laceration where it was placed to tamponade bleeding. The bleeding had resolved a this point. The wound was washed out thoroughly. The edges were then approximated with 3-0 vicryl with space for drainage in attempt to pre-empt risk of infection.
External gloves were exchanged. The fascia of the external oblique muscle was closed with a running 2-0 PDS suture from over the internal ring to the external ring. The subcutaneous tissues were reapproximated using running 3-0 Vicryl suture. The wound edges were reapproximated using a running 4-0 monocryl subcuticular stitch. Dermabond was applied over the incision. Scrotal support was also put in place.
I am thinking 13131 but I am unsure if I should also charge the 55110
Thank you
