58950 Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy

Name of the Procedure:

Resection (initial) of ovarian, tubal, or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy

Summary

This surgical procedure involves the removal of cancerous tumors from the ovaries, fallopian tubes, or peritoneal cavity. It also includes the removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy) and the removal of the omentum, a fold of fatty tissue in the abdomen (omentectomy). Essentially, this is a comprehensive surgery aimed at treating certain gynecologic cancers.

Purpose

The procedure is designed to treat ovarian, tubal, or primary peritoneal cancer. It aims to remove as much of the malignant tissue as possible, which can help to control the spread of cancer, alleviate symptoms, and improve the patient's prognosis and quality of life.

Indications

• Diagnosis of ovarian, tubal, or primary peritoneal malignancy
• Presence of tumors that are deemed resectable
• Symptoms like abdominal pain, bloating, or changes in bowel habits due to the cancer
• Patients who are candidates for aggressive surgical intervention

Preparation

• Patients are usually instructed to fast for a certain number of hours before the surgery.
• Medications may need to be adjusted or stopped prior to surgery.
• Preoperative blood tests, imaging studies (CT scans, MRI), and possibly a biopsy will be conducted to assess the extent of cancer.
• Discussing any allergies and anesthesia risks with the medical team.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the abdomen to access the pelvic and abdominal cavities.
3. The surgeon examines the area and then proceeds to remove both ovaries and fallopian tubes (bilateral salpingo-oophorectomy).
4. The omentum, a fatty apron-like tissue, is also removed (omentectomy).
5. Any visible malignant tissues or tumors in the peritoneal cavity are resected.
6. The surgical area is inspected for any remaining cancerous tissue and to control bleeding.
7. The incision is closed using sutures or staples.
8. Patients are moved to the recovery area and monitored for vital signs.

Duration

The procedure typically takes between 3 to 6 hours, depending on the extent of the cancer and the complexity of the surgery.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Lead Surgeon (Gynecologic Oncologist)
• Surgical Assistants
• Anesthesiologist
• Scrub Nurse
• Circulating Nurse

Risks and Complications

• Bleeding and blood clots
• Infection
• Injury to nearby organs (bladder, bowel)
• Infertility, due to removal of ovaries and fallopian tubes
• Complications from anesthesia

Benefits

• Removal of malignant tissue can help to control and possibly eliminate the cancer.
• Improved symptoms and quality of life.
• Potentially improved survival rate.

Recovery

• Hospital stay for 3-7 days after surgery.
• Instructions for wound care, activity restrictions, and pain management.
• Follow-up appointments for monitoring recovery and further treatment if necessary.
• Full recovery may take several weeks to months.

Alternatives

• Chemotherapy or radiotherapy
• Hormone therapy
• Watchful waiting in cases where surgery carries too high a risk
• Each alternative has its own pros and cons compared to surgical resection and should be discussed with the oncologist.

Patient Experience

• Patients will be under general anesthesia and unaware during the procedure.
• Post-operative pain and discomfort are common, which can be managed with pain medications and other comfort measures.
• Some patients might experience emotional and psychological impacts due to the nature of cancer surgery and recovery.