PROCEDURE IN DETAIL: Patient was taken to the operating room and was placed in dorsal lithotomy position and was prepped and draped in standard surgical fashion.
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Intra-abdominal entry was not made in this patient. The patient was examined under anesthesia. It appeared that patient had a rather aggressive LEEP in the past. Her cervix was virtually absent. When we placed the duck billed speculum in the vagina we could not find a cervix or a cervical opening.
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Intraoperative ultrasound was then performed which demonstrated a large collection of blood within the uterus with complete occlusion of the presumed cervical endocervical canal.
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Patient wanted to have kids and therefore a recanalization procedure along with division of the uterus was needed.
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Subsequently, multiple lacrimal duct probes were taken and a tentative cervical canal was formed with lacrimal duct probe and under ultrasound guidance an opening into the uterus was made in a transvaginal fashion. As soon as we entered the uterus, old hematometra was evacuated, evacuating approximately 200 mL of blood under ultrasound guidance. This blood was old and altered. Subsequently, we needed to suture the upper vagina to the endocervical canal with multiple interrupted stitches and the minimal cervical tissue that was found was subsequently sutured onto itself with a cervical stent. A red rubber Foley catheter was subsequently inserted into the uterus and was passed through the vagina to keep the newly created endocervical canal open.
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The red rubber Foley catheter was basted to the right thigh of a patient. Multiple intraoperative pictures with ultrasound guidance were taken and were uploaded to the patient’s chart.

I have NO idea. My surgeon wants me to use 58540 but that does not seem correct to me.

Any help is greatly appreciated!! 😮