Provided Surgical Procedures

1. Resection of soft tissue tumors
2. Hydrocele Repair
3. Inguinal Hernia Repair (Unilateral or Bilateral)
4. Umbilical Hernia Repair (Large)
5. Ventral Hernia Repair +/- mesh (special pediatric mesh used)
6. Orchidopexy
7. Repair of Anorectal anomalies
8. Resection of sacrococcygeal tumors (teratoma)
9. Resection/Sclerosis of lymphatic malformation
10. Resection of Pediatric thyroid masses
11. Sistrunk Procedure for Thyroglossal duct
12. Branchial cleft anomalies
13. Circumcision
14. Myotomy for Esophageal Achalasia
15. Pediatric (non-neonatal) diaphragmatic hernia
16. Resection of Ovarian Masses

1. CHALAZION EXCISION
2. ENTROPION REPAIR
3. ECTROPION REPAIR
4. REPAIR OF LID LACERATION
5. TARSORAPHY
6. EXCISION CONJUNCTIVAL LESION
7. PTERYGIUM EXCISION
8. CONJUNCTIVAL FREE GRAFT
9. SUTURE CORNEAL LACERATION
10. EXCISION OF BAND KERATOPATHY
11. SPHINCTEROTOMY
12. EXCISION PROLAPSED IRIS
13. SUTURE REPAIR OF IRIDODIALYSIS/KEY HOLE PUPIL
14. IRIDECTOMY/IRIDOTOMY
15. SUTURE SCLERAL LACERATION
16. REPOSITIONING PROLAPSED IRIS POST OP
17. INTRACAPSULAR CATARACT EXTRACTION
18. PHACOEMULSIFICATION CATARACT EXTRACTION
19. MANUAL SMALL INCISION CATARACT SURGERY
20. CATARACT EXTRACTION NEC
21. I&A REMOVAL OF CONGENITAL CATARACT
22. PARS PLANA VITRECTOMY
23. PRIMARY POSTERIOR CAPSULOTOMY
24. YAG CAPSULOTOMY
25. INSERTION OF IOL AT CATARACT EXTRACTION
26. SECONDARY INSERTION OF IOL
27. IMPLANTED LENS EXTRACTION
28. REPOSITIONING DISLOCATED IOL POSTOP
29. ANTERIOR VITREOUS EXCISION PEDS CONGENITAL CATARACT VITRECTOMY
30. MECHANICAL VITRECTOMY
31. ONE EXTRAOCULAR MUSCLE RECESSION
32. ONE EXTRAOCULAR MUSCLE RESECTION
33. REMOVAL PENETRATING FOREIGN BODY TO EYE
34. EVISCERATION WITH SYN IMPLANTATION
35. ENUCLEATION WITH IMPLANT
36. ENUCLEATION WITH NO IMPLANT
37. EXENTERATION
38. REPAIR EYEBALL RUPTURE
39. REMOVAL OF SUPERFICIAL FOREIGN BODY EYE

Congenital and Developmental Malformation Repair/Correction

1. Unilateral Cleft Lip Repair
2. Correction of Unilateral Cleft Lip Nasal Deformity (At time of primary repair)
3. Bilateral Cleft Lip Repair
4. Pre-maxillary Repositioning
5. Nasal Tip Rhinoplasty
6. Cleft Palate Repair – Two Flap Palatoplasty
7. Cleft Palate Repair – Furlow Palalasty
8. Cleft Palate Repair-Furlow Palatoplasty, with bilateral buccal fat flap augmentation
9. Cleft Palate Repair- Other (Langenbeck, Veau-Kilner, Etc.)
10. Secondary Correction of Velopharyngeal  Insufficiency – Superiorly based Pharyngeal Flap (Hogan)
11. Secondary Correction of Velopharyngeal Insufficiency – Pharyngoplasty
12. Secondary Correction of Velopharyngeal Insufficiency – Furlow Palatoplasty with bilateral buccal fat flap augmentation
13. Tonsillectomy in combination with Pharyngoplasty or Pharyngeal Flap
14. Tonsillectomy and Adenoidectomy
15. Oro-Nasal Fistula Repair – Anterior Maxillary Vestibule
16. Oro-Nasal Fistula Repair – Anterior Hard Palate
17. Oro-Nasal Fistula Repair – Posterior Hard Palate and/or Soft Palate
18. Cleft Alveolar Bone Graft 
19. Rare (Tessier #1-14, etc.) Facial Cleft Repair
20. Fronto-Nasal-Orbital Encephalocele Repair – Extra-cranial Approach only
21. Fronto-Nasal-Orbital Encephalocele Repair  – Intra-cranial Approach
22. Management of Persistent Cranial CSF Leakage
23. Occipital Encephalocele Repair
24. Orbital Osteotomies to correct Hypertelorism
25. Telecanthus Correction
26. Maxillary Osteotomy –  LeFORT 1 (maxillary repositioning)
27. Maxillary Osteotomy – LeFORT 2 (maxillary nasal repositioning)
28. Maxillary Osteotomy – LeFORT 3 (maxillary nasal orbital repositioning)
29. Mandibular Osteotomy – segmental subapical
30. Mandibular Osteotomy-Ramus, Subcondylar, extra oral
31. Mandibular Osteotomy-Ramus, Subcondylar, intraoral
32. Mandibular Osteotomy-Ramus, Sagittal
33. Mandibular Genioplasty-inferior mandibular sliding ostostomy for advancement
34. Thyroglossal Duct Cyst Excision
35. Branchial Cleft Cyst Excision
36. Ranula-excision
37. Cutaneous Tracheal Fistula (Laryngocele) Repair
38. Cervical Tracheoesophageal Fistula Repair
39. A-V malformation Excision
40. Lymphatic Malformation  (Lymphangioma, Cystic Hygroma) Excision, Debulking, Sclerosis
41. Hemangioma Excision or Debulking
42. Neurofibroma Excision or Debulking

Nasal Surgery

1. Rhinoplasty
2. Septoplasty
3. Nasal and Nasopharyngeal Polyp-excision
4. Choanal Atresia-repair
5. Caldwell-Luc Antrostomy
6. Intranasal Ethmoid surgery
7. External Ethmoidectomy
8. Sphenoid Sinusotomy
9. Frontal Sinusotomy
10. External Frontoethmoidectomy

Neoplasms – Early or Benign

1. Orbit
   • Orbital Exenteration with Temporalis Muscle Flap Obliteration
   • Orbital Exenteration with application of Split Thickness Skin Graft (when orbital  prosthesis can be made)
   • Enucleation of globe
   • Enucleation of globe, excision of Lacrimal Gland and Conjunctiva, Lid Closure
   • Enucleation of globe, excision of Lacrimal Gland & Conjunctiva, Free Dermal Graft Placement, Lid Closure
   •  Lacrimal Gland Tumour-excsion
   • Dacryocystorhinostomy
   • Lacrimal Duct-Sac-Canaliculi Repair during Maxillectomy with Silastic Tube (Crawford Tubes) placement
   • Lower Eye Lid Reconstruction
   • Upper Eye Lid Reconstruction
   • Medial Canthoplasty
   • Lateral Canthoplasty
   •  Lateral Tarsorrhaphy (also see included with Parotidectomy) 
   • Medial Tarsorrhaphy
2. Maxilla
   • Maxillectomy-partial
   • Maxillectomy-complete, with Temporalis Muscle Flap Reconstruction
   • Maxillectomy + orbital exenteration, with Temporalis Muscle Flap Reconstruction
3. Mandible
   • Mandibulectomy-partial, condyle preserved, midline not crossed
   • Mandibulectomy-hemi, condyle preserved
   • Mandibulectomy-hemi, including condyle
   • Mandibulectomy-hemi, including condyle, in child, with primary costo-condral  graft reconstruction
   • Mandibulectomy-anterior, condyles and rami preserved, midline crossed
   • Mandibulectomy-subtotal, one condyle and proximal ramus preserved
   • Mandibulectomy-total
   • Mandibular Reconstruction with Ileac Crest Bond Graft applied to Titanium Mandibular Bone Plate
   • Temporomandibular Joint (TMJ)-bony ankylosis release,  gap arthroplasty + interartcular temporalis flap (above 10 years of age)
   • Temporomandibular Joint-bony ankylosis release, costo-condral graft reconstruction (above 10 years of age)
   • Coronoidotomy
4. Cranium
   • Fibrosseous Lesion  Resection / Debulking 
5. Soft Tissue Tumors of Head and Neck
   • Parotidectomy-superficial
     
   • Parotidectomy-total
   • Parotidectomy-superficial or total, with VII nerve graft and/or repair
   •  Lateral Tarsorrhaphy-with Parotidectomy when VII function is lost
   • Parotectomy-“lumpectomy”
   • Submandibular Gland-excision
   • Thyroidectomy-hemi
   • Thyroidectomy-subtotal
   • Thyroidectomy-total
   • Neck Dissection (node clearance)-Radical, Modified, Functional
   • Carotid Body Tumour Excision
   • Hard and/or Soft Palate lesion excision
   • Pharyngeal Tumour excision-intraoral approach
   • Pharyngeal Tumour excision-extraoral approach
   • Laryngectomy-partial, total

Reconstructive Techniques

1. Temporalis Muscle and/or Fascia Flap
2. Pectoralis Major Myocutaneous  Flap
3. Deltopectoral Flap
4. Forehead Flap-midline
5. Glabellar Flap
6. Forehead Flap-temporal
7. Scalping Flap-Total External Nasal Reconstruction
8. Latissimis dorsi Flap
9. Trapezius Flap
10. Abbe Flap
11. Estlander Flap
12. Karapandzic Flap
13. Naso-labial Flap
14. Cervical Advancement Flap
15. Tongue Flap-dorsal
16. Tongue Flap-lateral
17. Free Vascular Flaps
18. Skin Graft-full thickness
19. Skin Graft-split thickness
20. Dermal Graft Harvest
21. Fascia lata Harvest
22. Sural Nerve Graft Harvest
23. Ileac Crest Bone Graft Harvest
24. Rib Graft Harvest-bone and/or cartilage
25. Cranial Bone Graft Harvest

Airway and Hemorrhage Management

1. Tracheostomy-non-urgent, adult
2. Tracheostomy-non-urgent, paediatric <2 years
3. Tracheostomy-urgent (emergency)
4. External Carotid Artery Ligation

Trauma

1. Mandibular Fractures
2. Maxillary Fractures
3. Orbital Fractures
4. Zygoma Fractures
5. Nasal Fractures
6. Frontal Bone Fractures
7. Skull Base Fractures
8. Burn Contractures Release / Skin Grafts: Facial, Neck

Miscellaneous Procedures

1. Facial Paralysis-facial slings
2. Face Lift-post tumour resection
3. Keloid Tumour Excision-Head & Neck
4. Wound debridement; Removal of Infected / Exposed bone grafts, bone plates, etc
5. Dental Extractions
6. Lateral Pharyngostomy – feeding tube placement 
7. Placement and Change of Wound Vac

1. Tendo Achilles / Hamstring Lengthening
2. Tendon Transfers
3. Tenotomy
4. Plantar Fascia Release
5. Contracture Release
6. Amputation: lower and upper extremity
7. Arthrodesis and Epiphyodesis: lower and upper limb
8. Repair of malunion / fracture of upper (elbow to hand) / lower limb (knee to foot) –  (Neglected trauma in children and adults)
9. Osteotomy (femoral and tibial) for correction of valgus and varus deformites
10. Tumor Excision
11. Other Soft Tissue Excision
12. Sequestrectomy – removal of dead bone in currently non-infected tissue (i.e. old osteomyelitis only)
13. Fasciotomy
14. Guided Growth: 8 plate insertion and removal (to be reviewed per Field Service)
15. Bone Graft
16. Adults (18-30)
    • Osteotomy for varus and valgus deformity – (Lower limb only)
    • Arthrodesis knee fusion (18-30)
    • Neglected club feet 
    • Carpal tunnel release
    • Trigger finger release

1. (Noma) Facial Reconstruction
2. Repair unhealed facial wounds (non-infectious)
3. Repair and Grafting of Tendon injuries upper and lower limbs
4. Peripheral nerve repair and grafting (upper, lower limbs or face)
5. Burn contracture release/reconstruction – Post burn and electrical injuries – (earlier than 4 or greater than 12 months post burn)
6. Facial soft tissue reconstruction with flap/suspension (See Maxillofacial Procedure list for specific flaps)
7. Haemangioma, lymphangioma, and cystic hygroma (Patient Review may be needed depending on size, location, CT report)
8. Neurofibroma debulking/excision
9. Cleft Lip
10. Other Facial Clefts
11. Stump Revision
12. Amputation – (Upper and Lower limb)
13. Soft tissue Repair/Reconstruction/z-plasty
14. Benign tumor/lesion excision
15. Malignant tumor/lesion excision skin (Patient Review if needed)
    • Premalignant lesions
    • Basal cell carcinoma
    • Squamous cell carcinoma
    • Other malignant skin tumors
16. Ear Repair/Reconstruction
17. Eyelid Repair/Reconstruction 
18. Flexor/Extensor tendon injury and reconstruction
19. Scar release/excision – *Large keloids only*
20. Graft, skin split/full thickness or bone graft
21. Reconstruction with bone plate/implants
22. Polydactyly and Syndactyly correction
23. Correction of Duplication of digits upper and lower extremity
24. Congenital abnormalities of the hands and feet (excluding club feet)
25. Hypo – and Epispadias
26. Placement of tissue expander
27. (Foot Reconstruction) associated with burn contracture release
28. (Hand and upper limb reconstruction) associated with burn contracture release
29. Dupuytren Disease (Contracture)
30. Soft tissue masses; head and neck, upper and lower limbs and torso  (all soft tissue tumors of the body)
31. Lower leg ulcers with specific criteria; age < 40, history of trauma or infection, but no hypertension, diabetes or varicose veins
32. Lymphoedema of lower legs

1. VVF (Vesico Vaginal Fistula) repair
2. UVF (Urethra Vaginal Fistula) repair
3. RVF (Recto Vaginal Fistula) repair
4. Re-implantation of ureters via Vaginal or Abdominal approach
5. PV (Pubo vaginal) sling
6. Urethral Dilation
7. Singapore Flap
8. Gracilis muscle flap
9. Other VVF related surgery
10. Elective Sterilization (Tubal Ligation) in conjunction with planned Laparotomy for repair
    See Surgical Sterilization Policy for Women’s Health Program for further guidance in decision for sterilization
11. Elective Sterilization (Tubal Ligation) without planned laparotomy – done as secondary procedure with primary procedure

 Minor Surgery Procedure List (Less than 3 Day Length of Stay)

1. Anterior / Posterior Colporrhaphy – Diagnosis: Cystocele and Rectocele
2. Enterocele repair – Diagnosis: Enterocele
3. Perineoplasty
4. Bartholin cystectomy/Marsupialization of Bartholin Cyst – Diagnosis: Bartholin cyst
5. Removal Bladder stone – Diagnosis: Bladder stone
6. Repair Vaginal stenosis – Diagnosis: Vaginal stenosis
7. Labial separation, surgical – Diagnosis: Labial Fusion
8. Vulvar/Vaginal: lesion/cyst removal – Diagnosis: Vulvar/vaginal cyst
9. Hymenectomy – Diagnosis: Persistent intact hymen
10. Polypectomy – Diagnosis: Cervical/Vaginal polyp
11. Repair 3^rd and 4^th degree anal laceration – Diagnosis: 3^rd and 4^th degree anal laceration
12. Ovarian Cystectomy

Major Surgery Procedure List (Greater than 3 Day Length of Stay)

1. Vaginal Vault Suspension  – Diagnosis:  Vaginal Vault prolapse
2. Total Vaginal Hysterectomy (TVH)/Total Abdominal Hysterectomy(TAH)/+/- (BSO – Bilateral Salpingoopherectomy) – Diagnosis: Menorrhagia (Bleeding), Leiomyomata uteri (Fibroids), and Uterine Prolapse

* Any combination of the above listed procedures, under minor and major may be performed based on the diagnosis of the patient –  uterine prolapse, cystocele, rectocele, enterocele, menorrhagia, leiomyomata (fibroids) , and vaginal vault prolapse

Procedures for Urinary Stress Incontinence

1. Abdominal Sling – Fascia Latta or Rectus sling

Elective Sterilization (Tubal Ligation) In Conjunction With Planned Laparotomy Within The List Of Gynecologic Procedures Or With Unplanned Laparotomy,  Doing It As The Secondary Procedure

See Policy “Surgical Sterilization Guidelines for Women’s Health Program” for further guidance in decision for sterilization

1. Simple excisions/biopsies of small skin lesions
2. Surgical biopsies of head/neck tumours for clinical diagnosis and surgical pathway
3. Simple flaps – Where ellipse incision is not possible may be used for closing larger lesions. Depending on size and complexity may include: Rotation flap closure, rhomboid flaps, bi-lobe rotation flaps, H and V-Y advancement and island flaps, keystone flaps, full thickness and and Halo grafts
4. Wedge resections ears and lips.
5. Excision lipomas( up to the size of  a fist)
6. Excision sebaceous/epidermal inclusion cysts
7. Enucleation Meibomian/chalazion eyelid cysts
8. Pleurocentesis/Paracentesis (with USS if possible)
9. Non-surgical Sclerotherapy treatment for Hydroceles
10. Banding haemorrhoids

Crew (or Day Crew) Only

1. Incision/drainage abscesses, could be done under ring block if not too big, or regional field block depending on the site
2. Wedge resection toenail and nailbed
3. Other office procedures include ear suction toilet, cryotherapy, steroid joint and soft tissue injections, diathermy/curettage, punch biopsy, implant insertions, plastering/casting