Ovarian cancer surgery

Surgery is one of the main treatments for ovarian cancer, fallopian tube cancer or primary peritoneal cancer. It also helps doctors to diagnose the type of cancer.

When is surgery used for cancer of the ovary, fallopian tube or peritoneum

Surgery is one of the main treatments for ovarian cancer, fallopian tube cancer or primary peritoneal cancer. You have surgery to remove the cancer. But it also helps doctors to:

  • diagnose the type of cancer
  • find out more about its stage.

You usually have surgery to remove the following:

  • the ovaries
  • the fallopian tubes
  • the womb
  • the omentum
  • lymph nodes.

We have more information on the ovaries, fallopian tubes and peritoneum.

If you have a very early-stage cancer and want children, it may be possible to have only the affected ovary and fallopian tube removed. This is called fertility-sparing surgery (see below).

If the cancer has spread to other areas in the pelvis, you may need more surgery.

Sometimes you have chemotherapy before surgery to shrink the cancer and make surgery easier.

Side view ovarian with ureter
Image: Side view ovarian with ureter

 

Before your operation

A surgeon called a gynaecological oncologist will do your surgery (operation).

Before you have surgery, your surgeon and nurse will talk it over with you and answer any questions. They will also explain how to prepare for your operation and what to expect after it.

We have more information on what to expect before and after your surgery for ovarian cancer.

Surgery to remove the cancer

The surgeon aims to remove all the cancer or as much of it as possible. During the operation, they usually remove:

  • the ovaries and fallopian tubes (bilateral salpingo‑oophorectomy)
  • the womb and cervix (total hysterectomy)
  • the omentum (omentectomy).

The surgeon will also check how far the cancer has spread. This is important because it tells them more about the stage of the cancer.

During surgery, they:

  • take samples of tissue (biopsies) from other areas nearby
  • remove some lymph nodes in the tummy and pelvis
  • put fluid into the tummy and collect it to test for cancer cells – this is called abdominal or peritoneal washing.

You may also need surgery to other areas to remove as much of the cancer as possible. This depends on where the cancer has spread in the pelvis.

Surgery to protect your fertility

If you have very early ovarian cancer, it may be possible to have surgery that means you can still get pregnant. This is usually possible if the cancer is stage 1a and is not high grade.

The surgeon only removes the affected ovary and fallopian tube. They leave the other ovary, other fallopian tube and the womb. During the operation, the surgeon checks the other ovary and may take biopsies from it.

If any biopsies, lymph nodes or fluid removed from the pelvis show the cancer has spread, you will need another operation. This is usually to remove the womb, remaining ovary and remaining fallopian tube.

You may find this difficult to cope with if you were hoping to have a pregnancy. Your specialist nurse will give you lots of support. They may be able to refer you to a counsellor for further emotional support.

Removing as much of the cancer as possible

Many cancers of the ovary, fallopian tube or peritoneum have spread when they are diagnosed. If the cancer has spread to other areas in the pelvis or tummy, it may not be possible to remove it all. Your surgeon will try to remove as much of the cancer as they can. Doctors sometimes call this debulking or cytoreductive surgery.

Removing part of the bowel

If the cancer has spread to the bowel, you may also need a section of bowel removed. If possible, the surgeon removes the affected piece of bowel and joins the 2 remaining pieces together. This is called a bowel re-join.

Sometimes the surgeon cannot safely join the remaining pieces of bowel together. Instead, they bring the upper end of the bowel out onto the skin of the tummy. This is called a stoma. After the operation, you wear a bag over the stoma to collect stools (poo). A stoma can be temporary to protect the bowel re-join. Or it may be permanent if a safe bowel re-join is not possible.

If you are likely to need part of your bowel removed, your surgeon will talk to you about this before your operation. If you need a stoma, your hospital team and a stoma nurse will give you support and advice.

We have more information on having a having a stoma.

About our information

  • References

    Below is a sample of the sources used in our ovarian cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Ledermann, Raja, Fotopoulou et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2013; Volume 24, Supplement 6. Updated online 2020. Available from www.esmo.org/guidelines (accessed July 2021)

    Management of epithelial ovarian cancer. Scottish Intercollegiate Guidelines Network (SIGN). Nov 2013 revised 2018. Available from www.sign.ac.uk

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.