Cpt code open ventral hernia repair

CPT® Code 49613 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...

Cpt code open ventral hernia repair. The component separation technique is a type of rectus abdominis muscle advancement flap that reconstructs ventral hernia and large abdominal wall defects. Component separation is a fascial release of the external oblique fascia with creation of musculofascial advancement flaps. The general indications for performing a component …

K43.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM K43.9 became effective on October 1, 2023. This is the American ICD-10-CM version of K43.9 - other international versions of ICD-10 K43.9 may differ. Applicable To.

CPT® Code 49616 in section: Repair of anterior abdominal hernia (s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), …The original open anterior component separation operation creates wide skin flaps to access the external oblique aponeuroses for division. Undermining subcutaneous tissue from the rectus muscle and its associated anterior epigastric perforating vessels can devascularize this tissue, creating potential for wound necrosis, infection, or seroma ...49560: Repair initial incisional or ventral hernia; reducible. 49561: Repair initial incisional or ventral hernia; incarcerated or strangulated. 49565: Repair recurrent incisional or ventral hernia; reducible. 49566: Repair recurrent incisional or ventral hernia; incarcerated or strangulated. 49590: Repair spigelian hernia.Results: Two hybrid techniques were used: (1) initial laparoscopic approach converted to open adhesiolysis followed by totally laparoscopic mesh fixation and (2) open repair and adhesiolysis with laparoscopic-assisted mesh fixation. In the first approach, after conversion to open adhesiolysis, mesh with four quadrant sutures was placed ...Mesh Can Be Separate. Surgeons will often place prosthetic mesh to facilitate hernia repair, but coders can only report +49568 separately when the surgeon repairs an incisional/ventral hernia (49560, 49561, 49565, 49566). For all other hernia repairs (epigastric, umbilical, etc., open or laparoscopic), you cannot claim +49568, even if the ...Mean operative time was longer in LVHR (116 min) as compared to open repair (67 min) (p<0.01). Patients experienced more pain on the first and seventh postoperative days in the open group (p<0.01) and they also had a longer duration of hospital stay as compared to the laparoscopic group (6.23 ± 0.35 vs 2.17 ± 1.12 days, p …The component separation technique is a type of rectus abdominis muscle advancement flap that reconstructs ventral hernia and large abdominal wall defects. Component separation is a fascial release of the external oblique fascia with creation of musculofascial advancement flaps. The general indications for performing a component …If a diagnostic laparoscopy results in an open surgical procedure, however, you may report the diagnostic/exploratory laparoscopy separately with modifier 58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period appended. Per the Policy Manual:

The original open anterior component separation operation creates wide skin flaps to access the external oblique aponeuroses for division. Undermining subcutaneous tissue from the rectus muscle and its associated anterior epigastric perforating vessels can devascularize this tissue, creating potential for wound necrosis, infection, or seroma ...The point of hardware repairs is to ensure your devices remain usable and in good condition as long as possible, so you don’t have to spend hundreds or thousands of dollars on a ne...Analysis of data from the Danish Hernia Database between January 1, 2007 and December 31, 2010 identified a reoperation rate for recurrence of 15.5% at median follow-up of 21 months after elective laparoscopic IPOM incisional hernia repair ( 22 ). This nationwide study included 1.763 laparoscopic repairs with a conversion rate of 7.1%. 1. Exploratory laparotomy. 2. Lysis of adhesions. 3. Reduction. PROCEDURE PERFORMED: Repair of ventral hernia in the left lower quadrant in the. DESCRIPTION OF PROCEDURE: The abdomen was prepped and draped in standard fashion. A lower midline incision was then made and carried through the subq tissues to reveal the fascia. Pre-op Dx: Ventral hernia. Post-op Dx: Umbilical hernia. Procedure: Repair of umbilical hernia. Note: The procedure would be billed as 49585 (repair umbilical hernia, age 5 years or over; reducible). There are many different hernia repair procedures, and using the correct CPT and diagnosis codes when billing for such services can be quite ...

Only one muscle flap is mobilized on each side. Additional coding considerations. The hernia repair codes and code 15734 include simple repair (12001–12007), intermediate repair (12031–12037), and/or complex repair (13100–13102) of skin and subcutaneous tissues. These codes should not be reported separately when the procedures are ...Step 1: Determine if Repair is Open or Laparoscopic. CPT® provides just the following two codes for laparoscopic inguinal hernia repair: 49650 (Laparoscopy, surgical; repair initial inguinal hernia) 49651 (… repair recurrent inguinal hernia) “You can see that the distinction between these two codes is whether this surgery is the initial ...What is the average time for robotic hernia repair? Surgery time depends on how complex the repair is. Simple procedures may be as short as 30 minutes. More complex procedures may take five hours or longer. Some studies suggest that, on average, robotic hernia repair takes longer than laparoscopic repair without a robot or open surgery.Feb 28, 2017 · If a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair (e.g., CPT codes 49560-49566, 49652-49657) is not separately reportable. The hernia repair is separately reportable if it is performed at a site other than the incision and is medically reasonable and necessary.

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CPT code 15734 describes an open procedure. For more complicated laparoscopic hernia repair procedures that may include separation of components (e.g., TAR), report code CPT code 49659 (Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy). The new hernia repair codes are for any approach (i.e., open, laparoscopic, robotic).Ventral hernias in the anterior abdominal wall include both spontaneous or primary hernias (e.g., umbilical, epigastric, and spigelian) and, most commonly, incisional …For 2023, CPT approved significant coding changes, as summarized in this column. The full 2023 CPT code descriptors are presented in Table 1. Delete codes 49560–49590, which …CPT® Code 49618 in section: Repair of anterior abdominal hernia (s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), …Open Ventral Hernia Repair. In open hernia repair, also called herniorrhaphy, a person is given general anesthesia to sedate or help the person sleep, and this is often augmented with epidural anesthesia to improve recovery time and pain control. Then the surgeon makes an incision on the abdomen, releases scar tissue, and moves the hernia ...Repair recurrent incisional or ventral hernia; reducible 090 12.37 22.20 +49568 Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair) ZZZ 4.88 7.76 + = add-on code

Step 1: Change the discharge visit code from 1.0 to 0.5 (e.g., 0.5 x CPT code 99238) and subtract one-half of the work RVU for that code. Step 2: Remove all inpatient visit codes (e.g., CPT codes 99231-99233) and subtract the work RVU for those codes. Step 3: Sum the “intra” face-to-face time for the deleted inpatient codes and multiple by ...Methods: Cost data on all consecutive open ventral hernia repairs (CPT codes 49560, 49561, 49565, and 49566) performed between 1 July 2008 and 31 May 2011 were analyzed. Cases were analyzed based upon hospital status (inpatient vs. outpatient) and whether the hernia repair was a primary or secondary procedure.Laparoscopic ventral hernia repair coding does not follow the exact parallel taxonomy of open repair. First, all laparoscopic procedures are valued to include placement of mesh or other prosthesis. In the laparoscopy section, there are two codes for the repair of umbilical, epigastric, or Spigelian hernias: one reducible (49652) and one ...was used for the ventral hernia repair, use 9568 as an add-on code. How does one code for the mesh when billing an umbilical hernia repair with mesh? Can the add-on code of 49568 still be used? No,dd-on this a code is only for incisional or ventral hernia. With the exception of incisional and ventral hernias ( 9560 and 9566), use ofAbstract. In this article, the authors describe their current operative technique for open ventral hernia repair using component separation. Although methods of anterior component separation are described, in their current practice, the authors primarily use posterior component separation with transversus abdominis release to permit dissection ...PROCEDURE. NATIONAL AVERAGE MEDICARE PAYMENT3. Facility Non-Facility. Debridement of the Abdominal Wall. 15734. 15777. Component Separation. Muscle, …The appropriate codes would be 47562 (Laparoscopy, surgical; cholecystectomy) and 49592 (Repair of anterior abdominal hernia (s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect (s); less ...The 2022 CPT codes for anterior abdominal hernia repair had a 90-day global period, and there were separate codes for reporting open and laparoscopic repair. The previous codeset had no option to discriminate for the size of the hernia to be repaired. The 2022 codes were deleted and replaced with new “any method” codes in 2023 that …Open repair of incisional hernia requiring mesh: 25/02/2016: T2503: ... Primary repair of ventral hernia not requiring mesh: Pre Sept 2014: ... These coding principles set out how the authors intend that the codes and narratives within the …For assistance with coding and reimbursement, please contact our Integra Reimbursement Hotline at 1-877-444-1122, option 3, option 1, Monday to Friday, 8 am to 6 pm, or via email at [email protected]. Reference: CPT® Code Book 2024. Current Procedural Terminology (CPT) copyright 2023 American Medical Association (AMA).Per NCCI manual: If a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair (e.g., CPT codes 49560-49566, 49652-49657) is not separately reportable. The hernia repair is separately reportable if it is performed at a site other than the incision and is medically reasonable …CPT® Code 49614 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...

This has led surgeons to explore the possibility of using the retro-rectus space for ventral hernia repair. ... Anurov M, et al. Impact of mesh positioning on foreign body reaction and collagenous ingrowth in a rabbit model of open incisional hernia repair. Hernia. 2010; 14:71–7.

49560: Repair initial incisional or ventral hernia; reducible. 49561: Repair initial incisional or ventral hernia; incarcerated or strangulated. 49565: Repair recurrent incisional or …CPT®. Description. 49613. Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, …Hernia repair with mesh should be considered for patients with defects larger than 4 cm. (Some would place the cutoff lower—for example, at 2.3 cm [] or as low as 1 cm. [] A study by Frey found mesh repair to be safe and effective for even smaller hernias. [] ) The type of mesh to be used is selected on the basis of the surgeon's preference and …Laparoscopic (including robotic) or open ventral (including incisional) hernia repair may be reported with CPT codes listed below depending on the size of defect and the indication. The separation component (CST) is reported with CPT code 15734 when performed open. When performed by laparoscopic technique, it is reported by unlisted CPT code ...I need help with CPT codes for the attached report. The diagnosis was Diastasis recti and the doctor indicates that he did an open ventral hernia repair, a laparoscopic ventral hernia repair with mesh and an abdominoplasty. The CPT codes I am considering are 49565, 49568, 15830, and 15847. I am not confident that these are the …Open Ventral Hernia Repair. In open hernia repair, also called herniorrhaphy, a person is given general anesthesia to sedate or help the person sleep, and this is often augmented with epidural anesthesia to improve recovery time and pain control. Then the surgeon makes an incision on the abdomen, releases scar tissue, and moves the hernia ...CPT stands for Current Procedural Terminology and is administered by the AMA (American Medical Association). HCPCS stands for Healthcare Common Procedural Coding System and is base...

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Laparoscopic ventral hernia repair coding does not follow the exact parallel taxonomy of open repair. First, all laparoscopic procedures are valued to include placement of mesh or other prosthesis. In the laparoscopy section, there are two codes for the repair of umbilical, epigastric, or Spigelian hernias: one reducible (49652) and one ...An average of 610,998 ventral hernia repairs were performed per year from 2016 to 2019 for a total of 2,443,989 patients in the study period. Patients undergoing open inpatient hernia repair had a higher mean comorbidity index score (2.2, 95% CI 2.1–2.2) vs. patients who underwent outpatient repair (1.8, 95% CI 1.7–1.8) (Table 2).CPT® Code 49616 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...Mesh Can Be Separate. Surgeons will often place prosthetic mesh to facilitate hernia repair, but coders can only report +49568 separately when the surgeon repairs an incisional/ventral hernia (49560, 49561, 49565, 49566). For all other hernia repairs (epigastric, umbilical, etc., open or laparoscopic), you cannot claim +49568, even if the ...My surgeon performed a Hybrid Hernia Repair. This is an open umbilical hernia repair (incarcerated) with robotic laparoscopic mesh placement. This type of... Menu. Forums. New posts Search forums. ... Code as open 49587 w/ ICD V64.41. L. liz_snyder Contributor. Local Chapter Officer. Messages 21 Location Lima, Ohio Best answers 0 ...CPT® Code 49592 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...Best answers. 0. Jun 10, 2011. #2. Just repot the colostomy take down if its at the same site, see NCCI documents on hernia repairs. 4. If a hernia repair is performed at the site of an incision for an open abdominal procedure, the hernia repair (CPT codes 49560-49566) is not separately reportable. The hernia repair is separately reportable if ...For assistance with coding and reimbursement, please contact our Integra Reimbursement Hotline at 1-877-444-1122, option 3, option 1, Monday to Friday, 8 am to 6 pm, or via email at [email protected]. Reference: CPT® Code Book 2024. Current Procedural Terminology (CPT) copyright 2023 American Medical Association (AMA).229. Best answers. 0. Jan 19, 2012. #2. Maybe: 44202-52 (-52 for no anastomosis) OR 44238 with 49653 (-51 if needed). I don't see any edits for these codes so I'd bill it. Payer might have a policy but I appeal with info below. CPT Assistant June '08 states "Hernia repair codes report the repair of the hernia only. ….

If your HP laptop is not working or is malfunctioning and you have done everything you can do to fix the problem yourself, you will need to have the laptop repaired by a profession...If a diagnostic laparoscopy results in an open surgical procedure, however, you may report the diagnostic/exploratory laparoscopy separately with modifier 58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period appended. Per the Policy Manual:Only one muscle flap is mobilized on each side. Additional coding considerations. The hernia repair codes and code 15734 include simple repair (12001–12007), intermediate repair (12031–12037), and/or complex repair (13100–13102) of skin and subcutaneous tissues. These codes should not be reported separately when the procedures are ...49565 Repair recurrent incisional or ventral hernia; reducible $ 808 49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated $ 987 49568 Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in ...Between 2009 and 2017, the percentage of minimally invasive inguinal hernia repairs increased from 23.1 to 37.8%, whereas the percentage of minimally invasive ventral hernias only increased from 31.5 to 36.6%. Open inguinal hernia repairs had a wound complication rate ranging from 0.60 to 0.74%, which was double the rate of minimally …CPT® Code 49613 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...CPT® Code 49595 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ...Incisional ventral hernias represent a considerable disease burden, as approximately 2 million abdominal operations are performed in the US each year, and up to 20% of those can be complicated by development of an incisional hernia. 1 Definitive management consists of elective repair; however, a variety of patient- and provider-driven factors can …Pre-op Dx: Ventral hernia. Post-op Dx: Umbilical hernia. Procedure: Repair of umbilical hernia. Note: The procedure would be billed as 49585 (repair umbilical hernia, age 5 years or over; reducible). There are many different hernia repair procedures, and using the correct CPT and diagnosis codes when billing for such services can be quite ... Cpt code open ventral hernia repair, Valuable guidance on this topic can be found in the NCCI Policy Manual, Chapter 6, section E.4, which states: “ If a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair (e.g., CPT codes 49560-49566, 49652-49657) is not separately reportable., Dec 31, 2016 · Laparoscopic ventral hernia repair coding does not follow the exact parallel taxonomy of open repair. First, all laparoscopic procedures are valued to include placement of mesh or other prosthesis. In the laparoscopy section, there are two codes for the repair of umbilical, epigastric, or Spigelian hernias: one reducible (49652) and one ... , Surgeons will often place prosthetic mesh to facilitate hernia repair, but coders can only report +49568 separately when the surgeon repairs an incisional/ventral hernia (49560, 49561, 49565, 49566). For all other hernia repairs (epigastric, umbilical, etc., open or laparoscopic), you cannot claim +49568, even if the surgeon places mesh during ..., CPT® Code 49594 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ..., Purpose. Ambiguity exists defining abdominal wall reconstruction (AWR) and associated Current Procedural Terminology code usage in the context of ventral hernia repair (VHR), especially with recent adoption of laparoscopic and robotic-assisted AWR techniques. Current guidelines have not accounted for the spectrum of repair complexity and have ..., There are thousands of existing codes that are updated each October. The current version is CPT 2018. But with thousands of codes out there at any given time, how can medical profe..., Open Ventral Hernia Repair. In open hernia repair, also called herniorrhaphy, a person is given general anesthesia to sedate or help the person sleep, and this is often augmented with epidural anesthesia to improve recovery time and pain control. Then the surgeon makes an incision on the abdomen, releases scar tissue, and moves the hernia ..., Background. In order to distinguish a ventral hernia repair from a purely cosmetic abdominoplasty, Aetna requires documentation of the size of the hernia, whether the ventral hernia is reducible, whether the hernia is accompanied by pain or other symptoms, the extent of diastasis (separation) of rectus abdominus muscles, whether there is a defect (as opposed to mere thinning) of the abdominal ... , Coders were not faced with this decision previously because incisional and ventral were under the same open codes. Florida Subscriber. Answer: You should use the appropriate incisional hernia repair code (49654-49655, Laparoscopy,surgical, repair, incisional hernia [includes mesh insertion, when performed] ... ; or 49656-49657, …, CPT® Code 49616 in section: Repair of anterior abdominal hernia (s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), …, AIM: To compare long term outcomes of laparoscopic and open ventral hernia mesh repair with respect to recurrence, pain and satisfaction. METHODS: We conducted a single-centre follow-up study of 194 consecutive patients after laparoscopic and open ventral hernia mesh repair between March 2000 and June 2010. Of these, …, Ventral hernias of the abdomen are defined as a non-inguinal, nonhiatal defect in the fascia of the abdominal wall. Annually, there are about 350,000 ventral hernia operations. The repair of these abdominal wall defects is a common surgery performed by general surgeons. Surgery is typically recommended for individuals with acceptable …, Patient has a history of hiatal hernia for many years, which has progressively gotten worse. The decision to repair the hernia was made, and the patient was sent to the operating room where the repair took place via the thorax and abdomen. 39503 Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of …, The original open anterior component separation operation creates wide skin flaps to access the external oblique aponeuroses for division. Undermining subcutaneous tissue from the rectus muscle and its associated anterior epigastric perforating vessels can devascularize this tissue, creating potential for wound necrosis, infection, or seroma ..., CPT®. Description. 49613. Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, …, Upper abdominal intraperitoneal hernia repairs would use anesthesia CPT code 00752 if the hernia is reducible and 00790 if the hernia is incarcerated or strangulated. For lower abdominal hernia procedures, anesthesia CPT code 00832 is used if the hernia is reducible and 00840 if it is incarcerated or strangulated. B. Complexity. Although the ..., Multiple Ventral Hernia Repair CPT Code The ventral hernia may be present at multiple sites of abdominal wall and repair is required to stop abdominal problems like bowel syndrome etc. Multiple hernia repair can be done wither by open or laparoscopic technique. The CPT code used for this process is 49650, 49560-66. …, was used for the ventral hernia repair, use 9568 as an add-on code. How does one code for the mesh when billing an umbilical hernia repair with mesh? Can the add-on code of 49568 still be used? No,dd-on this a code is only for incisional or ventral hernia. With the exception of incisional and ventral hernias ( 9560 and 9566), use of, The 2005–2012 ACS-NSQIP participant use data files were accessed on February 1, 2014. These files were queried to identify all patients undergoing ventral hernia repair (VHR). Current procedural terminology (CPT) codes were used to identify the following inpatient open hernia repairs: 49,560, 49,561, 49,565, and 49,566., Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair) (Use 49568 in conjunction with 11004–11006, 49560–49566) 4.88: 21 (15) New codes (as of 2023) 49591, Feb 14, 2022 ... A common scenario for selecting both a ventral hernia repair and prophylaxis option would be a parastomal hernia repair where the stoma was ..., Things break down, whether due to accidents, negligence, or just plain wear and tear. Instead of shelling out for an expensive repair or replacement, though, you can often fix the ..., The use of mesh to repair the hernia defect either open or laparoscopic is widely used now a day [9,10]. ... and validation of a risk-stratification score for surgical site occurrence and surgical site infection after open ventral hernia repair. J. Am. Coll. Surg. 2013; 217 (6):974–982., The appropriate codes would be 47562 (Laparoscopy, surgical; cholecystectomy) and 49592 (Repair of anterior abdominal hernia (s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of …, The original open anterior component separation operation creates wide skin flaps to access the external oblique aponeuroses for division. Undermining subcutaneous tissue from the rectus muscle and its associated anterior epigastric perforating vessels can devascularize this tissue, creating potential for wound necrosis, infection, or seroma ..., , In answer to the second question regarding sequencing for your scenarios; as the classification includes adhesions in the condition codes for ventral hernia ..., Read this article to learn about the best foundation repair methods as well as common foundation issues and signs of damage. Expert Advice On Improving Your Home Videos Latest View..., Purpose. Ambiguity exists defining abdominal wall reconstruction (AWR) and associated Current Procedural Terminology code usage in the context of ventral hernia repair (VHR), especially with recent adoption of laparoscopic and robotic-assisted AWR techniques. Current guidelines have not accounted for the spectrum of repair complexity and have ..., After about a month, most patients feel fine and are back to normal. Open Surgery. The incision for small ventral hernias is only about half an inch. In these cases, the repair can be made with stitches, instead of mesh. Open surgery for large ventral hernias, often called complex hernias, often requires abdominal wall reconstruction., The 1994 CPT code set added only two codes for laparoscopic hernia repair (49650 and 49651). Laparoscopic hernia repair was developed as a technique long after open hernia repair. In 1994, when codes 49650 and 49651 were created, very few laparoscopic inguinal hernia repairs were performed for incarcerated hernias., CPT® Code 49613 in section: Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic ..., 1. Exploratory laparotomy. 2. Lysis of adhesions. 3. Reduction. PROCEDURE PERFORMED: Repair of ventral hernia in the left lower quadrant in the. DESCRIPTION OF PROCEDURE: The abdomen was prepped and draped in standard fashion. A lower midline incision was then made and carried through the subq tissues to reveal the fascia.