PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/pcsp/ and changes regularly. See the Directory of published versions

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Logical Model: MajorSurgery - XML Profile

XML representation of the MajorSurgery logical model.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="MajorSurgery"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition MajorSurgery</b></p><a name="MajorSurgery"> </a><a name="hcMajorSurgery"> </a><a name="MajorSurgery-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery" title="Major Surgery.
Maturity Level: 2 - Ready for Review">MajorSurgery</a><a name="MajorSurgery"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/types.html#Base">Base</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Major Surgery<br/><span style="font-weight:bold">Instances of this logical model are not marked to be the target of a Reference</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.relatedDiagnosis" title="Progressive number of diagnosis (1=first; 2= second; 3 = third; ?).  
In this field must be reported the ordinal number of the tumor diagnosis for which the surgery was performed">relatedDiagnosis</a><a name="MajorSurgery.relatedDiagnosis"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Progressive number of diagnosis</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.relatedRelapse" title="Progressive number of relapse/progression (after FLT)">relatedRelapse</a><a name="MajorSurgery.relatedRelapse"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Progressive number of relapse/progression (after FLT)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.identifier" title="Progressive number of surgeries (1=first; 2= second; 3 = third; ?).
In this field must be reported the ordinal number of the surgeries given. ">identifier</a><a name="MajorSurgery.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Progressive Surgery number<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment" title="Please Identify the institution were surgery was performed">istitutionOfTreatment</a><a name="MajorSurgery.istitutionOfTreatment"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution of treatment</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment.description" title="Institution description">description</a><a name="MajorSurgery.istitutionOfTreatment.description"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution description</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment.name" title="Institution name">name</a><a name="MajorSurgery.istitutionOfTreatment.name"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution name</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck101.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment.address" title="Institution address">address</a><a name="MajorSurgery.istitutionOfTreatment.address"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution address</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment.address.name" title="Institution city">name</a><a name="MajorSurgery.istitutionOfTreatment.address.name"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution city</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.istitutionOfTreatment.address.country" title="Institution country">country</a><a name="MajorSurgery.istitutionOfTreatment.address.country"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Institution country</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.date" title="Date of surgery (dd/mm/yyyy). If the date is unkown or partially missed insert the year at the best of your knowledge.">date</a><a name="MajorSurgery.date"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Date of surgery</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.description" title="Please describe the type of surgery (is a free text section, no coding). In case of surgery on pair organs specify which organ (right or left) was operated.">description</a><a name="MajorSurgery.description"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Surgery description</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.affectedOrgan" title="Was one of these organs involved ? 
(Oesophagus; Abdomen; Brain; Face; Liver; Spine; Spinal Cord; Sympathetic nerves; Chest/thorax; Pelvis)">affectedOrgan</a><a name="MajorSurgery.affectedOrgan"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Affected Organs<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.sacrifiedOrgan" title="During surgery it is possible that some organs are 'sacrified' either to allow a radical excision of the tumor or on purpose (spleen) for staging procedures.
In case of partial resection of an organ (e.g. thyroid, kidney), the organ is not 'sacrified', this type of surgery should be then reported only in the 'tumor description' 
For other organs (e.g. hypothalamus) the only surgical procedure on it may determine some 'sacrifcice' of function, thus in this case, the organ should be coded as 'sacrified'.

(Spleen, Kidney, Eye, Lung, Ovary, Hypothalamus/hypophysis, Thyroid, Bladder, uterus Other)">sacrifiedOrgan</a><a name="MajorSurgery.sacrifiedOrgan"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Sacrified Organs<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.shuntApplication" title="Please report if a cerebrovascular shunt was inserted ">shuntApplication</a><a name="MajorSurgery.shuntApplication"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Shunt application<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.shuntApplication.type" title="This is a free text section in which it is possible to specify the type (e.g. ventriculo-peritoneal) of shunt used 
1 =&gt; Ventriculo-peritoneal
2 =&gt; Ventriculo atrial
3 =&gt; Subdural_peritoneal
4 =&gt;  Cisternostomy (III ventricule)
5 =&gt; Other
-9922 =&gt; NK">type</a><a name="MajorSurgery.shuntApplication.type"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Type of shunt</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.shuntApplication.laterality" title="Please specify the laterality of the shunt
1 = right
2= left
3 = midline
-9911 = not applicable
-9922 =&gt; NK">laterality</a><a name="MajorSurgery.shuntApplication.laterality"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Laterality of shunt</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.shuntApplication.isRemoved" title="Define if it is still in place or is already removed 
1 =&gt; Still in place
2 =&gt; Removed
 -9911 =&gt; NA
 -9922 =&gt; NK">isRemoved</a><a name="MajorSurgery.shuntApplication.isRemoved"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In place or removed ?</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.amputation" title="Here it is requested only a yes or no. Details should be reported in the surgery description 
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt; NK ">amputation</a><a name="MajorSurgery.amputation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Amputation</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.prothesis" title="Prothesis">prothesis</a><a name="MajorSurgery.prothesis"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Prothesis</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.prothesis.status" title="Please state if the survivor has a prosthesis either internal (e.g. hip replacement) or external (e.g. artificial arm)">status</a><a name="MajorSurgery.prothesis.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">status</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.prothesis.deviceType" title="Please define if prosthesis is internal (e.g. titanium bone) or external (e.g. artificial limb). Also in this case, details should be reported in the surgery description.
1 =&gt; Internal
2 =&gt; External
-9922 =&gt; NK">deviceType</a><a name="MajorSurgery.prothesis.deviceType"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">device type</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.colostomy" title="Colostomy">colostomy</a><a name="MajorSurgery.colostomy"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Colostomy</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.colostomy.status" title="State if a colostomy was created. Details should be reported in the surgery section.">status</a><a name="MajorSurgery.colostomy.status"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">status</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.colostomy.isRemoved" title="State if a colostomy was created. Details should be reported in the surgery section.
1 =&gt; Still in place
2 =&gt; Removed
-9922 =&gt;NK">isRemoved</a><a name="MajorSurgery.colostomy.isRemoved"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">In place or removed ?</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-MajorSurgery-definitions.html#MajorSurgery.gastrostomy" title="State if a gastrostomy was created. Details should be reported in the surgery section.
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt;NK">gastrostomy</a><a name="MajorSurgery.gastrostomy"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Gastrostomy</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url value="http://hl7.eu/fhir/ig/pcsp/StructureDefinition/MajorSurgery"/>
  <version value="0.2.0"/>
  <name value="MajorSurgery"/>
  <title value="Major Surgery"/>
  <status value="draft"/>
  <date value="2024-09-11T13:25:13+00:00"/>
  <publisher value="PanCareSurPass Project"/>
  <contact>
    <name value="PanCareSurPass Project"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.pancaresurpass.eu/"/>
    </telecom>
  </contact>
  <contact>
    <name value="PanCareSurPass Project"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.pancaresurpass.eu/"/>
    </telecom>
  </contact>
  <description value="Major Surgery.
Maturity Level: 2 - Ready for Review"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="150"/>
      <display value="Europe"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="fhir"/>
    <uri value="hl7.org/fhir/r4"/>
    <name value="MajorSurgery model to PCSP HL7 FHIR R4 Profiles"/>
  </mapping>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="http://hl7.eu/fhir/ig/pcsp/StructureDefinition/MajorSurgery"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="MajorSurgery">
      <path value="MajorSurgery"/>
      <short value="Major Surgery"/>
      <definition
                  value="Major Surgery.
Maturity Level: 2 - Ready for Review"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Base"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <isModifier value="false"/>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp')"/>
      </mapping>
    </element>
    <element id="MajorSurgery.relatedDiagnosis">
      <path value="MajorSurgery.relatedDiagnosis"/>
      <short value="Progressive number of diagnosis"/>
      <definition
                  value="Progressive number of diagnosis (1=first; 2= second; 3 = third; ?).  
In this field must be reported the ordinal number of the tumor diagnosis for which the surgery was performed"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.relatedDiagnosis"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".reasonReference"/>
      </mapping>
    </element>
    <element id="MajorSurgery.relatedRelapse">
      <path value="MajorSurgery.relatedRelapse"/>
      <short value="Progressive number of relapse/progression (after FLT)"/>
      <definition
                  value="Progressive number of relapse/progression (after FLT)"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.relatedRelapse"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".reasonReference"/>
      </mapping>
    </element>
    <element id="MajorSurgery.identifier">
      <path value="MajorSurgery.identifier"/>
      <short value="Progressive Surgery number"/>
      <definition
                  value="Progressive number of surgeries (1=first; 2= second; 3 = third; ?).
In this field must be reported the ordinal number of the surgeries given."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MajorSurgery.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment">
      <path value="MajorSurgery.istitutionOfTreatment"/>
      <short value="Institution of treatment"/>
      <definition
                  value="Please Identify the institution were surgery was performed"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="fhir"/>
        <map
             value="location.resolve().conformsTo(http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Location-eu-pcsp)"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.id">
      <path value="MajorSurgery.istitutionOfTreatment.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.extension">
      <path value="MajorSurgery.istitutionOfTreatment.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.modifierExtension">
      <path value="MajorSurgery.istitutionOfTreatment.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.description">
      <path value="MajorSurgery.istitutionOfTreatment.description"/>
      <short value="Institution description"/>
      <definition value="Institution description"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.description"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.name">
      <path value="MajorSurgery.istitutionOfTreatment.name"/>
      <short value="Institution name"/>
      <definition value="Institution name"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.name"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address">
      <path value="MajorSurgery.istitutionOfTreatment.address"/>
      <short value="Institution address"/>
      <definition value="Institution address"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment.address"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.address.city"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.id">
      <path value="MajorSurgery.istitutionOfTreatment.address.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.extension">
      <path value="MajorSurgery.istitutionOfTreatment.address.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="MajorSurgery.istitutionOfTreatment.address.modifierExtension">
      <path
            value="MajorSurgery.istitutionOfTreatment.address.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.name">
      <path value="MajorSurgery.istitutionOfTreatment.address.name"/>
      <short value="Institution city"/>
      <definition value="Institution city"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment.address.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.country">
      <path value="MajorSurgery.istitutionOfTreatment.address.country"/>
      <short value="Institution country"/>
      <definition value="Institution country"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.istitutionOfTreatment.address.country"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.address.country"/>
      </mapping>
    </element>
    <element id="MajorSurgery.date">
      <path value="MajorSurgery.date"/>
      <short value="Date of surgery"/>
      <definition
                  value="Date of surgery (dd/mm/yyyy). If the date is unkown or partially missed insert the year at the best of your knowledge."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.date"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Procedure.performedDateTime"/>
      </mapping>
    </element>
    <element id="MajorSurgery.description">
      <path value="MajorSurgery.description"/>
      <short value="Surgery description"/>
      <definition
                  value="Please describe the type of surgery (is a free text section, no coding). In case of surgery on pair organs specify which organ (right or left) was operated."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MajorSurgery.affectedOrgan">
      <path value="MajorSurgery.affectedOrgan"/>
      <short value="Affected Organs"/>
      <definition
                  value="Was one of these organs involved ? 
(Oesophagus; Abdomen; Brain; Face; Liver; Spine; Spinal Cord; Sympathetic nerves; Chest/thorax; Pelvis)"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MajorSurgery.affectedOrgan"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".bodySite"/>
      </mapping>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.sacrifiedOrgan">
      <path value="MajorSurgery.sacrifiedOrgan"/>
      <short value="Sacrified Organs"/>
      <definition
                  value="During surgery it is possible that some organs are 'sacrified' either to allow a radical excision of the tumor or on purpose (spleen) for staging procedures.
In case of partial resection of an organ (e.g. thyroid, kidney), the organ is not 'sacrified', this type of surgery should be then reported only in the 'tumor description' 
For other organs (e.g. hypothalamus) the only surgical procedure on it may determine some 'sacrifcice' of function, thus in this case, the organ should be coded as 'sacrified'.

(Spleen, Kidney, Eye, Lung, Ovary, Hypothalamus/hypophysis, Thyroid, Bladder, uterus Other)"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MajorSurgery.sacrifiedOrgan"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value=".extension('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan').valueCodeableConcept"/>
      </mapping>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication">
      <path value="MajorSurgery.shuntApplication"/>
      <short value="Shunt application"/>
      <definition
                  value="Please report if a cerebrovascular shunt was inserted"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="MajorSurgery.shuntApplication"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ShuntProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.id">
      <path value="MajorSurgery.shuntApplication.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.extension">
      <path value="MajorSurgery.shuntApplication.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.modifierExtension">
      <path value="MajorSurgery.shuntApplication.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.type">
      <path value="MajorSurgery.shuntApplication.type"/>
      <short value="Type of shunt"/>
      <definition
                  value="This is a free text section in which it is possible to specify the type (e.g. ventriculo-peritoneal) of shunt used 
1 =&gt; Ventriculo-peritoneal
2 =&gt; Ventriculo atrial
3 =&gt; Subdural_peritoneal
4 =&gt;  Cisternostomy (III ventricule)
5 =&gt; Other
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.shuntApplication.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.laterality">
      <path value="MajorSurgery.shuntApplication.laterality"/>
      <short value="Laterality of shunt"/>
      <definition
                  value="Please specify the laterality of the shunt
1 = right
2= left
3 = midline
-9911 = not applicable
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.shuntApplication.laterality"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value=".extension('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier').valueCodeableConcept"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.isRemoved">
      <path value="MajorSurgery.shuntApplication.isRemoved"/>
      <short value="In place or removed ?"/>
      <definition
                  value="Define if it is still in place or is already removed 
1 =&gt; Still in place
2 =&gt; Removed
 -9911 =&gt; NA
 -9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.shuntApplication.isRemoved"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".focalDevice.action"/>
      </mapping>
    </element>
    <element id="MajorSurgery.amputation">
      <path value="MajorSurgery.amputation"/>
      <short value="Amputation"/>
      <definition
                  value="Here it is requested only a yes or no. Details should be reported in the surgery description 
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.amputation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(AmputationProcedureTypeVs)).exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis">
      <path value="MajorSurgery.prothesis"/>
      <short value="Prothesis"/>
      <definition value="Prothesis"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.prothesis"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ProstheticProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.id">
      <path value="MajorSurgery.prothesis.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.extension">
      <path value="MajorSurgery.prothesis.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.modifierExtension">
      <path value="MajorSurgery.prothesis.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.status">
      <path value="MajorSurgery.prothesis.status"/>
      <short value="status"/>
      <definition
                  value="Please state if the survivor has a prosthesis either internal (e.g. hip replacement) or external (e.g. artificial arm)"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.prothesis.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.deviceType">
      <path value="MajorSurgery.prothesis.deviceType"/>
      <short value="device type"/>
      <definition
                  value="Please define if prosthesis is internal (e.g. titanium bone) or external (e.g. artificial limb). Also in this case, details should be reported in the surgery description.
1 =&gt; Internal
2 =&gt; External
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.prothesis.deviceType"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="usedCode"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy">
      <path value="MajorSurgery.colostomy"/>
      <short value="Colostomy"/>
      <definition value="Colostomy"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.colostomy"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ColostomyProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.id">
      <path value="MajorSurgery.colostomy.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.extension">
      <path value="MajorSurgery.colostomy.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.modifierExtension">
      <path value="MajorSurgery.colostomy.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.status">
      <path value="MajorSurgery.colostomy.status"/>
      <short value="status"/>
      <definition
                  value="State if a colostomy was created. Details should be reported in the surgery section."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.colostomy.status"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.isRemoved">
      <path value="MajorSurgery.colostomy.isRemoved"/>
      <short value="In place or removed ?"/>
      <definition
                  value="State if a colostomy was created. Details should be reported in the surgery section.
1 =&gt; Still in place
2 =&gt; Removed
-9922 =&gt;NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.colostomy.isRemoved"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".focalDevice.action"/>
      </mapping>
    </element>
    <element id="MajorSurgery.gastrostomy">
      <path value="MajorSurgery.gastrostomy"/>
      <short value="Gastrostomy"/>
      <definition
                  value="State if a gastrostomy was created. Details should be reported in the surgery section.
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt;NK"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="MajorSurgery.gastrostomy"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(GastrostomyProcedureTypeVs)).exists()"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="MajorSurgery">
      <path value="MajorSurgery"/>
      <short value="Major Surgery"/>
      <definition
                  value="Major Surgery.
Maturity Level: 2 - Ready for Review"/>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp')"/>
      </mapping>
    </element>
    <element id="MajorSurgery.relatedDiagnosis">
      <path value="MajorSurgery.relatedDiagnosis"/>
      <short value="Progressive number of diagnosis"/>
      <definition
                  value="Progressive number of diagnosis (1=first; 2= second; 3 = third; ?).  
In this field must be reported the ordinal number of the tumor diagnosis for which the surgery was performed"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".reasonReference"/>
      </mapping>
    </element>
    <element id="MajorSurgery.relatedRelapse">
      <path value="MajorSurgery.relatedRelapse"/>
      <short value="Progressive number of relapse/progression (after FLT)"/>
      <definition
                  value="Progressive number of relapse/progression (after FLT)"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".reasonReference"/>
      </mapping>
    </element>
    <element id="MajorSurgery.identifier">
      <path value="MajorSurgery.identifier"/>
      <short value="Progressive Surgery number"/>
      <definition
                  value="Progressive number of surgeries (1=first; 2= second; 3 = third; ?).
In this field must be reported the ordinal number of the surgeries given. "/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment">
      <path value="MajorSurgery.istitutionOfTreatment"/>
      <short value="Institution of treatment"/>
      <definition
                  value="Please Identify the institution were surgery was performed"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="location.resolve().conformsTo(http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Location-eu-pcsp)"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.description">
      <path value="MajorSurgery.istitutionOfTreatment.description"/>
      <short value="Institution description"/>
      <definition value="Institution description"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.description"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.name">
      <path value="MajorSurgery.istitutionOfTreatment.name"/>
      <short value="Institution name"/>
      <definition value="Institution name"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.name"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address">
      <path value="MajorSurgery.istitutionOfTreatment.address"/>
      <short value="Institution address"/>
      <definition value="Institution address"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.address.city"/>
      </mapping>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.name">
      <path value="MajorSurgery.istitutionOfTreatment.address.name"/>
      <short value="Institution city"/>
      <definition value="Institution city"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element id="MajorSurgery.istitutionOfTreatment.address.country">
      <path value="MajorSurgery.istitutionOfTreatment.address.country"/>
      <short value="Institution country"/>
      <definition value="Institution country"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Location.address.country"/>
      </mapping>
    </element>
    <element id="MajorSurgery.date">
      <path value="MajorSurgery.date"/>
      <short value="Date of surgery"/>
      <definition
                  value="Date of surgery (dd/mm/yyyy). If the date is unkown or partially missed insert the year at the best of your knowledge."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="Procedure.performedDateTime"/>
      </mapping>
    </element>
    <element id="MajorSurgery.description">
      <path value="MajorSurgery.description"/>
      <short value="Surgery description"/>
      <definition
                  value="Please describe the type of surgery (is a free text section, no coding). In case of surgery on pair organs specify which organ (right or left) was operated."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element id="MajorSurgery.affectedOrgan">
      <path value="MajorSurgery.affectedOrgan"/>
      <short value="Affected Organs"/>
      <definition
                  value="Was one of these organs involved ? 
(Oesophagus; Abdomen; Brain; Face; Liver; Spine; Spinal Cord; Sympathetic nerves; Chest/thorax; Pelvis)"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".bodySite"/>
      </mapping>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.sacrifiedOrgan">
      <path value="MajorSurgery.sacrifiedOrgan"/>
      <short value="Sacrified Organs"/>
      <definition
                  value="During surgery it is possible that some organs are 'sacrified' either to allow a radical excision of the tumor or on purpose (spleen) for staging procedures.
In case of partial resection of an organ (e.g. thyroid, kidney), the organ is not 'sacrified', this type of surgery should be then reported only in the 'tumor description' 
For other organs (e.g. hypothalamus) the only surgical procedure on it may determine some 'sacrifcice' of function, thus in this case, the organ should be coded as 'sacrified'.

(Spleen, Kidney, Eye, Lung, Ovary, Hypothalamus/hypophysis, Thyroid, Bladder, uterus Other)"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value=".extension('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan').valueCodeableConcept"/>
      </mapping>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication">
      <path value="MajorSurgery.shuntApplication"/>
      <short value="Shunt application"/>
      <definition
                  value="Please report if a cerebrovascular shunt was inserted "/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ShuntProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.type">
      <path value="MajorSurgery.shuntApplication.type"/>
      <short value="Type of shunt"/>
      <definition
                  value="This is a free text section in which it is possible to specify the type (e.g. ventriculo-peritoneal) of shunt used 
1 =&gt; Ventriculo-peritoneal
2 =&gt; Ventriculo atrial
3 =&gt; Subdural_peritoneal
4 =&gt;  Cisternostomy (III ventricule)
5 =&gt; Other
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.laterality">
      <path value="MajorSurgery.shuntApplication.laterality"/>
      <short value="Laterality of shunt"/>
      <definition
                  value="Please specify the laterality of the shunt
1 = right
2= left
3 = midline
-9911 = not applicable
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value=".extension('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier').valueCodeableConcept"/>
      </mapping>
    </element>
    <element id="MajorSurgery.shuntApplication.isRemoved">
      <path value="MajorSurgery.shuntApplication.isRemoved"/>
      <short value="In place or removed ?"/>
      <definition
                  value="Define if it is still in place or is already removed 
1 =&gt; Still in place
2 =&gt; Removed
 -9911 =&gt; NA
 -9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".focalDevice.action"/>
      </mapping>
    </element>
    <element id="MajorSurgery.amputation">
      <path value="MajorSurgery.amputation"/>
      <short value="Amputation"/>
      <definition
                  value="Here it is requested only a yes or no. Details should be reported in the surgery description 
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt; NK "/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(AmputationProcedureTypeVs)).exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis">
      <path value="MajorSurgery.prothesis"/>
      <short value="Prothesis"/>
      <definition value="Prothesis"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ProstheticProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.status">
      <path value="MajorSurgery.prothesis.status"/>
      <short value="status"/>
      <definition
                  value="Please state if the survivor has a prosthesis either internal (e.g. hip replacement) or external (e.g. artificial arm)"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.prothesis.deviceType">
      <path value="MajorSurgery.prothesis.deviceType"/>
      <short value="device type"/>
      <definition
                  value="Please define if prosthesis is internal (e.g. titanium bone) or external (e.g. artificial limb). Also in this case, details should be reported in the surgery description.
1 =&gt; Internal
2 =&gt; External
-9922 =&gt; NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value="usedCode"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy">
      <path value="MajorSurgery.colostomy"/>
      <short value="Colostomy"/>
      <definition value="Colostomy"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(ColostomyProcedureTypeVs))"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.status">
      <path value="MajorSurgery.colostomy.status"/>
      <short value="status"/>
      <definition
                  value="State if a colostomy was created. Details should be reported in the surgery section."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".exists()"/>
      </mapping>
    </element>
    <element id="MajorSurgery.colostomy.isRemoved">
      <path value="MajorSurgery.colostomy.isRemoved"/>
      <short value="In place or removed ?"/>
      <definition
                  value="State if a colostomy was created. Details should be reported in the surgery section.
1 =&gt; Still in place
2 =&gt; Removed
-9922 =&gt;NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map value=".focalDevice.action"/>
      </mapping>
    </element>
    <element id="MajorSurgery.gastrostomy">
      <path value="MajorSurgery.gastrostomy"/>
      <short value="Gastrostomy"/>
      <definition
                  value="State if a gastrostomy was created. Details should be reported in the surgery section.
1 =&gt; Yes
2 =&gt; No
-9911 =&gt; Not applicable
-9922 =&gt;NK"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="fhir"/>
        <map
             value="Procedure.conformsTo('http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp').where(code.memberOf(GastrostomyProcedureTypeVs)).exists()"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>