Please help, there are so many code and terms I'm sooo confused. Was thinking 49507 but don't see anything in that code regarding Mesh...???
REOP DIAG: Incarcerated left inguinal hernia
PROCEDURE PERFORMED: left inderect inguinal hernia repair with mesh
Abdomen prepped and draped in a sterile fashion. 6cm incision from the line connecting the pubic tubercle to the anterior superior illac spine using a #15 blade. The deeper tissue were dissected using the cautery current with bovie. The fascia incised using the cutting current of the bovie and then extended the incision medially and then laterally.
The fascia was grasped between 2 allis clamps and the hernia sac was easily seen as well as the ilioinguinal nerve which was dissected and removed and retracted out of the field. The sac opened and contents omentum which was reducted into abdominal cavity. The sac was then dissected free from the vas deferens and the blood supply. The testicle was brought out of the scrotum and the sac was completely dissected and the testicles returned back to the scrotum The sac was then ligated at its base and the sac was transected above the suture and sent off the field to path. The would was irrigated and dried. There was a small component of direct hernia persent as well and decision was made to use performed mesh with a small diaphragm that sits in the direct space. the apex of the mesh was sutured down to the pubic tubercle using a 2-0 prolene and interrupted stitches were used to suture the mest with a 2-0 prolene to the conjoined tendons superiorly and inferiorly to th einguinal ligament.
A small incision made in the mesh to wrap around the cord structures ensuring that the vas was protected. Continued to insure cord would not be strangulated. Fascia was closed over the repair using vicryl running stitch. This tied medially. Wound irrigated and dried. Scarpa's fascia was closed with vicryl in an interrupted fashion. Skin closed with 4.0 subcuticulars. irrigated and dried.
REOP DIAG: Incarcerated left inguinal hernia
PROCEDURE PERFORMED: left inderect inguinal hernia repair with mesh
Abdomen prepped and draped in a sterile fashion. 6cm incision from the line connecting the pubic tubercle to the anterior superior illac spine using a #15 blade. The deeper tissue were dissected using the cautery current with bovie. The fascia incised using the cutting current of the bovie and then extended the incision medially and then laterally.
The fascia was grasped between 2 allis clamps and the hernia sac was easily seen as well as the ilioinguinal nerve which was dissected and removed and retracted out of the field. The sac opened and contents omentum which was reducted into abdominal cavity. The sac was then dissected free from the vas deferens and the blood supply. The testicle was brought out of the scrotum and the sac was completely dissected and the testicles returned back to the scrotum The sac was then ligated at its base and the sac was transected above the suture and sent off the field to path. The would was irrigated and dried. There was a small component of direct hernia persent as well and decision was made to use performed mesh with a small diaphragm that sits in the direct space. the apex of the mesh was sutured down to the pubic tubercle using a 2-0 prolene and interrupted stitches were used to suture the mest with a 2-0 prolene to the conjoined tendons superiorly and inferiorly to th einguinal ligament.
A small incision made in the mesh to wrap around the cord structures ensuring that the vas was protected. Continued to insure cord would not be strangulated. Fascia was closed over the repair using vicryl running stitch. This tied medially. Wound irrigated and dried. Scarpa's fascia was closed with vicryl in an interrupted fashion. Skin closed with 4.0 subcuticulars. irrigated and dried.