Histrelin Implantation

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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.

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