cpc sterile

CPC sample question # 13

Indication: Chronic pelvic pain.

Procedure: The patient was taken to the operating room and IV infusion was performed. She was placed on the operating table in the dorsal supine position. Following induction of general endotracheal anesthesia, she was placed in the dorsal lithotomy position. Her abdomen and perineum were prepped and draped in the usual sterile fashion for the laparoscopy.

The cervix was visualized with a weighted speculum and a manipulator was placed. The speculum was removed and a picture of the laparoscopic portion of the procedure was tacken.

A 1 cm long vertical incision was made at the umbilicus. A Veress needle was introduced into the abdominal cavity. The umbilical site a suprapubic site were injected with 25 percent Marcaine with epinephrine prior to the incision. The abdomen was insufflated with CO₂  gas. The Veress needle was removed and a 10 mm trocar was placed in the umbilical incision without difficulty. The scope was placed through the sleeve and under direct visualization, a second puncture site was made with a 5 mm trocar. It was approximately 3 cm from the pubic symphysis in the midline. The pelvis was noted to be as previously described. The ovarian cyst was aspirated and approximately 20 cc of serous obtained. The area of fleshy appearing endometriosis along the right uterosacral ligament was cauterized. Hemostasis was assured.

The CO2 gases were allowed to escape and both trocar sleeves were removed with direct visualization and hemostasis noted. Each site then closed using 4-0 Vicryl in a subcuticular fashion. Sterile dressings were applied.

a.    49322, 625.9, 617.3, 620.2
b.    49323, 625.9, 617.1
c.    49322, 620.2, 617.3
d.    49323, 625.9, 620.2 


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