CPT® Code 58280

The CPT® Code 58280 refers to a surgical procedure known as a vaginal hysterectomy, which involves the removal of the uterus through the vaginal canal. This specific code is used when the procedure includes a total or partial vaginectomy, which is the surgical removal of part or all of the vaginal wall, along with the repair of an enterocele, a type of hernia that occurs when the small intestine protrudes into the vaginal wall. The procedure begins with the placement of tenacula, which are surgical instruments used to grasp the cervix, allowing for better access and visibility during the operation. The vaginal mucosa, or the lining of the vagina, is then incised around the cervix to facilitate the removal of the uterus. During the surgery, careful dissection is performed to separate the bladder from the uterus, ensuring that surrounding structures are preserved. The bladder is elevated to provide access to the peritoneal vesicouterine fold, which is then incised to expose the cul-de-sac. The broad ligament, which supports the uterus, is also exposed and manipulated to allow for the clamping and division of the uterosacral and cardinal ligaments, which are critical for uterine support. Once the uterus is detached, it is delivered into the vagina, and the fallopian tubes are transected. The procedure may also involve the removal of the vaginal wall, with incisions made along both the anterior and posterior aspects, depending on whether a total or partial vaginectomy is performed. The enterocele repair is an integral part of this procedure, where the sac is incised, and the small bowel is repositioned before closing the sac with sutures. This comprehensive approach ensures that both the uterus and any associated conditions, such as an enterocele, are effectively addressed during the surgical intervention.