Ovarian cancer is usually diagnosed and staged with laparotomy or laparoscopy. Both of these procedures involve surgically removing samples of tissues to determine whether they have cancer cells. In many instances when ovarian cancer is suspected, the surgeon will attempt to remove as much of the tumor as possibleâ€”a procedure called debulking. However, further surgery is often needed. Chemotherapy and/or radiation therapy may also be necessary. Infertility is often a side effect of ovarian cancer treatment, and women who are interested in having children in the future should discuss this issue with their cancer team prior to treatment.
Tumor debulking (also called cytoreduction) involves removing as much of the tumor as possible. If the cancer has spread, the procedure is typically performed to improve patient prognosis (expected outcome) and increase survival time. Tumor debulking can reduce the size of the tumor before chemotherapy or radiation therapy.
An oophorectomy is a surgical procedure to remove one or both of the ovaries. A bilateral oophorectomy, removal of both ovaries, will result in infertility and premature menopause for women who are still menstruating. A unilateral oophorectomy, removal of one ovary, may be possible for some young women with certain types of early-stage ovarian cancer. Removing only one ovary may allow women to bear children in the future.
A salpingectomy is a surgical procedure to remove one or both of the Fallopian tubes. Salpingectomy is usually combined with an oophorectomy (removal of one or both ovaries), hysterectomy (removal of the uterus), and omentectomy (removal of the omentumâ€”see description below) to treat patients with ovarian cancer. All of these procedures are typically performed under general anesthesia. A salpingectomy alone is associated with a short recovery time.
A hysterectomy involves surgically removing the uterus through the vagina or an incision in the abdomen. The surgery may or may not include removing tissues near the uterus, such as the parametria and uterosacral ligaments, the upper portion of the vagina, and the pelvic lymph nodes. For ovarian cancer patients, a hysterectomy is often accompanied by a bilateral oophorectomy (removal of both ovaries), salpingectomy (removal of the Fallopian tubes) and many times an omentectomy (removal of the thin tissue covering the stomach and large intestine) and removal of the lymph nodes in the abdomen.
An omentectomy is a surgical procedure to remove the omentum, a fold of abdominal tissue that contains blood vessels, nerves, lymph vessels, and lymph nodes. For ovarian cancer patients, an omentectomy is usually combined with an oophorectomy (removal of one or both ovaries), hysterectomy (removal of the uterus), and salpingectomy (removal of one or both Fallopian tubes).