CPT® Code 58263

The CPT® Code 58263 refers to a surgical procedure known as a vaginal hysterectomy, specifically for a uterus weighing 250 grams or less. This procedure involves the removal of the uterus along with the associated fallopian tubes and/or ovaries, and it includes the repair of an enterocele, which is a type of hernia that occurs in the pelvic region. The procedure is performed through the vaginal canal, utilizing various surgical techniques to ensure the safe and effective removal of the reproductive organs while addressing any complications such as an enterocele. The process begins with the placement of tenacula on the cervix to provide traction, followed by an incision of the vaginal mucosa around the cervix. The bladder is then carefully separated from the uterus using both blunt and sharp dissection techniques. This meticulous approach allows for the elevation of the bladder and exposure of the peritoneal vesicouterine fold, which is subsequently incised to facilitate access to the pelvic cavity. The procedure continues with the clamping and division of the uterosacral and cardinal ligaments, leading to the delivery of the uterus into the vagina. If necessary, the fallopian tubes and ovaries are also removed during this procedure. The enterocele repair involves opening the vaginal mucosa over the enterocele, dissecting the perirectal fascia, and closing the sac with sutures after repositioning the small bowel. This comprehensive description highlights the complexity and precision required in performing a vaginal hysterectomy with enterocele repair, ensuring that all anatomical structures are handled with care to promote optimal patient outcomes.