58953 Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking

Name of the Procedure:

Bilateral Salpingo-Oophorectomy with Omentectomy, Total Abdominal Hysterectomy, and Radical Dissection for Debulking

Summary

This is a complex surgical procedure involving the removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy), the omentum (omentectomy), the uterus (total abdominal hysterectomy), and extensive removal of surrounding tissues (radical dissection) to reduce the size of a tumor or mass in the abdominal or pelvic region.

Purpose

• Medical Condition: This procedure is typically performed to address ovarian cancer, endometrial cancer, or other abdominal/pelvic malignancies.
• Goals: The primary aim is to remove as much tumor mass as possible to improve the patient's prognosis and response to further treatments like chemotherapy.

Indications

• Symptoms such as chronic pelvic pain, abnormal bleeding, or a palpable mass.
• Diagnosed ovarian, endometrial, or pelvic malignancies.
• Advanced-stage cancer requiring aggressive surgical intervention.

Preparation

• Pre-Procedure Instructions: Patients are generally required to fast for 8-12 hours before surgery. Medications may need to be adjusted, and blood thinners are typically discontinued.
• Diagnostic Tests: Pre-operative imaging (CT, MRI), blood tests including tumor markers, and a thorough physical examination.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A vertical or horizontal incision is made in the abdomen.
3. Removal: The surgeon removes the ovaries, fallopian tubes, uterus, and omentum. Radical dissection involves taking out additional surrounding tissues to ensure as much of the tumor is removed as possible.
4. Closure: The incision is closed with sutures or staples.
5. Post-Operative Care: The patient is monitored in the recovery room before being moved to a hospital room.

Duration

The procedure typically takes 4 to 6 hours, depending on the extent of the disease and complexity of the surgery.

Setting

The procedure is performed in a hospital operating room.

Personnel

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

Risks and Complications

• Common risks: Bleeding, infection, blood clots, and reactions to anesthesia.
• Possible complications: Injury to surrounding organs (bowels, bladder), lymphocele formation, and complications from extensive tissue removal.

Benefits

• The main benefit is the reduction of tumor mass, which can significantly improve survival rates and effectiveness of further treatments.
• Alleviation of symptoms caused by the tumor.

Recovery

• Post-Procedure Care: Pain management, antibiotics, and blood thinners post-operation.
• Recovery Time: Full recovery can take 6 to 8 weeks. Restrictions on heavy lifting and strenuous activities are typically advised.
• Follow-up: Scheduled follow-up appointments to monitor healing and further treatment planning.

Alternatives

• Chemotherapy or Radiation: Less invasive but may not be as effective for advanced-stage tumors.
• Minimal Invasive Surgeries: Laparoscopic procedures may be possible in less extensive cases but are not suitable for large tumors requiring debulking.

Patient Experience

• During the Procedure: The patient will be under general anesthesia and will not feel any pain or be aware of the procedure.
• Post-Operative Pain: Managed with medication. Pain and discomfort are expected at the incision site.
• Recovery: Patients may experience fatigue, a temporary loss of appetite, and restricted mobility, all managed with supportive care and gradual activity increase.

Please consult a specialized healthcare provider for personal medical advice and detailed information tailored to your specific condition.