Omentectomy

What is an omentectomy

An omentectomy is a surgical procedure to remove all or part of your omentum. Your omentum is a layer of fatty tissue that covers some of the organs in your abdominal cavity, including your stomach and intestines. It consists of fatty tissue and blood vessels, which provide blood supply and physical protection to your organs.

Why would the omentum need to be removed?

Omentectomy surgery is usually related to cancer. While it’s rare for cancer to begin in your omentum, it’s common for cancer to spread to it from other places in your abdomen. Some types of cancer that may require an omentectomy include:

• Ovarian cancer.
• Prostate cancer.
• Fallopian tube cancer.
• Uterine cancer (endometrial).
• Stomach cancer.
• Colorectal cancer.
• Appendix cancer.
• Peritoneal mesothelioma.
• Pseudomyxoma peritonei.

If you have cancer in your omentum, your doctor will usually recommend removing it surgically. If you have cancer nearby that's likely to spread to your omentum, your doctor may recommend removing it to prevent cancer from spreading there.

Sometimes doctors remove the omentum to look for microscopic evidence of cancer in it. Evidence that cancer has spread to the omentum from somewhere else helps them determine the stage of the cancer and how they should treat it.

What are the different types of omentectomy?

You may have a partial or a total omentectomy. A total omentectomy (supracolic omentectomy) removes your entire omentum. A partial omentectomy (infracolic omentectomy) removes only a portion of your omentum.

What happens before an omentectomy?

Omentectomy is usually performed as part of a larger cancer surgery and not as a separate procedure.

Before any surgery, you’ll meet with a team of healthcare specialists to discuss the procedure. They’ll counsel you on the risks and benefits of the surgery and assess your overall health to make sure you’re physically fit for the operation.

Abdominal surgery requires that you can safely spend several hours under general anesthesia. You'll take a series of health screening tests to determine this, including blood tests and an EKG test to check your heart.

What happens during an omentectomy?

Omentectomy can sometimes be performed by minimally invasive surgical methods, such as laparoscopic surgery or robotic surgery. But this depends on several factors, including your condition, the extent of your surgery and the experience and judgment of your surgeon.

An omentectomy by itself might be a relatively simple procedure, but an omentectomy to remove cancer is often just one part of a larger operation. If you have cancer in other places, your surgeon will want to remove it all at once.

If you have a laparoscopic omentectomy, your incisions will be smaller and your recovery will be faster. Your surgeon will complete the operation through 3 to 4 small “keyholes” about a half-inch wide, using long surgical tools and a tiny camera called a laparoscope.

If you have open abdominal surgery, your surgeon will make one long incision across your abdomen to open up your abdominal cavity. They will remove your omentum along with any other affected organs in an attempt to remove as much cancer as possible.

Omentectomy is commonly combined with one or several other operations, including:

• Hysterectomy to remove your uterus.
• Salpingectomy to remove one or both of your fallopian tubes.
• Oophorectomy to remove one or both of your ovaries.
• Prostatectomy to remove your prostrate.
• Gastrectomy to remove part or all of your stomach.
• Colectomy to remove part or all of your colon.
• Retroperitoneal lymph node dissection to remove one or several lymph nodes in your abdomen.
• Cytoreductive or debulking surgery to remove cancer throughout your abdomen.

If your cancer is still in its early stages, your surgeon may perform a “peritoneal wash” of your abdominal cavity. They wash it with a sterile saltwater solution and then extract the solution and send it to the lab to analyze. This can tell them if the cancer has spread.

What happens after an omentectomy?

You'll likely spend several days recovering in the hospital. Your stay may be shorter if you have laparoscopic surgery, or longer if you have several organs removed. Your surgeon will discuss the results of the surgery and any important laboratory findings with you after the procedure.

Together, you’ll review your condition and the next steps in your treatment plan. Surgery for cancer is often followed by other cancer treatments to make sure that no cancer cells are left behind. This might mean radiation therapy or chemotherapy.

What are the advantages of omentectomy surgery?

Your omentectomy may be preventative, exploratory, therapeutic or curative. If your cancer is in the early stages, removing and analyzing the omentum may prevent cancer from spreading there or may give your surgeon crucial information about how far it has spread.

If your surgeon has located cancer in your omentum but the cancer is limited, removing it may possibly cure you. If you have metastatic cancer that has spread to many places, removing as much of it as possible will help produce the best possible outcome.

What are the possible complications or side effects of omentectomy?

All surgeries carry a small risk of certain complications, including:

• Bleeding.
• Infection.
• Injury to nearby organs.

Potential problems that can develop post-omentectomy include:

• Small bowel obstruction: Bands of scar tissue in your abdominal cavity called adhesions can create a partial or complete blockage in your bowels.

Is cancer in your omentum curable?

Cancer in your omentum has almost certainly spread from somewhere else in your abdomen. By definition, cancer that has spread from somewhere else may be more advanced. Your prognosis will depend on the specifics of your condition. Your surgeon will attempt to cure it by removing all of the cancer they can find, including your omentum and the site of origin.

Can the omentum grow back after surgery?

No. This misunderstanding comes from the fact that your omentum is part of your peritoneum, the tissue that lines your abdominal cavity and wraps around your organs. Peritoneal tissue is known to have rapid healing properties. But no, your omentum won’t grow back after being removed.

How long will it take to recover from surgery?

This will depend on the type of surgery you had and how extensive it was. Smaller operations, especially laparoscopic ones, may take only a few weeks of recovery. A major operation removing multiple organs may take up to eight weeks of recovery.

A note from Cleveland Clinic

Surgery is an aggressive and optimistic treatment for cancer. It attempts to remove it completely by removing the affected tissues. If your healthcare provider has recommended an omentectomy, it’s because they believe the cancer is curable.

Many types of cancer can lead to an omentectomy, each with its own nature. This operation may be the end or the beginning of your treatment. In the scheme of things, the omentectomy itself is a relatively simple operation with great potential benefits.