Surgery is usually the first step in treating ovarian cancer and it should be performed by a gynecologic oncologist. Most surgery is performed using a procedure called a laparotomy during which the surgeon makes a long cut in the wall of the abdomen. Occasionally, early stage ovarian cancer can be managed by laparoscopic surgery whereby a small (1/2” to 3/4” incision is made in the belly button or lower abdomen. Laparoscopic surgery sometimes can also be performed on women with advanced ovarian cancer.
If ovarian cancer is found, the gynecologic oncologist performs the following procedures:
- Salpingo-oophorectomy: both ovaries and fallopian tubes are removed.
- Hysterectomy: the uterus is removed.
- Staging procedure, including omentectomy, lymph node removal
For staging, the omentum, a fatty pad of tissue that covers the intestines, is removed along with nearby lymph nodes, and multiple tiny samples of tissues from the pelvis and abdomen.
If the cancer has spread, the gynecologic oncologist removes as much cancer as possible. This is called “debulking” surgery. Often this will involve extensive surgery, including removal of portions of the small or large intestine, and removal of tumor from the liver, diaphragm and pelvis. Removal of as much tumor as possible is one of the most important factors affecting cure rates.
If you have early Stage I cancer, and still hope to get pregnant, it may be possible to only remove one ovary and fallopian tube. Your future pregnancy wishes should be discussed with your gynecologic oncologist before surgery.
Side Effects of Surgery
Some discomfort is common after surgery. It often can be controlled with medicine. Tell your treatment team if you are experiencing pain. Other possible side effects are:
- Nausea and vomiting
- Infection, fever
- Wound problem
- Fullness due to fluid in the abdomen
- Shortness of breath due to fluid around the lungs
- Swelling caused by lymphedema, usually in the legs
- Blood clots
- Difficulty urinating or constipation
Talk with your doctor if you are experiencing any of the side effects listed above.