Surgery for ovarian cancer

Surgery for ovarian cancer allows your gynaecological oncologist to confirm the diagnosis of ovarian cancer and work out how far the cancer has spread. They will also remove as much of the cancer as possible. This may involve several procedures during the operation.

Your gynaecological oncologist will talk to you about the most suitable type of surgery, as well as the risks and side effects. These may include infertility. If having children is important to you, talk to your doctor before surgery and ask for a referral to a fertility specialist.

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How the surgery is done

You will be given a general anaesthetic and will have either a laparoscopy (with 3–4 small cuts in your abdomen) or a laparotomy (with a vertical cut from around your bellybutton to your bikini line).

The type of surgery you have will depend on how certain the gynaecological oncologist is that cancer is present and how far they think the cancer has spread. A laparoscopy may be used to see if a suspicious mass is cancerous; if the cancer is advanced, you will usually have a laparotomy.

Taking a biopsy

The gynaecological oncologist will look inside your pelvis and abdomen for signs of cancer, and take tissue and fluid samples (biopsy). During the operation, the samples may be sent to a specialist called a pathologist, who checks them right away for signs of cancer. This is called a frozen section analysis or biopsy.

Debulking

If cancer is present, the operation will continue and as much cancer as possible will be removed. This is called debulking.

The surgeon usually has to remove some or all of the reproductive organs:

Total hysterectomy and bilateral salpingo-oophorectomy

Unilateral salpingo-oophorectomy

Depending on how far the cancer has spread, other organs or tissue may also be removed during the same operation:

Omentectomy

The omentum is a sheet of fatty tissue that hangs down in front of the intestines like an apron. If the cancer has spread to the omentum, it will need to be removed.

Lymphadenectomy

Cancer cells can spread from your ovaries to nearby lymph nodes. Your doctor may suggest removing some in a lymphadenectomy (also called lymph node dissection).

Colectomy

If cancer has spread to the bowel, some of the bowel may need to be removed. A new opening called a stoma might be created (colostomy or ileostomy).

Removal of other organs

Ovarian cancer can spread to many organs in the abdomen. In some cases, parts of the liver, diaphragm, bladder and spleen may be removed if it is safe to do so.

Further treatment

It may not be possible to remove all the cancerous tissue during the operation, but surgery for ovarian cancer is often followed by other treatments to shrink or destroy any remaining cancer cells.

Will I need further treatment after surgery?

All tissue and fluids removed during surgery are checked for cancer cells by a pathologist. The results will help confirm the type of ovarian cancer you have, if it has spread (metastasised), and its stage.

Your doctor should have all the test results within two weeks of surgery.

Further treatment will depend on the type of ovarian cancer, the stage of the disease and the amount of any remaining cancer.

If the cancer is advanced, it’s more likely to come back, so surgery will usually be followed by chemotherapy, and occasionally by targeted therapy. Radiation therapy is recommended only in particular cases.

For more on this, see our general section on Surgery.

Video: What is surgery?

Watch this short video to learn more about surgery.

This information was last reviewed in May 2020. View who reviewed this content.

A/Prof Sam Saidi, Senior Staff Specialist, Gynaecological Oncology, Chris O’Brien Lifehouse, NSW; A/Prof Penny Blomfield, Gynaecological Oncologist, Hobart Women’s Specialists, and Chair, Australian Society of Gynaecologic Oncologists, TAS; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Sonja Kingston, Consumer; Clinical A/Prof Judy Kirk, Head, Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, and Sydney Medical School, The University of Sydney, NSW; Prof Linda Mileshkin, Medical Oncologist and Clinical Researcher, Peter MacCallum Cancer Centre, VIC; Deb Roffe, 13 11 20 Consultant, Cancer Council SA; Support Team, Ovarian Cancer Australia; Emily Stevens, Gynaecology Oncology Nurse Coordinator, Department of Obstetrics and Gynaecology, Flinders Medical Centre, SA; Dr Amy Vassallo, Fussell Family Foundation Research Fellow, Cancer Research Division, Cancer Council NSW; Merran Williams, Consumer.

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