What is the surgical treatment for ovarian cancer?

The first line in the treatment and diagnosis of ovarian cancer is surgery. During ovarian cancer surgery, doctors locate and remove as much of the tumor tissue as possible, called debulking, and try to understand the extent of the cancer in the ovaries and elsewhere in the abdomen.

During surgery for ovarian cancer, doctors also collect samples of a variety of tissues to test for the presence of cancer, so they can proactively address any cancer metastasis in your treatment plan.

During the initial debulking surgery, doctors may perform a variety of procedures, depending on the type and stage of ovarian cancer, as well as your individual fertility concerns.

These procedures may be done one of two ways: During a laparotomy, an incision is made to open up the abdomen. During a laparascopy, small incisions are made in the abdomen. Your ovarian cancer surgical oncology team will discuss the best approach for you, which may include any of the following:

• Unilateral salpingo-oophorectomy: Surgical removal of one ovary and one fallopian tube.
• Bilateral salpingo-oophorectomy: Surgical removal of both ovaries and both fallopian tubes.
• Total hysterectomy: Surgical removal of the uterus, including the cervix.
• Omentectomy: Surgical removal of part or all of the omentum, a fold of fatty tissue inside the abdomen.
• Bowel resection: Surgical removal of part of the small or large intestine.
• Diaphragm or appendix surgery: Surgical removal of part of all of each organ.
• Lymph node biopsy: Surgical removal of part or all of one or more lymph nodes in the abdomen.
• Abdominal fluid biopsy: Removal of a fluid sample from the abdomen (if fluid is present) to be sampled and tested. A catheter also may be installed to drain the excess fluid.

Ovarian cancer surgery may be followed by chemotherapy. Often the chemotherapy will be administered directly into the abdominal cavity, known as intraperitoneal chemotherapy. If you are a candidate for this type of chemotherapy, your oncologist will put a thin tube in the abdomen during surgery. Once it heals, chemotherapy treatment will begin.