The operation you are having is called a radical debulking, total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy. This means the uterus, tubes, ovaries and the fat pad that hangs from stomach called the omentum will be removed. Biopsies may be taken to determine the spread of disease. Part of the bowel, lymph nodes and other organs may also need to be removed if affected.
Your Admission to hospital
- You are required to check in at the Admissions desk of the hospital on arrival. You will then be admitted to the Ward.
- Please bring to hospital with you any medications you might be taking and any x-rays. The nursing staff will attend to your admission. This involves asking you a series of questions (if you have not attended the nursing pre-admission clinic prior to your procedure). Your blood pressure, temperature, pulse and weight will be taken.
- An anaesthetist wills ee you to discuss your anaesthetic and postoperative pain management just before your procedure.
- To help reduce the risk of clots in your legs you will be given support stockings to wear. You will also be given Clexane injections and wear calf compression devices to assist with this.
- Bowel preparation will commence the day before your surgery. A clear fluid diet is allowed during this time. An intravenous drip is also inserted (in your arm) to prevent dehydration, if you are an inpatient.
A shave of your abdomen and pubic area will be attended.
You may be given a premedication injection to help you relax.
A nurse from your ward will escort you to theatre.
An intravenous drip and possibly an epidural will be inserted.
Your surgery will take approximately 2-3 hours.
You will wake up in the recovery room and stay for up to 2 hours, depending on your blood pressure and pain relief requirements.
Depending on the extent of your operation if it often necessary to spend a night in High Dependency Unit. Family members are able to visit.
After your Operation
On return to the ward the nurses will monitor you closely.
You will have an intravenous drip in your arm and an infusion for pain relief.
A fine catheter will be in place, draining urine from your bladder for 2-4 days.
The incision in your abdomen will usually be vertical (up and down). There will be no visible stitches.
You will be allowed to have ice and then fluids until you pass wind and progress slowly to a diet.
You will be assisted to mobilise (sitting out of bed by Day 2 and showering on Day 3).
The physiotherapist may show you how to do breathing and leg exercises.
You will continue to wear the support stockings for the duration of your hospital stay and 2-3 weeks following discharge.
Some vaginal bleeding following surgery is expected and will be monitored. If you have any bowel surgery you may have a naso-gastric tube draining fluid from your stomach. This stops you from feeling nauseated.
Your Discharge from hospital
The usual length of stay is 4-7 days.
Prior to your discharge you will be given information about what to do during your recovery.
A post operative appointment will be made for you in 6 weeks.
At your appointment the doctor will explain the results of your surgery again and any further treatment you may require.
Follow up at regular intervals will continue.
Possible Complications of Surgery
The operation may involve removing tissue from the walls of major veins and arteries. The average blood loss is 500 ml and up to 5-10% of patients will require a blood transfusion.
A minor infection of the wound or the bladder occurs in up to 20% of patients. Severe infections are rare.
Damage to Surrounding Organs
It is possible that the bladder, ureter or bowel may be damaged during the operation. These injuries are uncommon.
Blood clots may develop in the veins of the legs or pelvis. A clot can rarely travel to the lungs causing breathing difficulties and in extreme cases even death. A number of precautions including support stockings, anticoagulant injections, calf compressors, leg exercises and early mobilization are taken to decrease the risk of clot formation.
There is approximately a 1 in 100000 chance of dying from anaesthesia. However a number of minor complications can occur (e.g. broken tooth, sore throat). Discuss any concerns with the anaesthetist before the operation.
Any surgery causes a degree of discomfort. Post operative pain relief is priority for our patients and options for analgesia will be discussed with you.
The above list covers the main possible side effects and complications of your surgery but is by no means complete. Please discuss with your doctor any specific concerns you may have about the proposed procedure.
The list of complications appears daunting but the overall risk of major complications is low.
Scope of Surgery
The aim of the surgery is to remove as much tumour as possible.
If the tumour appears confined to the ovary this usually means a total abdominal hysterectomy and bilateral salpingo-oophorectomy (removal of the uterus, tubes and ovaries), omentectomy (removal of the fat pad that hangs from the stomach) and staging (biopsies looking for disease spread).
If the tumour appears advanced you will have a radical debulking which may also involve removal of cancer found in other organs such as bowel, spleen and bladder.
Results of Treatment
Your surgery can have a number of outcomes:
-The cancer appeared completely confined to the ovary. In this case usually no further treatment is required. Your chance of the cancer returning is 10% or less.
-If you had an advanced cancer chemotherapy is used to attempt to eliminate any remaining cancer. With surgery and chemotherapy around 30% of women with advanced ovarian cancer are cured. Most women (approximately 80%) will live for 2 or more years. During this time they are usually well with a good quality of life.