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Omentectomy


Medical editor Claes Tropè MD
Gynecological Oncologist
Oslo University Hospital

General

The omentum is removed for ovarian cancer, fallopian tube cancer, and cancer in the peritoneum, as well as serous papillary and clear-cell endometrial cancer because there is often macro and/or microscopic spreading. The omentum is removed to diagnose spreading. 

The omentectomy is part of the stage determination.

Indications

  • Ovarian cancer 
  • Fallopian tube cancer 
  • Cancer in the peritoneum
  • Serous papillary and clear-cell endometrial cancer

Goal

  • Remove visible tumors and to check for possible micrometastases.

Equipment

Gynecological surgery tray


Preparation

  • Large bowel emptying
  • Thrombosis prophylaxis

Implementation

  • Lift the omentum to obtain good visualization of the blood vessels. 
  • The blood vessels are divided and ligated immediately distal to the colon. 
  • The middle layer of thin tissue consisting of two peritoneal sheets with loose connective tissue in between is divided with diathermy.
  • The omentum may be adherent to the spleen and pulling may cause the spleen to rupture and bleed.
  • In cases where the tumor tissue is close to the colon, the tissue will often open when carefully splitting the peritoneum with diathermy.  
  • All blood vessels are ligated.

At Oslo University Hospital, the tissue specimens are sent dry to the pathology lab for processing and fixing.


Follow-up

Observe for normal postoperative complications.


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