58940 Oophorectomy, partial or total, unilateral or bilateral

Name of the Procedure:

Oophorectomy, partial or total, unilateral or bilateral. Commonly referred to as ovary removal surgery.

Summary

An oophorectomy is a surgical procedure to remove one (unilateral) or both (bilateral) ovaries. The removal can be partial or total, depending on the patient's medical needs.

Purpose

Oophorectomy is performed to treat or prevent various conditions such as ovarian cysts, ovarian cancer, endometriosis, or as a preventive measure for those at high risk of breast and ovarian cancer. The goal is to remove diseased tissue, alleviate symptoms, or reduce cancer risk.

Indications

• Persistent ovarian cysts or tumors
• Ovarian cancer
• Endometriosis that has not responded to other treatments
• Severe pelvic infections
• Prophylactic removal for patients with BRCA1 or BRCA2 genetic mutations to lower cancer risk

Preparation

• Fasting for at least 8 hours before surgery
• Discontinuation or adjustment of certain medications as advised by the doctor
• Undergoing preoperative diagnostic tests, such as blood tests, imaging studies (ultrasound, MRI, or CT scan), and sometimes, a biopsy

Procedure Description

1. Anesthesia: The patient will receive general anesthesia.
2. Incision: A small incision is made in the abdomen, often using a laparoscope for minimally invasive surgery, or a larger incision for open surgery.
3. Removal: The surgeon either removes part of an ovary (partial oophorectomy) or the entire ovary (total oophorectomy). If both ovaries are removed, it's called a bilateral oophorectomy.
4. Closure: The incisions are closed with sutures or staples, and the area is bandaged.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Injury to adjacent organs (bladder, intestines)
• Hormonal changes (if both ovaries are removed)
• Adhesions or scar tissue
• Postoperative pain and discomfort

Benefits

• Relief from symptoms caused by ovarian conditions
• Reduced risk of ovarian and possibly breast cancer for high-risk patients
• Improved quality of life for those suffering from chronic ovarian-related issues

Recovery

• Postoperative monitoring in the recovery room
• Pain management with medications
• Instructions on wound care, activity restrictions, and signs of complications
• Gradual return to normal activities over 2 to 6 weeks
• Follow-up appointments to monitor recovery and address any concerns

Alternatives

• Hormone therapy for hormonal imbalances
• Medications to manage symptoms of endometriosis or ovarian cysts
• Less invasive procedures like cystectomy (removal of cysts only)
• Regular monitoring and imaging for those at risk but opting out of surgery

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Postoperatively, discomfort and pain around the incision site are common, which can be managed with pain relief measures. Most patients experience a gradual return to normalcy, although those who have both ovaries removed may experience menopausal symptoms and require hormone replacement therapy.