In simple words: This surgery removes the uterus and cervix (the lower part of the uterus), along with nearby lymph nodes and possibly the fallopian tubes and ovaries.A large incision is made in the abdomen to perform this extensive procedure.

This procedure involves the complete removal of the uterus and cervix, including the parametrium, via an abdominal incision.It also includes the removal of all pelvic lymph nodes bilaterally and sampling of para-aortic lymph nodes.The fallopian tubes and/or ovaries may also be removed as part of the procedure.The procedure begins with a midline abdominal incision, exploration of the abdominal cavity, and taking washings for pathology. The round ligaments are cut, and the uterus is mobilized by incising and clamping the broad ligaments, uterine arteries (near the ureters), uterosacral ligaments, and separating the bladder and rectum from the vagina.Pelvic and para-aortic lymph node dissection follows, potentially before or after uterine removal.A suprapubic catheter may be placed. Finally, the vagina is closed, followed by closure of the peritoneum, muscle, fascia, and skin incision.

Example 1: A 55-year-old female patient presents with a diagnosis of stage IB cervical cancer.A radical abdominal hysterectomy with bilateral pelvic and para-aortic lymph node dissection is performed., A 48-year-old patient presents with stage II endometrial cancer. A radical abdominal hysterectomy, bilateral salpingo-oophorectomy (removal of fallopian tubes and ovaries), and pelvic and para-aortic lymph node dissection are performed., A 60-year-old patient with a history of cervical cancer is undergoing a second surgery for recurrent disease after prior radiation therapy. A radical hysterectomy with bilateral pelvic lymphadenectomy and para-aortic lymph node sampling is performed, along with additional surgical management of the recurrence.

* Detailed pathology report of removed specimens (uterus, cervix, lymph nodes, etc.)* Operative report clearly detailing all surgical steps, including lymph node counts and locations* Preoperative imaging (e.g., MRI, CT scan) showing the extent of the disease* Complete patient history and physical exam documenting the diagnosis and indication for surgery* Any relevant consultations with other specialists

** This code represents a significant surgical undertaking and requires meticulous documentation to ensure accurate coding and reimbursement.Understanding the nuances of lymph node dissection and the potential inclusion of other structures is crucial for proper coding.