The omentum comprises a double layer of fatty tissues that support and cover the organs in the lower abdomen. It functions as an important storage organ for fat deposits. An Omentectomy is a surgical procedure performed to remove the omentum.
This procedure is recommended during the treatment of ovarian cancer, if the cancerous cells have invaded the omentum. Done to prevent malignant spread, a trained surgeon such as a gynecologic oncologist is assigned to perform the omentectomy.
There are two types of omentectomy, namely:
Complete removal of omentum.
A portion of the omentum is removed.
It is typically performed in combination with other treatments such as hysterectomy (removal of the uterus and cervix) or salpingo-oophorectomy (removal of ovaries and fallopian tubes).
How is Omentectomy Performed?
Omentectomy is a surgical procedure that is done to remove the primary tumour in the omentum, and to prevent the spread of the tumour to the stomach and other organs.
This can be done in two ways:
- A single, large incision in the abdomen, called Open-Abdominal Surgery.
- Laparoscopic surgery with smaller incisions in the abdomen. This involves a camera to guide the surgeon throughout the surgery.
Open-Abdominal Surgery is effective, but it leads to longer recovery times, cosmetic defects and a delay in resuming daily activities. Laparoscopy, on the other hand, is a minimally invasive procedure with small incisions, which leads to faster recovery rates and lesser cosmetic defects.
Preparation for Omentectomy
Prior to an Omentectomy, it is advised to check for physical fitness to ensure handling and recovery post anaesthesia. Before the procedure, blood tests, cardiopulmonary tests, chest X- ray and an echocardiogram is done to thoroughly check the patient’s medical history. Patients are advised to refrain from smoking and drinking a couple of weeks before the procedure.
Any previous history regarding procedures under anaesthesia is also checked for. Once the patient arrives at the hospital for the procedure, the preparation steps include:
- Changing to the hospital gown
- Shaving near the region of the surgery
- Shower before the procedure
Patients are also advised to start fasting a few hours prior to the procedure to avoid any complications with anaesthesia.
Follow up Post-Omentectomy
In the case of cancer patients who have undergone Omentectomy or any other ovarian surgery, chemotherapy is suggested to destroy residual cancer cells. Right after the surgery, the patient’s blood pressure, infection at the site of surgery and any other immediate signs are checked for. Post operation, the patient is put on a liquid diet for 3-4 days and discharge is not recommended until patients tolerate a soft diet and the pain subsides, at least 4-5 days post-surgery.
Risks Associated with Omentectomy
The benefit of an Omentectomy is to mainly remove the cancerous spread of the tumour. As with any other surgery, certain risks or side effects are associated with Omentectomy too, which include:
- Bleeding
- Nerve damage
- Temporary tenderness or pain
- Recurrence of small bowel obstruction
- Nausea due to anaesthesia
- Lymphedema (collection of fluids if lymph vessels are blocked)
- Infection
- Mild fever
Recovery Post-Omentectomy
It takes around 2-8 weeks for full recovery from an omentectomy surgery. Recovery also depends on additional procedures done along with the omentectomy. Ensure that you receive information from your health provider regarding breathing exercises to avoid lung infection, walking and leg exercises to avoid blood clots and hygiene around the area of the surgery.
Exercising proper hygiene and cleanliness can help avoid infections. There may be a pause on certain medication before and after the omentectomy. On the other hand, in cases of cancer, fertility preservation medicines and other medications may be recommended post-surgery. Taking the proper steps during the post-surgery duration can boost recovery.
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