Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking
CPT4 code
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
- Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
- Incision: A vertical or horizontal incision is made in the abdomen.
- 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.
- Closure: The incision is closed with sutures or staples.
- 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.