Checklist; Anus: Excisional Biopsy Anus: Excisional Biopsy 1/1/ Checklist; Anus: Resection Anus: Resection 1/1/2005
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1 ChecklistTemplateVersions ChecklistTemplateVersion Ckey OfficialName VisibleText RevisionDate Checklist; Adrenal gland: Resection Adrenal gland: Checklist; Ampulla of Vater: Ampullectomy Ampulla of Vater: Ampullectomy 1/1/2005 Checklist; Ampulla of Vater: Pancreaticoduodenectomy Ampulla of Vater: Pancreaticoduodenectomy 1/1/2005 Checklist; Anus: Excisional Biopsy Anus: Excisional Biopsy 1/1/2005 Checklist; Anus: Local Excision (Transanal Disk Excision) Anus: Local Excision (Transanal Disk Excision) 1/1/ Checklist; Anus: Resection Anus: Checklist; Appendix: Resection Appendix: Resection 7/1/ Checklist; Bone Biopsy Bone Biopsy 7/1/ Checklist; Bone Marrow: Blood Film, Aspirate, Cell Block, Trephine Biopsy, Touch Imprint Bone Marrow: Blood Film, Aspirate, Cell Block, Trephine Biopsy, Touch Imprint 1/1/ Checklist; Bone Resection Bone Resection 7/1/2006
2 Checklist; Brain/Spinal Cord: Biopsy/Resection Checklist; Breast: Excision Less Than Total Mastectomy (Includes Wire Guided Localization Excisions); Total Mastectomy, Modified Radical Mastectomy, Radical Mastectomy Checklist; Breast: Excision Less Than Total Mastectomy (Includes Wire Guided Localization Excisions); Total Mastectomy, Modified Radical Mastectomy, Radical Mastectomy Checklist; Colon and Rectum: Excisional Biopsy (Polypectomy) Checklist; Colon and Rectum: Excisional Biopsy (Polypectomy) Checklist; Colon and Rectum: Excisional Biopsy (Polypectomy) Checklist; Colon and Rectum: Resection Checklist; Colon and Rectum: Resection Brain/Spinal Cord: Biopsy/ Breast CS2 DRAFT: Excision Less Than Total Mastectomy (Includes Wire Guided Localization Excisions); Total Mastectomy, Modified Radical Mastectomy, Radical Mastectomy 6/15/2007 Breast: Excision Less Than Total Mastectomy (Includes Wire Guided Localization Excisions); Total Mastectomy, Modified Radical Mastectomy, Radical Mastectomy 1/1/2005 Colon and Rectum: Excisional Biopsy (Polypectomy) 1/1/2005 Colon and Rectum: Excisional Biopsy (Polypectomy) 6/6/2007 Colon and Rectum: Excisional Biopsy (Polypectomy) CS2 DRAFT 6/12/2007 Colon and Rectum: Colon and Rectum: Resection CS2 DRAFT 6/12/2007
3 Checklist; Endometrium: Biopsy Endometrium: Biopsy 1/1/ Checklist; Endometrium: Tissues Checklist; Endometrium: Tissues Endometrium: Tissues 1/1/2005 Endometrium: Tissues 7/31/2007 Checklist; Endometrium: Tissues Endometrium: Tissues CS2 DRAFT 6/15/2007 Checklist; Esophagus: Biopsy Esophagus: Biopsy 1/1/2005 Checklist; Esophagus: Resection Esophagus: Checklist; Extrahepatic Bile Extrahepatic Bile Ducts: Ducts: Resection Checklist; Fallopian Tube: Unilateral Salpingectomy, Fallopian Tube: Unilateral Salpingectomy, Salpingooophorectomy, or Salpingo oophorectomy, or Hysterectomy with Salpingo oophorectomy Hysterectomy with Salpingo oophorectomy 1/1/2005
4 Checklist; Gallbladder: Resection/Cholecystectom y Gallbladder: Resection/Cholecystectom y 1/1/ Checklist; Gastrointestinal Lymphoma: Resection Gastrointestinal Lymphoma: Checklist; Heart: Resection Heart: Checklist; Hepatoblastoma Hepatoblastoma 4/1/2007 Checklist; Hodgkin Lymphoma: Biopsy/Staging Procedure Hodgkin Lymphoma: Biopsy/Staging py gprocedure 1/1/ Checklist; Kidney: Biopsy Kidney: Biopsy 1/1/2005 Checklist; Kidney: Nephrectomy, Partial or Radical Kidney: Nephrectomy, Partial or Radical 1/1/ Checklist; Liver: Resection Liver: Checklist; Lung: Biopsy Lung: Biopsy 1/1/ Checklist; Lung: Biopsy Lung: Biopsy CS2 DRAFT 7/31/ Checklist; Lung: Resection Lung:
5 Checklist; Lung: Resection Lung: Resection CS2 DRAFT 7/31/ Checklist; Major Salivary Glands: Resection Major Salivary Glands: Checklist; Neuroblastoma: Resection Neuroblastoma: Resection 7/1/2005 Checklist; Non Hodgkin Lymphoma: Biopsy, Resection Non Hodgkin Lymphoma: Biopsy, Checklist; Ovary: Oophorectomy, Salpingooophorectomy, Subtotal Oophorectomy or Removal of Tumor in Fragments, Hysterectomy with Salpingo oophorectomy Checklist; Pancreas (Endocrine): Excisional Biopsy (Enucleation), Resection Checklist; Pancreas (Exocrine): Resection Ovary: Oophorectomy, Salpingo oophorectomy, Subtotal Oophorectomy or Removal of Tumor in Fragments, Hysterectomy with Salpingooophorectomy 1/1/2005 Pancreas (Endocrine): Excisional Biopsy (Enucleation), Pancreas (Exocrine): Checklist; Peritoneum: Resection Peritoneum:
6 Checklist; Pleura/Pericardium: Biopsy Pleura/Pericardium: Biopsy 1/1/2005 Checklist; Pleura/Pericardium: Resection Pleura/Pericardium: Checklist; Primitive Neuroectodermal Tumor / Ewing Sarcoma: Resection Checklist; Prostate Gland: Needle Biopsy Checklist; Prostate Gland: Needle Biopsy, py Transurethral Prostatic Resection (TUR), Enucleation Specimen Primitive Neuroectodermal Tumor / Ewing: Prostate Gland: Needle Biopsy 7/1/2006 Prostate Gland: Needle Biopsy, Transurethral Prostatic Resection (TUR), Enucleation Specimen 1/1/ Checklist; Prostate Gland: Radical Prostatectomy Checklist; Prostate Gland: Radical Prostatectomy Checklist; Prostate Gland:Transurethral Prostatic Resection (TUR), Enucleation Specimen Checklist; Rectum: Local Excision (Transanal Disk Excision) Prostate Gland: Radical Prostatectomy 1/1/2005 Prostate Gland: Radical Prostatectomy 7/1/2006 Prostate Gland:Transurethral Prostatic Resection (TUR), Enucleation Specimen 7/1/2006 Rectum: Local Excision (Transanal Disk Excision) 1/1/2005
7 Checklist; Renal pelvis: Resection/Nephroureterec tomy, Partial or Complete Checklist; Retinoblastoma: Enucleation, Partial or Complete Exenteration Checklist; Rhabdomyosarcoma and Related Neoplasms: Excision, Local or Wide; Compartmentectomy; Excision, Radical; Amputation; Other Renal pelvis: Resection/Nephroureterec tomy, Partial or Complete 1/1/2005 Retinoblastoma: Enucleation, Partial or Complete Exenteration 1/1/2005 Rhabdomyosarcoma and Related Neoplasms: Excision, Local or Wide; Compartmentectomy; Excision, Radical; Amputation; Other 1/1/2005 Checklist; Carcinoma of the Skin: Resection Skin Carcinoma: Checklist; Melanoma of the Skin Melanoma: Excision; Skin: Excision; Re Excision Re Excision 1/1/2005 Checklist; Melanoma of the Skin Melanoma: Excision; Skin: Excision; Re Excision Re Excision CS2 DRAFT 7/31/ Checklist; Small Intestine: Polypectomy, Segmental Resection, Pancreaticoduodenectomy, Partial or Complete, With or Without Partial Gastrectomy (Whipple Resection) Small Intestine: Polypectomy, Segmental Resection, Pancreaticoduodenectomy, Partial or Complete, With or Without Partial Gastrectomy (Whipple Resection) 1/1/2005
8 Checklist; Soft Tissue Biopsy Soft Tissue Biopsy 7/1/2006 Checklist; Soft Tissue Resection Soft Tissue Resection 7/1/ Checklist; Stomach: Biopsy Stomach: Biopsy 1/1/2005 Checklist; Stomach: Resection Stomach: Checklist; Testis: Radical Orchiectomy Testis: Radical Orchiectomy 1/1/2005 Checklist; Testis: Retroperitoneal Lymphadenectomy Testis: Retroperitoneal Lymphadenectomy 1/1/2005 Checklist; Thymoma and Thymic Carcinoma: Biopsy Thymoma and Thymic Carcinoma: Biopsy 1/1/2005 Checklist; Thymoma and Thymic Carcinoma: Thymectomy, Other Procedure Thymoma and Thymic Carcinoma: Thymectomy, Other Procedure 1/1/2005 Checklist; Thyroid: Resection Thyroid: Checklist; Thyroid: Resection Thyroid: Resection 7/1/2006 Checklist; Trophoblast: Dilation and Curettage/Resection Trophoblast: Dilation and Curettage /
9 Checklist; Upper Aerodigestive Tract and Minor Salivary Glands: Incisional and Excisional Biopsy/Resection Upper Aerodigestive Tract and Minor Salivary Glands: Incisional and Excisional Biopsy/ Checklist; Ureter: Resection Ureter: Checklist; Urinary bladder, Urinary Bladder, Ureter, Ureter, Renal Pelvis: Biopsy Renal Pelvis: Biopsy 1/1/2005 Checklist; Urinary bladder: Cystectomy, Partial, Total, or Radical; Anterior Exenteration Checklist; Uterine Cervix: Colpectomy, Hysterectomy, Pelvic Exenteration Checklist; Uterine Cervix: Cone Biopsy Checklist; Uveal Melanoma: Resection Urinary Bladder: Cystectomy, Partial, Total, or Radical; Anterior Exenteration 1/1/2005 Uterine Cervix: Colpectomy, Hysterectomy, Pelvic Exenteration 1/1/2005 Uterine Cervix: Cone Biopsy 1/1/2005 Uveal Melanoma: Checklist; Vagina: Biopsy Vagina: Biopsy 1/1/2005 Checklist; Vagina: Excisional Biopsy, Resection Vagina: Excisional Biopsy,
10 Checklist; Vulva: Excisional Biopsy/Resection Vulva: Excisional Biopsy/ Checklist; Kidney: Resection for Wilms Tumor Wilms Tumor:
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