Tisshield™ is applicable in any open surgical procedure where deep retraction or shielding is required, and to expedite non-assisted large incision fascial closure. Some suggested procedures and CPT codes are included on this page, falling under the categories of General, Obstetrics/Gynecology, and Orthopaedic surgery. More procedures will be added as device applicability is determined by surgeons. To the right is a diagram illustrating how the device gently expedites fascial closure.

Diagram of fascial closure

Diagram of Large-Incision Fascial Closure. The curved shield attaches to Bonnie Forceps, held in the left hand, to retract the skin and subcutaneous layer, exposing the fascia. The suture needle is then driven through the fascia with a needle driver in the right hand, to be picked up by the forceps. The process can be repeated on the patient's left side by inverting the forceps.

General Surgery

Jejunostomy

Retraction and shielding with Debakey Forceps (gasatrojejunostomy)

Large-Incision Fascial Closure

Non-Assisted Large-Incision Fascial Closure using Bonnie Forceps

Attach Tisshield™ to Debakey and Bonnie forceps in any open abdominal procedure to retract tissues or to retract skin during non-assisted fascial closure. Use the flat blade to fit into tighter areas for additional retraction or shielding, as in liver resections.

Gastrointestinal

CPT Code	Procedure
37140	Sarfeh shunt (portocaval)
37799	Y graft for pancreas tx
38100	Splenectomy
38570	Lymph node biopsy
39599	Diaphragm unlisted (thoracentesis)
43325	Fundoplasty (esophagogastric)
43611	Excision stomach CA
43639	Partial prox gastrectomy, vagotomy, Pyloroplasty
43820	Gastrojejunostomy w/o vagotomy
43830	Gastrostomy tube, open
44005	Enterolysis
44010	Duodenotomy for biopsy, explore
44010	Duodenum exploration
44015	Feeding jejunostomy
44120	SB resection
44130	Entero-enterostomy
44602	Enterorrhaphy for perforation, SB
44602	Enterorrhaphy for perforation
44800	Meckel's excision

Hepatobiliary

CPT Code	Procedure
47001	Liver biopsy
47010	Open drainage of liver abscess, hepatotomy
47100	Liver biopsy, wedge
47120	Hepatectomy
47120	Segment resection, liver
47122	Trisegmentectomy
47125	L lobectomy (liver)
47130	R lobectomy
47300	Marsupialization of abscess/cyst
47350	Repair simple liver hem. with suture
47360	Repair complex liver fx with suture
47380	RFA open
47382	RFA percutaneous
47399	Liver mobilization (unlisted procedures)
47420	Choledochostomy (CBD expl)
47460	Transduod sphincteroplasty
47480	Cholecystostomy
47550	Choledochoscopy
47554	With removal of stones
47562	Lap cholecystectomy
47563	Lap cholecystectomy w/ IOC
47600	Open cholecystectomy

Pancreatic

CPT Code	Procedure
47612	Cholecystectomy w/ CBD expl
47701	Portoenterostomy
47712	Excision of BD tumor, intrahepatic
47711	Excision of BD tumor (ampullary)
47715	Choledochal cystectomy
47760	Choledocho-jejunostomy
47765	Intrahep duct-GI anatomosis
47785	Intrahep duct-GI anatomosis, roux-en-Y
47800	CBD-CBD anastomosis
48005	Debride pancreas tissue
48100	Pancreas biopsy
48140	Distal pancreatectomy
48145	Pancreaticojejunostomy
48150	Whipple, standard
48153	Whipple, pylorus sparing
48180	Pancreaticojejunostomy, S-S anastomosis
48520	Enteropseudocystostomy
49000	Exploratory laparotomy
49000	Abdomen biopsy
49002	Re-exploration, recenntly open
49040	Abscess drainage/abdomen
49255	Omental biopsy, excision
49320	Diag laparoscopy, abd, peritoneum, omentum
49560	Incisional
49585	Hernia repair, umbilical
74300	Cholangiogram, intra-op

Obstetrics/Gynecology

Tisshield is useful for retraction of obstructive surrounding vaginal tissues. Place the device on Debakey forceps to facilitate left-side retraction and increase exposure. Below is an expanding list of procedures verified by surgeons.

CPT Code	Procedure
57280	Abdominal Sacral Colpopexy, Burch
TBD	TBD

Orthopaedic Surgery

Attach Tisshield™ to Bonnie forceps to expedite large-incision fascial closure at the apex of the incision. Anywhere from 3-5 minutes can be saved if the closure is non-assisted.

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