The Goal of Debulking Surgery for Ovarian Cancer

Usually this type of surgery involves removing the uterus, ovaries, fallopian tubes, and the omentum, a fold of fatty tissue inside the abdomen. Some lymph nodes in the pelvis and abdomen might be biopsied in search of microscopic disease that could be hiding. This helps doctors determine whether or not the cancer has spread. If there is fluid in the pelvis or abdominal cavity, it too will be removed for testing. All the tissue and fluid samples that have been removed are sent to a lab to look for cancer cells.

The next step is what is called "debulking," which is the portion of the surgery to remove every visible bit of cancer. "We know from multiple studies that even a small amount of residual disease, say five millimeters, can impair survival, and we obviously want to give our patients the greatest advantage possible," says Dr. Saketh Guntupalli, gynecologic oncologist at University of Colorado Denver. "That is what we call an optimal cytoreductive surgery, where all of the tumor is removed." Patients whose tumors have been optimally debulked, meaning no tumor larger than 1 cm remains, have a better prognosis than those left with larger tumors.

During the operation, doctors explore the surfaces of each and every organ within the bellythe liver, the spleen, the stomach, the large and small intestinesand try to remove any tumors they may see. Though ovarian cancer does form some balls of tumor, it has this tendency of coating other areas. A lot of times it is a sort of a sheer sheet of tumor, and that can be shaved down as best the doctor can.

Occasionally, doctors may be able to perform the surgery using minimally invasive techniques such as a laparoscopy. However most ovarian cancer debulking usually requires an "open" surgical procedure, which includes a vertical incision in the abdomen.

Although no two ovarian cancer experiences are the same, most women will remain in the hospital for 3-7 days after their surgery and can expect their full recovery to take 6 to 8 weeks. By about four weeks, doctors say that most women will feel back to themselves.

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