Question Answered step-by-step Operation: Tubal sterilization by bilateral salpingectomy, Excision… Operation:Tubal sterilization by bilateral salpingectomy,Excision of vulvar skin tagAnesthesia: GeneralProcedure: Under general anesthesia in the dorsal lithotomy position, the patient was prepped and draped in the usual sterile fashion. A suprapubic transverse incision of 3 cm was made. This was carried down to the level of the fascia by blunt dissection. The fascia was identified and incised, and the incision was carried laterally in both directions. The pyramidalis muscles were divided and the peritoneal entered sharply. Using a previously placed Hulka tenaculum, the uterus was brought up to the subperitoneal area. The left fallopian tube was grasped near its insertion into the uterus with a Babcock. Then, using a second Babcock, the tube was walked its entire length until the fimbriated end was well identified. The Babcock was replaced in the middle of the tube and a knuckle of tube raised. A suture was placed both proximally and distally and a 1-cm portion of tube excised. The mesosalpinx was sutured ligated with a single figure-of-eight stitch. There was no active bleeding following these maneuvers. The suture used was 0 chromic. On the right, the fallopian tube was somewhat more difficult to mobilize. The fimriated end was abnormally shaped and clubbed. It appeared nonpatent. The fimbriated end was well mobilized and elevated. A 2-cm portion of the deformed fimbria was excised, suture ligated, and cauterized. No active bleeding was noted. At this point, the instruments and lap sponge were removed. The anterior fascia was closed with a 0 Vicryl suture. Subcutaneous tissue was reapproximated with 0 Vicryl suture and the skin was closed using a running subcuticular 4-0 Vicryl. Attention was then directed to the vulva, where an approximately 1.5-cm skin tag that was discolored was noted in the upper portion of the labia minora just lateral to the clitoris. This area was grasped with an Allis and local anesthesia placed in the base. Using a scalpel, a football shaped incision was made, excising the skin tag. Hemostasis was achieved with electrocautery. A running subcuticular Vicryl stitch was used to close the skin. The wound was dressed with antibiotic ointment. At this point, the procedure was terminated. The tolerated the procedure well. What is the PCS Code only the tubal sterilization. Health Science Science Nursing HIM-2020 MISC Share QuestionEmailCopy link Comments (0)
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