Question 1714

Question Answered step-by-step Assign ICD-10-PCS codes to the following case studies.2. Operative ReportPREOPERATIVE DIAGNOSIS: Recurrent sigmoid volvulus and tumorPOSTOPERATIVE DIAGNOSIS: Recurrent sigmoid volvulus and tumorOPERATION: Laparoscopic-assisted sigmoidectomyDESCRIPTION: Under general anesthesia, three trocars were placed, one each in the left mid quadrant, the right lower quadrant and right mid area. The patient was placed in Trendelenberg position and the small bowel are retracted. We then stapled across the proximal rectum. The proximal margin was measured for distance from the tumor and for adequate length for re-anastomosis. We opened up a lower pelvic wound and dissected down. The fascia was opened and rectus muscle retracted. The distal end of the colon was pulled out through the wound to the desired length. The sigmoid was transected with a stapler and specimen sent off the table. A colostomy was not necessary. Therefore, staple line was opened up and a running baseball stitch suture was placed around the anvil. We then placed the colon back into the abdominal cavity. Gloves were changed. The EEA stapler was placed into the rectum. The spike was pierced through and the anvil was attached and secured. The colon was checked for twisting or kinking. The EEA stapler was closed, final checked and fired. The stapler was opened and removed from the rectum with the two intact donuts, which were sent as proximal and distal margins. Returning to the lower pelvic wound, the pelvis was irrigated clear. The gutters were inspected and suction dried. The trocars were then removed under direct visualization. Hemostasis achieved. The pelvic wound fascia was reapproximated with 0-vicryl. The subcutaneous and skin was closed with 4-0 Vicryl. Trocar wounds were clean, dry and dressed with steri-strips and clean dressing. Health Science Science Nursing HIM 2410 Share QuestionEmailCopy link Comments (0)

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