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A radical vaginal hysterectomy, specifically referred to as the Schauta type operation, is a comprehensive surgical procedure that involves the removal of several key reproductive structures. This procedure is characterized by the excision of the uterus, cervix, pelvic lymph nodes, and the upper third of the vagina. In many cases, the fallopian tubes and ovaries are also removed, along with the surrounding parametrial tissue. The operation typically requires a combination of vaginal and abdominal approaches to ensure complete access to the pelvic and para-aortic lymph nodes, which are critical for assessing potential cancer spread. The procedure begins with the sampling of para-aortic lymph nodes, which involves making an abdominal incision to isolate and biopsy these nodes. Following this, the surgeon proceeds with the radical hysterectomy through the vaginal route, meticulously dissecting and removing the necessary tissues while preserving important anatomical structures such as the genitofemoral nerve and psoas muscle. The operation concludes with the excision of the upper vaginal wall, which may be followed by additional reconstructive procedures if necessary. This detailed approach is essential for treating various gynecological conditions, particularly malignancies, while aiming to minimize complications and ensure thorough removal of affected tissues.
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The radical vaginal hysterectomy (Schauta type operation) is indicated for various gynecological conditions, particularly those involving malignancies. The following are specific indications for this procedure:
The radical vaginal hysterectomy involves several critical procedural steps, each designed to ensure thorough removal of the targeted tissues while minimizing complications.
Post-procedure care following a radical vaginal hysterectomy includes monitoring for complications such as bleeding, infection, and urinary issues. Patients are typically advised to rest and avoid strenuous activities for a specified recovery period. Follow-up appointments are essential to assess healing and address any concerns. Additionally, patients may require counseling regarding hormonal changes and potential impacts on sexual function, depending on whether the ovaries were removed during the procedure. Pain management and wound care instructions are also provided to facilitate recovery.
| Short Descr | EXTENSIVE HYSTERECTOMY | Medium Descr | VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION | Long Descr | Vaginal hysterectomy, radical (Schauta type operation) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1E - Major procedure - hysterctomy | MUE | 1 | CCS Clinical Classification | 124 - Hysterectomy, abdominal and vaginal |
| 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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