Struggling between 57287 and 57288.. Surgeon lists this as a SPARC under "procedure performed" but it kind of seems like he tightened the existing sling? Thoughts? Thanks
The patient had significant previous surgery, pelvic adhesions and vaginal adhesions. We opened up the vagina and indeed there was previously sling had in place. After we had resected out to the endopelvic fascia bilaterally, we then made incisions directly above the suprapubic area and did notice that it was difficult to get through the adhesions and also to get into the vagina. We did cystoscopy to make sure that there was no perforation. Making sure that there was no perforation, the sling was then tied and pulled up against the Kelley clamp to provide the appropriate amount of tension. The sling was irrigated with Ancef solution. We cut off the sling at the skin and start our closure...
The patient had significant previous surgery, pelvic adhesions and vaginal adhesions. We opened up the vagina and indeed there was previously sling had in place. After we had resected out to the endopelvic fascia bilaterally, we then made incisions directly above the suprapubic area and did notice that it was difficult to get through the adhesions and also to get into the vagina. We did cystoscopy to make sure that there was no perforation. Making sure that there was no perforation, the sling was then tied and pulled up against the Kelley clamp to provide the appropriate amount of tension. The sling was irrigated with Ancef solution. We cut off the sling at the skin and start our closure...
