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Posted By Lillian Boyanton on 08-19-2019, 08:56:37 in Gastroenterology
I'm having difficulty coding this procedure and need some help.

The patient went back to the OR for a resection of the eviscerated omentum reduction and repair of umbilical incision with diagnostic laparoscopy.
She is 3 days post of from Evisceration of surgical incision at umbilicus and laparoscopic tubal ligation.

This is the op note portion of the px:

The patient was taken back to the operating room, given a general anesthetic, prepped and draped in the supine position. The knuckle of omental fat was gently grasped and teased further out of the incision, carefully palpated to make sure that there was no bowel noted in this tissue and then about 2 inches of the omentum was resected with the LigaSure device. Then, the omentum was reduced back into the abdominal cavity and an 8-millimeter laparoscope was placed through that umbilical incision and a pneumoperitoneum was created. The left lower quadrant laparoscopic wound which was already there was teased open and a 5-millimeter trocar was inserted at that site. The pelvic contents were carefully inspected and the bowel appeared to be normal. The omentum appeared to be hemostatic, but just for extra precaution, I used the LigaSure device to further cauterize the end of the omentum and then the pelvis and abdomen was copiously irrigated with warm sterile saline. The 5-millimeter umbilical trocar was then removed and a Carter-Thomason endoscopic suture closure device was used to close the incision with a 0 Vicryl stitch. The fascia was oversewn with 0 Vicryl on a UR-6 needle to ensure that the closure was air tight. Then, the CO2 was allowed to escape through the left lower quadrant trocar, and after which I oversewed the subcutaneous fat with a 3-0 Vicryl suture. The fascia could not be identified to close separately. Then, a 4-0 Vicryl suture was used to close the skin on both incisions. The procedure was terminated. The patient was awakened and transferred to recovery in stable condition.

Thank you so much.
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