ksb0211
Guest
Just wanted a little input with this one. I don't usually code these types of surgeries out, so I just wanted someone else's opinion and I don't want to miss anything. Thanks.
OPERATION PERFORMED
Thoracoscopy with bleb resection, bilateral
ANESTHESIA
General
The patient was taken to the OR after induction of adequate general anesthesia, the patient was prepped with DuraPrep and draped sterilely. The patient was noted to be stable immediately after intubation on positive pressure. The patient was placed in a right lateral position and then prepped and draped. The skin incision was made in the mid axillary line approximately seventh interspace with a #15 blade. The OptiView port was passed without difficulty. I entered the chest cavity. The lung had been well deflated. The patient was noted to have evidence of ruptured blebs involving the lower lobe on the left side. The rest of the lung appeared to be remarkable for a few blebs, which appeared to be intact and asymptomatic. The 60 cm Endo stapling device was fired x3 to resect this portion of the lung. They leading edge of the left upper lobe was resected. The talc pleurodesis was then performed by spraying 5 g of aerosolized talc throughout the chest cavity. No air leak was detected at the end of the procedure. A 36 chest tube was placed and secured with 0 silk suture. The trocar sites were closed with 4-0 nylon vertical mattress sutures. A dry sterile dressing was applied.
With this completed, the patient was turned in a left lateral position. The right chest was prepped and draped. The chest tubes were removed. The skin was incised inferiorly on the right side with a #15 blade. OptiView port was passed without difficulty. The chest was entered safely. A 5 and a 12 port were then again passed as per previous. The area in question at this time was medially in the right upper lobe. The blebs were resected. The patient tolerated this well. The talc pleurodesis was again performed, a 36 chest tube was placed and secured with 0 silk. The patient tolerated the procedure. The dry sterile dressing was applied. The estimated blood loss for both procedures, perhaps 200 mL. The patient was taken to the recovery room in guarded condition. Extubation will be attempted.
OPERATION PERFORMED
Thoracoscopy with bleb resection, bilateral
ANESTHESIA
General
The patient was taken to the OR after induction of adequate general anesthesia, the patient was prepped with DuraPrep and draped sterilely. The patient was noted to be stable immediately after intubation on positive pressure. The patient was placed in a right lateral position and then prepped and draped. The skin incision was made in the mid axillary line approximately seventh interspace with a #15 blade. The OptiView port was passed without difficulty. I entered the chest cavity. The lung had been well deflated. The patient was noted to have evidence of ruptured blebs involving the lower lobe on the left side. The rest of the lung appeared to be remarkable for a few blebs, which appeared to be intact and asymptomatic. The 60 cm Endo stapling device was fired x3 to resect this portion of the lung. They leading edge of the left upper lobe was resected. The talc pleurodesis was then performed by spraying 5 g of aerosolized talc throughout the chest cavity. No air leak was detected at the end of the procedure. A 36 chest tube was placed and secured with 0 silk suture. The trocar sites were closed with 4-0 nylon vertical mattress sutures. A dry sterile dressing was applied.
With this completed, the patient was turned in a left lateral position. The right chest was prepped and draped. The chest tubes were removed. The skin was incised inferiorly on the right side with a #15 blade. OptiView port was passed without difficulty. The chest was entered safely. A 5 and a 12 port were then again passed as per previous. The area in question at this time was medially in the right upper lobe. The blebs were resected. The patient tolerated this well. The talc pleurodesis was again performed, a 36 chest tube was placed and secured with 0 silk. The patient tolerated the procedure. The dry sterile dressing was applied. The estimated blood loss for both procedures, perhaps 200 mL. The patient was taken to the recovery room in guarded condition. Extubation will be attempted.