Background Information:

What are the other Names for the Procedure?

• Complete Oophorectomy for Tumor Excision
• Ovarian Tumor Excision
• Partial Oophorectomy for Tumor Excision

What is Ovarian Tumor Removal surgical procedure?

An Ovarian Tumor Removal surgery involves the removal of a tumor, attached to an ovary.

What part of the Body does the Procedure involve?

An Ovarian Tumor Removal surgery involves the ovary and pelvic region of women.

Why is the Ovarian Tumor Removal surgical procedure Performed?

The Ovarian Tumor Removal procedure is performed for the removal of a suspected cancerous tumor on an ovary.

What are some Alternative Choices for the Procedure?

A surgery is often the last and decisive treatment option when indicated.

What are the Recent Advances in the Procedure?

An Ovarian Tumor Removal procedure may be performed laparoscopically (using a tube fitted with a camera), which is a minimally-invasive procedure.

What is the Cost of performing the Ovarian Tumor Removal surgical procedure?

The cost of an Ovarian Tumor Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused by the information regarding Ovarian Tumor Removal surgery on what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5^th Edition, New York, 2006

http://www.surgeryencyclopedia.com/La-Pa/Oophorectomy.html (accessed on 10/31/2014)

Prior to Ovarian Tumor Removal surgical procedure:

How is the Ovarian Tumor Removal surgical procedure Performed?

• The Ovarian Tumor Removal surgery may be performed under general anesthesia
• The surgeon makes an incision (horizontal/vertical) over the abdomen and dissects through the layers, until the ovary is visible
• The ovarian tumor is removed. This involves a resection of the ovary, either partially or completely
• After ensuring that there is no bleeding, the abdomen is closed in layers

The procedure may also be performed laparoscopically (using a tube, fitted with a camera).

• After inflating the abdomen with gas, a tube fitted with a camera (laparoscope) is introduced through a small incision
• Further instruments may be inserted via small incisions called ports, and the tumor is removed

Where is the Procedure Performed?

An Ovarian Tumor Removal procedure is performed at a hospital.

Who Performs the Procedure?

The Ovarian Tumor Excision is performed by any of these medical personnel, with or without assistance from an anesthesiologist:

• General surgeon
• Obstetrician-gynecologist

How long will the Procedure take?

The Ovarian Tumor Excision procedure may take a few hours.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Ovarian Tumor Removal procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
• Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
• Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Ovarian Tumor Removal procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Ovarian Tumor Removal surgical procedure?

Before an Ovarian Tumor Removal procedure, the patient has to undergo certain tests, such as:

• Routine blood and urine analysis
• Ultrasound imaging
• Computerized tomography (CT scan) of the pelvic organs
• Laparoscopy
• Culdoscopy
• Chest x-ray
• Lower abdominal culdocentesis
• Lower intestinal tract culdocentesis

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is an Ovarian Tumor Removal surgery?
• Why is this procedure necessary?  How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• What are the costs involved?

During the Ovarian Tumor Removal surgical procedure:

What kind of Anesthesia is given, during the Procedure?

General anesthesia by injection and inhalation is administered prior to the Ovarian Tumor Removal procedure.

How much Blood will you lose, during the Procedure?

Some blood loss may be expected during the Ovarian Tumor Removal procedure.

What are the possible Risks and Complications during the Ovarian Tumor Removal surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

• Obesity: Generally greater the degree of obesity, greater is the surgical risk
• Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
• Advancing age
• Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
• Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
• Poorly functioning liver, as evidenced by increased blood liver function tests
• Hypertension (increased blood pressure), especially if it is poorly controlled
• Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
• Poor lung function, as evidenced by abnormal lung function tests
• History of bleeding disorders
• Longstanding illness, such as autoimmune disorders, chronic infections
• Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Ovarian Tumor Removal surgery are:

• Excessive bleeding
• Infection surrounding the surgical wound
• Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Ovarian Tumor Removal surgical procedure?

• After the surgical procedure, patients will be sent to an area of the hospital, called the postoperative recovery area or PACU
• The patient’s blood pressure, heart rate, and respiration cycle, will be closely monitored. Any additional pain associated with the procedure will also be treated
• Individuals are usually discharged from the hospital 3-5 days after the surgery is performed

After the Ovarian Tumor Removal surgical procedure:

What are the possible Risks and Complications after the Ovarian Tumor Removal surgical procedure?

The possible risks and complications that may arise after an Ovarian Tumor Removal procedure include:

• Excessive bleeding
• Infection in the surgical wound
• Excessive scarring, called keloid formation, might occur
• Recurrence of the cancerous tumor

What is the Prognosis after the Surgery?

• A complete recovery from an Ovarian Tumor Removal procedure is usually achieved
• The prognosis depends on the type of tumor removed

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

• Pain that worsens and swelling of the surgical wound
• Bleeding or fluid drainage from the surgical wound
• The occurrence of any symptom that causes uneasiness, such as nausea or vomiting, constipation, abnormal swelling within the abdomen, or hot flashes
• Signs of an infection
• Dizziness
• Muscle aches, headache
• Fever, feeling sick
• Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Ovarian Tumor Removal surgical procedure?

At home, the following post-operative care is recommended, after an Ovarian Tumor Removal procedure:

• Slowly resume regular/daily activities as early as possible, which aids in a faster recovery
• Use a heat pad or warm compress to relieve pain due to the incision
• Resume showering and keep the wound clean and dry. Avoid taking baths until the surgical wound is completely healed. Gently wash the surgical wound with unscented soap and bandage it again
• Elevate legs while resting, to prevent the formation of blood clots and reduce the possibility of swelling
• Complete the course of prescribed medication
• Take stool softeners to prevent constipation, as advised by your physician
• Take antibiotic medication to help combat or prevent infection, per physician’s advice
• Avoid taking nonprescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain (per physician’s advice)
• Avoid all activities that are physically strenuous for about 6 weeks, as advised by your physician
• Avoid sex till complete healing has taken place (under advise by the physician)
• Individuals are advised to have to clear liquids immediately after the surgery, until the gastrointestinal tract begins properly functioning. Then individuals are advised to have a well-balanced diet, which can aid in a faster recovery

How long does it normally take to fully recover, from the Procedure?

It usually takes approximately 4 weeks to fully recover from an Ovarian Tumor Removal surgical procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

• The tissue removed is processed in the laboratory under a pathologist's supervision.
• Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
• Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Ovarian Tumor Removal surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The outpatient facility or a physician’s clinic/office
• An anesthesiologist (if anesthesia was administered)
• A pathologist
• A general surgeon or a obstetrician-gynecologist

The patient is advised to inquire and confirm the type of billing, before the Ovarian Tumor Removal surgery is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA