CPT® Code 58285

A radical vaginal hysterectomy, specifically referred to as the Schauta type operation, is a comprehensive surgical procedure that involves the removal of several key reproductive structures. This procedure is characterized by the excision of the uterus, cervix, pelvic lymph nodes, and the upper third of the vagina. In many cases, the fallopian tubes and ovaries are also removed, along with the surrounding parametrial tissue. The operation typically requires a combination of vaginal and abdominal approaches to ensure complete access to the pelvic and para-aortic lymph nodes, which are critical for assessing potential cancer spread. The procedure begins with the sampling of para-aortic lymph nodes, which involves making an abdominal incision to isolate and biopsy these nodes. Following this, the surgeon proceeds with the radical hysterectomy through the vaginal route, meticulously dissecting and removing the necessary tissues while preserving important anatomical structures such as the genitofemoral nerve and psoas muscle. The operation concludes with the excision of the upper vaginal wall, which may be followed by additional reconstructive procedures if necessary. This detailed approach is essential for treating various gynecological conditions, particularly malignancies, while aiming to minimize complications and ensure thorough removal of affected tissues.