Surgery for ovarian cancer

Surgery is one of the main treatments for ovarian cancer. The type of operation you have will depend on the stage of the cancer. Sometimes, doctors won’t know the stage until the surgery starts. Your surgeon will talk to you about the possible options before the operation.

The different types of surgery may involve:

  • removing both ovaries and the womb
  • removing the affected ovary and fallopian tube
  • removing as much of the cancer as possible (debulking surgery).

During the operation, the surgeon will take samples of tissue from other areas to see if the cancer has spread.

Some of these cancer treatments will affect your fertility (ability to get pregnant). If you need your womb removed, you will not be able to get pregnant. Being told that your cancer treatment will mean that you won’t be able to have children can be very difficult. You might want to talk through your feelings with your specialist doctor or a close friend. There is information and support available to help you.

Types of surgery

Surgery is one of the main treatments for cancer of the ovary, and may sometimes also be needed to make the diagnosis. A specialist gynaecological oncologist will do your operation.

Your doctor and specialist nurse will talk to you about the most appropriate type of surgery for your situation. This often depends on the stage of the cancer.

Sometimes information about the stage of the cancer only becomes available during the operation itself, or afterwards when the pathologist examines the tissue that was removed.

Your surgeon and specialist nurse will talk to you about the possible options before the operation.

When reading this information, it may help to look at the diagrams showing the organs close to the ovaries.


Surgery to remove the ovaries and womb

The aim of this operation is to remove all of the cancer.

It involves removing:

  • the ovaries and fallopian tubes (called a bilateral salpingo oophorectomy or BSO)
  • the womb and cervix (called a total abdominal hysterectomy or TAH)
  • the omentum, which is the fatty layer that covers the bowel (called an omentectomy).

During the operation, the surgeon takes biopsies from other tissues and may remove some of the lymph nodes in the abdomen and pelvis. This is to check whether the cancer has spread. The surgeon will also put fluid into the abdomen, remove it and then test it for cancer cells. Doctors call this abdominal or peritoneal washing.

After this operation, you will no longer have a womb and so won’t be able to get pregnant. Being told that your cancer treatment will make you infertile can be very difficult. You may find it helpful to read our information about fertility and cancer treatment.


Fertility-conserving surgery

Women with a borderline tumour or stage 1a ovarian (low-grade) cancer may be able to have surgery that allows them to remain fertile (able to get pregnant). It may be possible for the surgeon to remove only the affected ovary and fallopian tube. This means you may be able to become pregnant and have children in future.

During the operation, the surgeon checks the other ovary and may take a sample from it. They also remove lymph nodes and take washings and samples (biopsies) from the pelvis and abdomen.

If the washings and biopsies show the cancer has spread, unfortunately it means you need a second operation. The most effective treatment is to remove the womb, omentum and remaining ovary and fallopian tube.


Removing as much of the cancer as possible

When cancer has spread to other areas in the pelvis or abdomen, the aim of surgery is to try to remove as much of the cancer as possible. Doctors may call this debulking surgery.

If scan results show the cancer has spread, your surgeon will discuss this type of operation beforehand. If, when removing the ovaries and womb, the surgeon finds the cancer has spread they usually try to remove as much of the cancer as possible.

Removing part of the bowel

Some women have some of their bowel removed. If you are likely to need bowel surgery, your surgeon or specialist nurse will talk to you about this before the operation.

You may need some bowel removed if the cancer has started to grow on the outside of the bowel. If possible, the surgeon removes the affected piece of bowel and rejoins the two remaining pieces together.

Rarely, the surgeon cannot rejoin the two ends of bowel. In this situation, the upper end of the bowel is brought out onto the skin of the abdomen to form a stoma. You wear a bag over the stoma to collect stools (bowel motions). If this happens, you will be given a lot of support from your hospital team and a specialist stoma nurse to help you to cope.

Back to Surgery explained

What happens after surgery?

You’ll be monitored very closely after your operation. You will be very tired so it’s important to rest and look after yourself.