What is an Omentectomy Surgical Procedure?
An Omentectomy is an operation on the omentum, a thin layer of tissue near the abdomen. The omentum is a double-layered fatty tissue that supports the intestines and abdomen. It consists of the greater omentum and the lesser omentum. The greater omentum provides storage for fat deposits and hangs down over the stomach, while the lesser omentum holds the stomach and intestines in place and connects them to the liver via blood vessels.
During this surgical procedure, the surgeon removes cancerous tumors from the omentum. Omentectomy treatment treats peritoneal mesothelioma, fallopian tube cancer, and other ovarian cancers that may have spread to the omentum. But when it comes to the question, can an Omentectomy treat mesothelioma, the answer is a bit more complex than a simple Yes or No. Let’s start at the beginning.
Who is a Candidate for Treatment?
Anyone diagnosed with peritoneal mesothelioma or ovarian cancer that has spread to the omentum may be a candidate for omentectomy treatment. Once diagnosed, the doctor will help develop an omentectomy treatment plan. A doctor can assess the severity of cancer and evaluate the patient’s overall health to choose the type of treatment necessary. The patient also may need an omentectomy to diminish the risk of ovarian cancer spreading to other organs.
Steps of an Omentectomy
A few weeks before the surgery, preparation for an omentectomy begins. The doctor runs blood and urine tests, takes an X-ray of the abdomen area, and checks heart rhythm with an electrocardiogram (EKG, ECG). The doctor then clarifies regulations for the patient when preparing for surgery which may include abstaining from smoking or alcohol, terminating use of certain medications, and fasting 8-12 hours before the surgery.
After the doctor makes all necessary preparations, the omentectomy takes place. During omentectomy surgery, the surgeon will take one of two approaches. A laparoscopic procedure, or robotic-assisted procedure, consists of small incisions in the abdomen. However, a traditional approach consists of one large incision. The surgeon will also perform any other operation in the area during the omentectomy if necessary.
After surgery, the doctor typically expects the patient to stay in the hospital for up to a week. Recovery time will vary depending on the surgery or surgeries performed. If a part of the colon is taken out, the patient may be required to wear a colostomy bag, and a catheter may be necessary if a part of the bladder is removed. The doctor will prescribe medication to manage pain while in recovery.
Types of Omentectomy
Each patient with peritoneal mesothelioma, fallopian tube cancer, and any other ovarian cancer that may have spread to the omentum, requires a specific type of omentectomy treatment. Three types of omentectomy treatment can help eradicate cancer in the omentum: infracolic, supracolic, and partial.
What is an Infracolic Omentectomy?
In an infracolic omentectomy, the surgeon removes the omentum for staging purposes in an attempt to shrink the tumor before an omentectomy. An infracolic omentectomy helps doctors measure the cancer’s response to omentectomy treatment.
What is a Supracolic Omentectomy?
In a supracolic omentectomy, also known as a total omentectomy, the surgeon removes the entire omentum. This procedure is necessary when a partial omentectomy cannot remove the entirety of the cancerous tumor in the omentum.
What is a Partial Omentectomy?
In a partial omentectomy, the surgeon removes only a portion of the omentum. Sometimes, cancer does not spread far enough to require a supracolic omentectomy. A partial omentectomy allows the removal of the tumor while keeping most of the omentum intact.
Benefits and Risks of Surgical Treatment
Any surgical treatment procedure comes with both benefits and risks. An Omentectomy may help treat cancer, but it does pose a risk of post-surgery side effects.
The main benefit of an omentectomy is that it can remove cancer in the omentum and help doctors evaluate the condition of the omentum while attempting to shrink the tumor before a supracolic surgery. Patients with peritoneal mesothelioma have a form of cancer in the abdomen area caused by ingested asbestos fibers. These patients may have pain and swelling in the abdomen as well as nausea. An omentectomy helps relieve these symptoms of peritoneal mesothelioma.
Some risks of an omentectomy include damage to nearby organs, lymphedema (the absorption of fluid in an area when lymph vessels are blocked), infection, and bleeding. Omentectomy treatment can also cause damage to the digestive tract. The risk of any cancer-related surgery is that there is a chance of recurrence. Even after an omentectomy, cancer cells may redevelop in the affected area. This makes answering the question of if an Omentectomy can successfully treat mesothelioma even more difficult to answer.