CPT® Code 57111

The CPT® Code 57111 refers to a surgical procedure known as a complete radical vaginectomy, which involves the total removal of the vaginal wall along with the adjacent paravaginal tissue. This procedure is more extensive than a standard vaginectomy, as it not only excises the vaginal wall but also includes the removal of the paracolpium, the connective tissue surrounding the vagina. The surgical approach begins with an incision made across the top of the vaginal vault, followed by two longitudinal incisions that extend full thickness along both the anterior (ventral) and posterior (dorsal) aspects of the vaginal wall. These incisions run from the top of the vaginal vault down to the introitus, or vaginal opening. Additionally, an incision is made around the introitus to facilitate the excision of the right and left halves of the vaginal wall. In the case of CPT® Code 57111, the procedure is characterized by the transection of the bladder and rectal pillars at their attachment points, allowing for the complete resection of the anterior and posterior vaginal walls, as well as the lateral paravaginal spaces. It is important to note that any subsequent vaginal reconstruction, which may involve the use of skin grafts, can be reported separately, either during the same surgical session or at a later date.