Ovariectomy

Ovariectomy is the surgical removal of one or both ovaries. If one ovary is removed, a woman may continue to menstruate and have children. If both ovaries are removed, menstruation stops and a woman loses the ability to bear children.

General information about Ovariectomy

Ovariectomy is also called Oophorectomy. The procedure can be done under general anesthesia. Ovariectomy is performed through the same type of incision as an abdominal hysterectomy. The surgeon makes a 4-6 in (10-15 cm) incision either horizontally across the pubic hair line from hip bone to hip bone or vertically from naval to pubic bone. Horizontal incisions leave a less noticeable scar, but vertical incisions give the surgeon a better view of the abdominal cavity.

After the incision is made, the abdominal muscles are pulled apart (not cut) so that the surgeon can see the ovaries. The blood vessels are tied off to prevent excess bleeding. Then the ovaries, and often the fallopian tubes, are removed.

The advantages of abdominal incision are that the ovaries can be removed even if a woman has many adhesions from previous surgery. The surgeon gets a good view of the abdominal cavity and can check the surrounding tissue for disease. A vertical abdominal incision is mandatory if cancer is suspected. The disadvantages are that bleeding is more likely to be a complication of this type of operation. The operation is more painful than a laparoscopic operation and the recovery period is longer. A woman can expect to be in the hospital two to five days and will need three to six weeks to return to normal activities.

Ovariectomy can sometimes be done with a laparoscopic procedure. With this surgery, a tube containing a tiny lens and light source is inserted through an incision in the navel. A camera can be attached that allows the surgeon to see the abdominal cavity on a video monitor. The surgeon then inserts slender instruments through small incisions in the abdomen and uses them to cut and tie off the blood vessels and fallopian tubes. When the ovaries are detached, they are removed though a small incision at the top of the vagina. The ovaries can also be cut into smaller sections and removed through the tiny abdominal incisions.

The advantages of a laparoscopic procedure are that the incisions are only about .5 in (1.3 cm) long, the operation is causes less discomfort than an abdominal procedure, and bleeding rarely occurs. The hospital stay is usually only one day and recovery time is reduced to about two weeks. The disadvantage is that this operation is relatively new and requires great skill by the surgeon.

Why is a Ovariectomy performed

• Remove cancerous ovaries
• Remove a large ovarian cyst
• Excise an abscess
• Treat endometriosis
• Remove the source of estrogen that stimulates some cancers.

In an Ovariectomy one, both, or a portion of one ovary may be removed. When Ovariectomy is done to treat ovarian cancer or other spreading reproductive system cancers, both ovaries are removed. This is called a bilateral Ovariectomy. Sometimes a bilateral Ovariectomy is performed in women with breast cancer to remove the main source of estrogens, since estrogens seem to stimulate the growth of some breast cancer.

Occasionally both healthy ovaries are removed in women over age 45 when they have a hysterectomy to eliminate the risk of ovarian cancer. The value of this practice has been questioned in recent years. The removal of both ovaries may also be done to treat pelvic inflammatory disease (PID) or endometriosis. Removing both ovaries to treat premenstrual syndrome (PMS) is controversial, since other, less drastic, treatments for this disorder are available.