CPT® Code 58600

1. Indications

The procedure described by CPT® Code 58600 is indicated for the following conditions:

• Female Sterilization This procedure is primarily performed for the purpose of permanent contraception, where the patient desires to prevent future pregnancies.

2. Procedure

The procedure for ligation or transection of the fallopian tubes can be performed using either an abdominal or vaginal approach, with each method having specific steps involved.

• Abdominal Approach In the abdominal approach, the surgeon begins by making an incision in the lower abdomen to gain access to the pelvic cavity. Once the incision is made, the fallopian tubes are exposed. If a mini-laparotomy technique is utilized, the surgeon locates the fimbriated end of the fallopian tube, which is identifiable by the presence of the round ligament as a distinct structure. The fallopian tube is then grasped in its mid-portion using forceps. A loop of suture is applied to ligate the tube, effectively blocking it. Following ligation, the mesosalpinx of the loop is perforated with sutures, and the tube is transected, which means it is cut to sever its continuity. If the procedure is to be performed bilaterally, the same steps are repeated on the opposite fallopian tube.
• Vaginal Approach The vaginal approach, although less frequently utilized, involves making an incision in the posterior fornix of the vagina to access the posterior cul-de-sac. Once access is achieved, the surgeon locates the fallopian tube and grasps it in its mid-portion using forceps. Similar to the abdominal approach, the tube is then suture ligated to block it. The mesosalpinx of the loop is perforated with sutures, and the tube is transected. If necessary, this procedure is also repeated on the opposite side to ensure both fallopian tubes are addressed.

3. Post-Procedure

After the completion of the ligation or transection of the fallopian tubes, patients may be monitored for any immediate postoperative complications. Recovery typically involves standard postoperative care, including pain management and monitoring for signs of infection or other complications. Patients are usually advised on activity restrictions and follow-up appointments to ensure proper healing. The specific recovery timeline may vary based on the individual and the approach used, but most patients can expect to resume normal activities within a few weeks, depending on their overall health and the nature of the procedure performed.