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Operations: Bilateral oophorectomy and salpingectomy (in isolation)

Insurance code: Q2230

Introduction: This information is written by John Fairbank and is provided for the benefit of his patients. Additional information will be given during consultation in the clinic and during the pre-operative discussion. It is not appropriate for all surgeons’ individual practice or for all patients.

Purpose of operation: To remove the ovaries and fallopian tubes. This operation is performed to remove ovaries diseased by endometriosis or cancer of the ovaries where they cause pelvic pain or pressure from large ovarian cysts. The removal of ovaries in women with a family history of ovarian cancer (prophylactic oophorectomy) can often be carried out laparoscopically and is described in a separate section (Q3380).

Description of procedure
A thin plasic tube is sometimes inserted through the bladder up the pipes which drain the kidneys (ureters). This reduces the risk of inadvertent surgical damage to these vital structures. A catheter is placed in the bladder to drain off all the urine and protect the bladder from surgical damage. The abdominal cavity is opened through a transverse supra-pubic (bikini line) or midline vertical abdominal incision. The ovaries are removed with a series of stitches to secure the blood vessels which supply them. Once the ovaries are safely removed the abdominal cavity is closed with strong stitches and the skin stitched with fine stitches which are left in place to be removed five days later.

Anaesthetic These operations are usually carried out under general anaesthetic.

Length of stay A ‘bikini’ line incision normally allows for a four night stay and a vertical midline incision normally requires a five night stay.

Post-operative management The catheter is normally removed the following day. The IV fluid line is left in place until oral fluids are tolerated. The painkilling pump is kept in place until it is no longer required. Stitches or skin staples are normally removed the days of discharge from hospital.

Potential complications
Complications at the time of surgery include peri-operative bleeding, and damage to structures such as bladder and bowel. These complications are rare but require corrective surgery immediately or as soon as a problem is recognised. Venous thrombosis (DVT) can follow any pelvic surgery. Stockings are therefore worn and heparin injections given each day to reduce the risk. Early mobilisation and early discharge from hospital reduce the risk of thrombosis

Post-operative consultation
A routine appointment is normally booked for four weeks to ensure the wound is well healed although other appointments may be necessary to ensure the post-operative course goes smoothly.

Other considerations
Sex is best avoided until the skin has healed and sutures have dissolved. This may take up to four weeks. Heavy lifting is best avoided for three months to prevent stitches giving way but light lifting is not a problem. Driving short distances is practical once comfortable and strong sedative pain killers are no longer being taken.

Relevant websites

Type ‘Residual ovary syndrome’ into Google for information on pelvic pain following hysterectomy and so called residual ovary syndrome.

Information on prophylactic oophorectomy for prevention of ovarian cancer