58951 Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy

Name of the Procedure:

Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy

Summary

This procedure involves surgically removing cancerous tissues from the ovaries, fallopian tubes, or the lining of the abdominal cavity. It includes removing both ovaries and fallopian tubes, a portion of the fatty layer in the abdomen, the uterus, and nearby lymph nodes.

Purpose

This procedure addresses various gynecological cancers such as ovarian, tubal, or primary peritoneal cancer. The goal is to remove as much of the malignant tissue as possible to improve patient survival rates and reduce the risk of cancer spreading.

Indications

• Diagnosed with ovarian, tubal, or primary peritoneal cancer.
• Symptoms such as unexplained pelvic pain, bloating, and abnormal bleeding.
• Eligibility based on overall health and stage of cancer.

Preparation

• Fasting for at least 8 hours before surgery.
• Stopping certain medications as advised by the doctor.
• Preoperative tests like blood work, imaging studies, and possibly a bowel prep.

Procedure Description

1. Anesthesia: Patient is given general anesthesia.
2. Incision: A horizontal or vertical incision is made on the abdomen.
3. Exploration: The surgeon examines the abdominal cavity for any visible cancer spread.
4. Resection: Removal of ovaries, fallopian tubes, uterus, part of the omentum (abdominal fat layer), and nearby pelvic and limited para-aortic lymph nodes.
5. Closure: The incision is closed with sutures or staples.

Specialized surgical instruments and techniques, including possibly laparoscopic tools, are used for precise tissue removal.

Duration

The procedure typically takes 3 to 5 hours, depending on the extent of the disease and complexity.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Gynecologic Oncologist (Surgeon)
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Common: Infection, bleeding, blood clots, adverse reaction to anesthesia.
• Rare: Damage to surrounding organs, lymphocele (fluid accumulation), lymphedema, long-term bowel or bladder issues.

Benefits

• Potentially curative for early-stage cancers.
• Significant reduction in cancerous tissue load.
• Improved long-term survival rates and quality of life.

Recovery

• Hospital stay of 3 to 7 days post-surgery.
• Pain management with prescribed medications.
• Restrictions on heavy lifting and strenuous activities for 4 to 6 weeks.
• Follow-up appointments for monitoring and to remove sutures/staples.

Alternatives

• Chemotherapy alone: May be less effective in removing solid tumor masses.
• Radiation therapy: Not typically the primary treatment for these cancers.
• Hormonal therapy: May be considered based on specific cancer types.

Each alternative has varying success rates and potential side effects.

Patient Experience

• During: The patient will be under general anesthesia and unaware of the procedure.
• After: Postoperative pain managed with medications, discomfort from the incision, gradual resumption of normal activities.
• Pain management: Regularly scheduled pain medication and counseling on pain control measures.