Find out about the different types of surgery for ovarian cancer.
Surgery to remove the womb, ovaries and fallopian tubes
Surgery for ovarian cancer is usually quite a big operation. Your surgeon (gynaecological oncologist) needs to make sure that they remove as much cancer as possible.
Most women with ovarian cancer will have surgery to remove:
- both ovaries and fallopian tubes
- the womb, including the cervix
This operation is called a total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO).
If you have a borderline ovarian tumour or a low grade very early stage cancer (stage 1a) you may have just the affected ovary and fallopian tube removed.
Surgery for early stage ovarian cancer
During surgery to remove your ovaries and womb, your surgeon will take samples from several areas within the abdomen and pelvis to find out if the cancer has spread. This helps them to fully stage the cancer and decide if you need treatment after surgery.
Your surgeon will remove a layer of fatty tissue close to the ovaries, called the omentum. This is called an omentectomy. Ovarian cancer can spread to the omentum so checking this area is important.
Your surgeon will also put some sterile fluid inside your abdomen and then remove it. This is called peritoneal or abdominal washings. They send this fluid to the laboratory to see if it contains cancer cells.
Your surgeon may remove some lymph nodes from around the womb and ovaries, in the pelvis and from your abdomen. They will also take samples of tissue (biopsies) from the lining of your pelvis and abdomen to check for cancer.
Surgery for advanced ovarian cancer
If the cancer has spread to other areas in your pelvis or abdomen, your surgeon will aim to remove as much of the cancer as possible. This is called debulking. The less cancer there is left after surgery, the easier it is for chemotherapy to kill the remaining cancer cells.
You might have chemotherapy before and after surgery. This is called interval debulking surgery (IDS).
As with early stage ovarian cancer, your surgeon may take several samples from within the abdomen and pelvis to check where else the cancer may have spread to. If you have a build up of fluid in your abdomen (ascites), they may send a sample to the lab to check for cancer cells.
Sometimes surgeons have to remove part of the bowel if the cancer has spread there and is blocking the bowel. They may have to create an opening (stoma) on the outside of the abdomen for bowel movements to come out into a bag. This is called a colostomy. It is often only temporary. The surgeon can do a smaller operation to close the stoma up again once everything has settled down from your first operation.
How your surgeon does your operation
You have surgery for ovarian cancer under general anaesthetic. So you are asleep the whole time.
Depending on the surgery you have, you are generally in hospital for 3 to 4 days, and recovering at home afterwards for at least a month or so.