Staging surgery and debulking surgery are procedures usually used to treat ovarian cancer.
- Minimally invasive surgery is often the initial procedure for diagnosing and staging ovarian cancer, though the COVID-19 pandemic is forcing doctors to re-think the order of treatment when appropriate.
- During surgical debulking, which can sometimes take 6 to 8 hours, doctors aim to remove all visible disease.
- Surgery will normally involve a complete hysterectomy, which means removing the uterus, ovaries, fallopian tubes, and cervix. Sometimes, other organs are also affected.
- In some cases robotic surgery may be an option, but for most patents an open incision is necessary to try to remove all the cancer.
“Minimally invasive surgery allows us to assess the stage of the disease, where disease is present and where it’s not," says Daynelle Dedmond, gynecologic oncologist with Centura Health. A slender, lit camera called a laparoscope may be used to examine the organs in the abdomen and pelvis to investigate the extent of the cancer. "It's also helpful to be able to get a biopsy of the actual tumor, which can't always be done without surgery." Dr. Dedmond explains that doing an initial, minimally invasive procedure can be a good initial approach, "even if we're not sure that we'll be able to complete an entire surgical debulking [removing as much of the tumor as possible] in that operative setting."
Read MoreThe more extensive debulking surgery generally starts with a complete hysterectomy, which involves removing the uterus, fallopian tubes, ovaries, cervix. Surgeons also remove the omentum–an apron of fatty tissue that covers and supports the intestines and organs in the abdomen–because ovarian cancer sometimes spreads to this area. Doctors then check the diaphragm, and bit by bit go over each and every organ and try to remove any tumors that they may see. Though ovarian cancer does form some balls of tumor, it has a tendency to coat other areas.
Debulking surgery is often very lengthy”removing every [visible] area of disease possible can take up to six to eight hours," Dr. Dedmond says. "That’s really our goal as gynecologic oncologists: to provide a patient with an optimal surgical debulking, which means that no evidence of disease that we can feel or see is left behind."
This attention to detail is crucial, as patients whose tumors have been optimally debulked have a better prognosis than those left with larger tumors after surgery.
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