Omentectomy

An omentectomy is a surgical procedure to remove the omentum, and is often used to treat or stage cancer.

What is an omentum?

The omentum is an area of tissue rich in blood vessels covering the intestines and other organs in the abdomen. As a fatty lining, the omentum helps support the abdominal organs, as well as nerves, blood vessels, lymph nodes and lymph vessels. 

Does omentum grow back?

After an omentectomy, the omentum does not grow back. However, this tissue doesn’t serve a significant function in terms of abdominal organ operation, so its removal is not likely to cause long-term issues.

Why is an omentectomy done?

Omentum cancer is extremely rare, but an omentectomy may be necessary if cancer (such as ovarian cancer) has spread to the area. Other times, the care team may recommend it to help determine the stage of the cancer.

An omentectomy is most frequently used in patients with epithelial ovarian cancer. In these cases, the expert performing the surgery should be a surgeon trained in treating ovarian cancer, such as a gynecologic oncologist.

Other surgeries may be performed along with an omentectomy to stage or treat ovarian cancer. These procedures include:

• Hysterectomy to remove the uterus and cervix     
• Salpingo-oophorectomy to remove the ovaries and fallopian tubes
• Lymph node dissection to remove lymph nodes 
• Cytoreductive/debulking surgery to remove cancer that has spread to other areas of the abdomen     

Types of omentectomy

The surgeon may perform one of the two types of omentectomy listed below.

Partial omentectomy: A portion of the omentum is removed.

Total or supracolic omentectomy: The entire omentum is removed.

How to prepare for an omentectomy

Before an omentectomy, the patient should expect to meet the cancer care team involved with the surgery, such as the operating doctor. The care team will make sure the patient is physically fit enough for surgery. This is important to make sure that his or her body can handle the anesthesia and that he or she can recover properly afterward.

Some of the tests patients may undergo before the omentectomy include:

• Blood work
• Breathing tests
• Cardiopulmonary exercise test to measure heart and lung function
• Chest X-ray
• Echocardiogram to monitor the patient's heart

These steps may help patients prepare for an omentectomy:

• Ask questions in advance to help better understand the procedure, such as:
  • What will happen during the procedure?
  • How long will I be in the hospital?
  • Will I need other cancer treatments?
  • Will I be in any pain?
  • What other procedures will be done at the same time?
• Find out whether it's important to stop smoking or drinking alcohol before surgery. Many times, health professionals recommend that the patient stop smoking a couple of weeks in advance.
• Ask whether certain breathing exercises will help the patient avoid developing a lung infection after surgery. Similarly, leg exercises may help the patient avoid the formation of blood clots after surgery.
• Patients should know what to take to the hospital, such as personal hygiene items, sleepwear, underwear, or small electronic devices.
• Arrange for care of children, home and/or pets during the hospital stay.
• Confirm which medications may be taken in the days before the omentectomy. The care team may want the patient to stop certain medications that may increase the risk for bleeding, such as non-steroidal anti-inflammatory drugs and blood thinners. If the patient must take medications the day of surgery, he or she will likely be told to take them with a small sip of water.

What to expect from omentectomy surgery

Before the omentectomy, the patient will receive anesthesia for surgery. Doctors may perform an omentectomy in one of three ways:

• With a laparoscopic or robotic-assisted laparoscopic approach, in which the doctor will use small incisions in the abdomen
• With traditional surgery, where the doctor will make one larger incision in the abdomen

The care team may perform other necessary surgeries at the same time, such as removal of ovarian cancer.

Omentectomy patients typically stay in the hospital for two to four days.

Omentectomy side effects

The benefit of an omentectomy is to remove cancer if it’s spread to the omentum or to help stage the cancer to determine the most beneficial treatment.

Cancer surgeries, such as an omentectomy, may cause side effects including those listed below.

• Temporary tenderness, pain or discomfort for a few days as the body heals, especially if other procedures occur at the same time
• Fluid retention due to blocked lymphatic blood vessels
• Difficulty using the bathroom, both urinating and passing stool
• Risk for an infection, bleeding or nerve damage, as with any type of surgery
• Possible recurrence of an adhesive small bowel obstruction, a type of blockage in the digestive tract

Understanding the results of an omentectomy

The care team may review the results with the patient—not only the findings of the omentectomy, but also those of any other surgery done at the same time. If the procedure was done to help determine the stage of cancer, these findings will help to formulate the treatment options recommended by the care team.