Ovarian Cancer Surgery: What to Expect

While ovarian cancer usually starts in the ovaries, it’s usually not detected until it has spread to other organs.

“Our job during an operation is to remove as much of the tumor as possible from within the abdomen,” says Dr. Jeanne Schilder, division director of gynecologic oncology at Indiana University Medical Center.

The medical term for this surgery is debulking.

During surgery, a hysterectomy is performed, which means removing the uterus, usually the cervix, and any ovary and fallopian tube tissue that’s involved with the cancer. Even if the tissue appears normal, it will be removed, Dr. Schilder says.

“For example, one ovary might be involved while the other appears normal, but we usually remove both ovaries, both fallopian tubes, and the omentum [a curtain of tissue in the abdomen that most people have never heard of — and whose function isn’t well understood by doctors],” Dr. Schilder says. “…We also evacuate the ascites, the fluid that’s created from the tumor cells. In removing the majority of cancer cells, this helps with response to chemotherapy.”

Ovarian cancer tends to grow on the surfaces of organs and doesn’t typically invade organs such as the liver or kidneys.

In some cases, based on the imaging and other information they have, doctors may decide to shrink the tumors before they operate. In those cases, doctors start with chemotherapy — called “neoadjuvant chemotherapy” — and then move on to surgery.

The operation, whether it occurs before chemotherapy or after, is quite extensive, requiring a midline incision down the abdomen, from the ribs all the way to the pubic bone. And though it’s a big procedure, it gives doctors all the exposure they needed in order to get all of the cancer out.

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