Omentectomy

An omentectomy is a surgical procedure to remove the omentum, an area of tissue rich in blood vessels covering the intestines and other organs in the abdomen.

Why it may be done

Sometimes, an omentectomy is done because cancer (such as ovarian cancer) has spread to the area. Other times, your care team may recommend it to help determine the stage of the cancer.

An omentectomy is most frequently used in patients with epithelial ovarian cancer. In these cases, the expert performing your surgery should be a surgeon trained in treating ovarian cancer, such as a gynecologic oncologist.

Other surgeries may be performed along with an omentectomy to stage or treat ovarian cancer. These procedures include:

• Hysterectomy to remove the uterus and cervix     
• Salpingo-oophorectomy to remove the ovaries and fallopian tubes
• Lymph node dissection to remove lymph nodes 
• Cytoreductive/debulking surgery to remove cancer that has spread to other areas of the abdomen     

How to prepare for an omentectomy

Ahead of an omentectomy, you should expect to meet the cancer care team involved with your surgery, such as the operating doctor. Your care team will make sure you’re physically fit enough for surgery. This is important to make sure that your body can handle the anesthesia and that you can recover properly afterward.

Some of the tests you may undergo before your omentectomy include:

• Blood work
• Breathing tests
• Cardiopulmonary exercise test to measure your heart and lung function
• Chest X-ray
• Echocardiogram to monitor your heart

These steps may help prepare for an omentectomy:

• Ask questions in advance to help you better understand the procedure, such as:
  • What will happen during the procedure?
  • How long will I be in the hospital?
  • Will I need other cancer treatments?
  • Will I be in any pain?
  • What other procedures will be done at the same time?
• Find out whether you need to stop smoking or drinking alcohol before your surgery. Many times, health professionals recommend that you stop smoking a couple of weeks in advance
• Ask whether there are breathing exercises you can do to avoid developing a lung infection after surgery. Similarly, there may be leg exercises to help avoid the formation of blood clots after surgery.
• Prepare what you’re taking to the hospital, such as personal hygiene items, sleepwear, underwear, or small electronic devices.
• Arrange for care of your children, home and/or pets during your hospital stay.
• Confirm which medications you can take in the days before the omentectomy. Your doctor may want you to stop certain medications that may increase your risk for bleeding, such as non-steroidal anti-inflammatory drugs and blood thinners. If there are medications you can take the day of surgery, you’ll likely be told to take them with a small sip of water.

What to expect

Before the omentectomy, you will receive anesthesia for surgery. Doctors may perform an omentectomy in one of three ways:

• With a laparoscopic or robotic-assisted laparoscopic approach, the doctor will use small incisions in the abdomen.
• With traditional surgery, the doctor will make one larger incision in the abdomen.

Your care team may perform other necessary surgeries as well at the same time, such as removal of an ovarian cancer.

Omentectomy patients typically stay in the hospital for two to four days.

Benefits and risks of an omentectomy

The benefit of an omentectomy is to remove cancer if it’s spread to the omentum or to help stage the cancer to determine the most beneficial treatment.

Cancer surgeries, such as an omentectomy, can cause side effects including temporary tenderness or pain. It's normal to feel discomfort or even pain for a few days as your body heals, especially if you’ve had other procedures at the same time. An omentectomy may cause fluid retention due to blocked lymphatic blood vessels. You may have difficulty using the bathroom, both urinating and passing stool, during this period. As with any type of surgery, there’s also the risk for an infection, bleeding or nerve damage.

One very specific risk of an omentectomy is recurrence of an adhesive small bowel obstruction, a type of blockage in the digestive tract.  

Understanding the results of an omentectomy

Your doctor may review the results with you—not only the findings of the omentectomy, but also those of any other surgery done at the same time. If the procedure was done to help determine the stage of cancer, these findings will help to formulate the treatment options recommended by your care team.