Ovarian surgery

Ovary or fallopian tube removals are carried out primarily with laparascopic surgery (abdominal imaging). Only three small skin incisions are required to insert the instruments and a camera into the abdomen. Tumours, cysts and endometriosis lesions are treated or adhesions are removed from the fallopian tubes with the surgery.

Diseases on the ovaries or fallopian tubes requiring surgery include: ovarian cysts, ovarian cancer (ovarian carcinoma), fallopian tube cancer (tubal carcinoma), fallopian tube pregnancy or fallopian tube adhesions. In addition, endometriosis lesions are surgically removed from the ovaries or the fallopian tubes more often than not. Endometrioses are "islands" of uterine mucosa which occur outside the uterus.

Ligation of the fallopian tubes is undertaken when a woman wants to be sterilised.

The ovaries and fallopian tubes are situated close together in anatomical terms. Therefore, the surgical techniques for the procedures in both areas are very similar. In the case of diseases which affect both the ovaries and the fallopian tubes, the surgical treatment is usually undertaken in the same operation. The surgical procedures on the ovaries or the fallopian tubes are normally carried out with the help of surgical imaging (laparoscopy) without opening the abdominal wall. Three small skin incisions are usually sufficient for this minimally invasive procedure. Open surgery, i.e. laparotomy, is rarely carried out. The following explanations therefore relate to the laparascopic procedure.

What preparations are carried out before the procedure?

Different clarifications and examinations are undertaken before the procedure. An ultrasound examination is part of the standard clarifications. Sometimes a computed tomography, an MRI or an ovarian puncture is carried out. All blood-thinning medication must be discontinued before the procedure takes place. This operation is performed under general anaesthetic and involves all the usual preparations required for a general anaesthetic.

How is the operation performed?

First, two or three small openings are cut in the abdominal wall. Then a laparascope and the requisite surgical instruments are inserted. The stomach is inflated with CO2 so there is sufficient space for the surgery. The ovaries or the fallopian tubes can be gently removed with the laparascope using the camera as a guide. Endometriosis or adhesions in the fallopian tubes are removed using the same method. After the surgery, the CO2 is released and the abdominal cuts are sutured together again. Sometimes a drainage tube is then inserted. The procedure lasts approximately two hours.

A further surgical procedure is colpotomy. During this method, access is gained to the abdomen via an incision in the vagina.

What is the success rate of this procedure?

The results depend on the underlying disease. This procedure normally remedies cysts or adhesions. Endometriosis lesions can sometimes reform. In the case of cancer, the stage of the disease determines the prognosis.

What are the possible complications and risks of this procedure?

This is a low-risk operation and generally proceeds without complications. As with all surgery, the operation may lead to infections, post-operative haemorrhaging or blood clots (thromboses) in rare cases. Sometimes, growths can appear in the abdomen.

What happens after the operation?

After the surgery, the patient is monitored during the recovery phase as they wake up from the anaesthesia. If everything proceeds normally, you can usually leave hospital the following day. You should avoid lifting heavy objects and major physical exertion for some time after the surgery,  and refrain from sexual intercourse. Depending on the underlying disease, regular follow-up check-ups are required.

If both fallopian tubes are removed, the production of the female sex hormone ceases. Women who are not yet in the menopause will experience menopausal changes or symptoms immediately after the surgery. Sometimes hormone replacement therapy is necessary to ease or prevent these symptoms.

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