Histrelin Implantation
Codes
Histrenlin implantation (CPT 11980)
Background
- Histrelin is an implantable GnRH agonist releasing device
- Suppresses LH, FSH release
- Some may have to be exchanged regularly (every 12 mo)
Indications
- precocious puberty ICD 10 = E30.1
- Gender identity disorder ICD 10 = F64.0
Preoperative workup
- usually at recommendation of endocrinologist
Surgical technique
- Position patient supine, left arm out
- Do not usually need circumferential prep
- Make a 2 cm incision and create a subdermal pocket with a hemostat
- Inject the medication and close
Complications and post-op care
- do not need routine follow up with surgeon
Surgeon specifics
Kaveh Vali
- drape with sticky drapes
- pediatric laparotomy drape
- Closes with the included suture in the kit
- Steri-strip and 2x2 gauze with tegaderm
Sample dictation
PREOPERATIVE DIAGNOSIS: Hormonal imbalance. ICD 10 = E30.1
PROCEDURE: Left arm subcutaneous, insertion of hormone implant. cpt =11980
The patient was taken to the OR, intubated, general anesthesia done, timeout done, antibiotics given. We made a left 1.5 cm incision at the medial aspect of the upper arm, created a subcutaneous pocket and introduced a Histrelin implant subcutaneously. The wound was closed in 2 layers with 3-0 and 4-0 Vicryl. Steri-Strips and dressings were applied. The patient was extubated and brought to PACU.