CCANTER
Networker
I am trying to determine whether i should use 76942 or 76872.
i have 55874 includes imaging
55876 does not include imaging
A bilateral pudendal nerve block was performed utilizing standard technique with 2% lidocaine solution. Local anesthetic was infiltrated through the mid perineum bilaterally and advanced toward the expected location of the pudendal neurovascular bundles. Adequate time was allowed for complete anesthetic effect. Additional local anesthetic was infiltrated along the planned transperineal access tract.
Initial axial measurements were obtained demonstrating the native distance between the posterior prostate and anterior rectal wall at the mid gland.
Attention was first turned toward fiducial marker placement. Under continuous transrectal ultrasound guidance, fiducial needles were advanced transperineally into the prostate. Fiducial markers were strategically deployed within the right base, left base, and prostatic apex to optimize future radiation targeting and localization. Excellent distribution of fiducial markers was confirmed sonographically.
Attention was then turned toward placement of the BioProtect rectal balloon spacer. Under ultrasound guidance, an 18-gauge needle was advanced transperineally into the potential space between Denonvilliers’ fascia and the anterior rectal wall. Correct positioning was confirmed in both sagittal and axial imaging planes. A small approximately 6 mm transperineal skin incision was made using a #11 blade scalpel.
The introducer sheath and dilator assembly were advanced carefully to the level of the prostate base. Blunt hydrodissection and mechanical dissection of the Denonvilliers’ fascia was performed to create adequate separation between the prostate and rectum. Axial imaging confirmed that the introducer system remained external to the rectal wall, with independent movement of the sheath without tethering of the rectum.
The dilator was then removed while maintaining introducer sheath position, and the BioProtect balloon device was advanced through the sheath into the perirectal space. The sheath was gradually withdrawn to expose the balloon in the desired position.
Under continuous transrectal ultrasound guidance, the balloon was smoothly and continuously inflated with approximately 15 cc of sterile saline, creating a satisfactory separation plane between the posterior prostate and anterior rectal wall. Final axial measurements confirmed substantial increased separation between the prostate and rectum at the mid gland.
The deployment system was removed in standard fashio
i have 55874 includes imaging
55876 does not include imaging
A bilateral pudendal nerve block was performed utilizing standard technique with 2% lidocaine solution. Local anesthetic was infiltrated through the mid perineum bilaterally and advanced toward the expected location of the pudendal neurovascular bundles. Adequate time was allowed for complete anesthetic effect. Additional local anesthetic was infiltrated along the planned transperineal access tract.
Initial axial measurements were obtained demonstrating the native distance between the posterior prostate and anterior rectal wall at the mid gland.
Attention was first turned toward fiducial marker placement. Under continuous transrectal ultrasound guidance, fiducial needles were advanced transperineally into the prostate. Fiducial markers were strategically deployed within the right base, left base, and prostatic apex to optimize future radiation targeting and localization. Excellent distribution of fiducial markers was confirmed sonographically.
Attention was then turned toward placement of the BioProtect rectal balloon spacer. Under ultrasound guidance, an 18-gauge needle was advanced transperineally into the potential space between Denonvilliers’ fascia and the anterior rectal wall. Correct positioning was confirmed in both sagittal and axial imaging planes. A small approximately 6 mm transperineal skin incision was made using a #11 blade scalpel.
The introducer sheath and dilator assembly were advanced carefully to the level of the prostate base. Blunt hydrodissection and mechanical dissection of the Denonvilliers’ fascia was performed to create adequate separation between the prostate and rectum. Axial imaging confirmed that the introducer system remained external to the rectal wall, with independent movement of the sheath without tethering of the rectum.
The dilator was then removed while maintaining introducer sheath position, and the BioProtect balloon device was advanced through the sheath into the perirectal space. The sheath was gradually withdrawn to expose the balloon in the desired position.
Under continuous transrectal ultrasound guidance, the balloon was smoothly and continuously inflated with approximately 15 cc of sterile saline, creating a satisfactory separation plane between the posterior prostate and anterior rectal wall. Final axial measurements confirmed substantial increased separation between the prostate and rectum at the mid gland.
The deployment system was removed in standard fashio