Laparoscopic helium plasma coagulation for the treatment of endometriosis

NICE interventional procedures guidance [IPG171] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic helium plasma coagulation for the treatment of endometriosis.

It replaces the previous guidance on laparoscopic helium plasma coagulation for the treatment of endometriosis (Interventional Procedures Guidance no. 54, March 2004).

As part of the NICE's work programme, the current guidance was considered for review in June 2009 but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current.

  • Description

    Laparoscopic helium plasma coagulation is used to treat endometriosis.

    Endometriosis is a common condition. Women with endometriosis have deposits of endometrial tissue, which should be confined to the lining of the uterus, outside the uterus. Symptoms include pelvic pain, dyspareunia, dysmenorrhoea or infertility.

    Most women with endometriosis can be treated with analgesia and hormone treatment. Women who do not respond may be offered minimally invasive surgery to excise or vaporise the endometriotic deposits, most commonly by electrocautery or laser through a laparoscope. Women with very severe symptoms may be offered more radical treatment with hysterectomy and removal of the ovaries.

    Laparoscopic helium plasma coagulation of endometriosis is another way of vaporising endometrial deposits. Using a laparoscope, an ionised beam of helium gas is directed at endometrial deposits to destroy the affected tissue. 

  • OPCS4.6 Code(s)

    The assignment of an OPCS-4 code(s) is dependent on the anatomical site of the endometriosis. For example, if the endometrial deposits are outside of the uterus, this procedure may be assigned a code referring to operations on the peritoneal cavity or operations specifically directed at other individual intra-abdominal organs. Depending on the main procedure code assigned; an additional OPCS-4 procedure code Y13.1 Cauterisation of lesion of organ NOC can be utilised in a secondary position, in addition to the body system code, to classify the helium plasma coagulation.

    The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.

    The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

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