Surgery for Early Stage and Advanced Ovarian Cancer

Treatment for ovarian cancer begins with a surgery called a exploratory laparotomy. An incision is made in the abdominal wall to gain access to the pelvic and abdominal cavities. These procedures may be done during staging.

The extent of surgery depends on how advanced the cancer is. Radical surgery is the best treatment for ovarian cancer since the cancer can spread and be hard to detect. Radical surgery, which removes the most tissue, increases the chance that all the cancer cells will be removed.

Surgical procedures may include one or all of the following:

• Abdominal hysterectomy —Removal of the uterus.
• Bilateral salpingo- oopherectomy —Removal of both ovaries and fallopian tubes. This procedure may be recommended for women who are at high risk for ovarian cancer. Removing the ovaries before cancer is present is considered prophylactic (a preventive measure).
• Omentectomy —Removal of the omentum, a large apron-like structure that covers the organs in the abdominal cavity.
• Debulking —If ovarian cancer has spread into the pelvis or abdomen, as many of the tumors as possible will be removed. In some cases, this means leaving no tumors that are 1 centimeter or larger behind. It may be done on any organ in the pelvis or abdomen, such as the colon or bladder. Debulking can be done during a first or follow-up surgery.

Lymph nodes and/or other suspicious tissue will be removed and examined under a microscope for the presence of cancer cells.

In women where cancer is in a very early stage and who want to have children, a unilateral salpingo-oopherectomy (one ovary and fallopian tube) may be considered. Before starting treatment, talk to your doctor about preserving fertility.