CPT® Code 58262

The CPT® Code 58262 refers to a surgical procedure known as a vaginal hysterectomy, specifically for the removal of a uterus weighing 250 grams or less, along with the removal of one or both fallopian tubes and/or ovaries. This procedure is typically indicated for various gynecological conditions that necessitate the removal of the uterus and associated reproductive structures. The process involves several critical steps, beginning with the placement of tenacula on the cervix to provide traction. The vaginal mucosa is then incised around the cervix, allowing access to the surrounding anatomical structures. Blunt and sharp dissection techniques are employed to separate the bladder from the uterus, ensuring that the bladder is elevated to expose the peritoneal vesicouterine fold, which is subsequently incised. The procedure continues with the exposure of the cul-de-sac and the broad ligament, where the uterosacral and cardinal ligaments are clamped, divided, and ligated to facilitate the removal of the uterus. The posterior uterine wall is grasped, and the uterus is delivered into the vagina. If the fallopian tubes and ovaries are to be removed, additional steps are taken to clamp and incise the tubo-ovarian round ligaments, followed by the transection of the fallopian tubes. The procedure concludes with the careful removal of the uterus, tubes, and ovaries, if applicable, and the management of any bleeding from the broad ligament. The peritoneum is then closed, and the vaginal cuff is left open to allow for drainage of the pelvis. This comprehensive description outlines the essential components of the procedure, emphasizing the surgical techniques and anatomical considerations involved in a vaginal hysterectomy with the removal of additional reproductive structures.