An omentectomy is the surgical removal of the omentum, a large layer of tissue that surrounds the abdominal organs. This surgery is most often needed for ovarian cancer but may be necessary for some other types of cancer, too.

An omentectomy helps to stage and treat ovarian cancer, which frequently spreads to your omentum. Other cancers that may spread to your omentum include stomach, uterine, and colorectal cancers.

This article takes a closer look at an omentectomy, when it’s needed, and what to expect if you have this treatment.

An omentectomy is a surgical procedure in which a surgeon removes all or part of your omentum. Your omentum is a layer of fatty tissue that surrounds your stomach, intestines, and other abdominal organs. It has two parts:

  • The greater omentum (supracolic): This spans the width of your abdomen. It stretches from the curve of your stomach to your transverse colon (the long horizontal segment of your colon).
  • The lesser omentum (infracolic): This extends from your liver, below your transverse colon and stomach.

Researchers don’t fully understand all the functions of your omentum. It’s thought to have a role in immune response, such as controlling inflammation and infection. It also stores fat and acts as a protective layer for your abdominal organs.

If you have ovarian cancer, there are a few reasons a doctor might recommend this procedure. For instance, It may:

  • help determine the stage of your cancer and total treatment plan for you
  • prevent ovarian cancer from reaching your omentum
  • remove ovarian cancer that has already invaded your omentum

Most of the time, an omentectomy isn’t a stand-alone procedure. It’s part of cytoreductive surgery, also known as debulking surgery. The goal of debulking is to remove as many cancer sites as possible from your abdominal cavity. For ovarian cancer, this may include:

In ovarian cancer, the omentum is one of the most common sites of metastasis. Approximately 55% of the time, ovarian cancer is already metastatic — it has spread from the original site to a distant part of the body — at the time you receive the diagnosis.

Epithelial ovarian cancer is a specific type that starts in the outer surface of your ovaries and tends to spread to your omentum. About 85–90% of ovarian cancers are epithelial.

If you have epithelial ovarian cancer, the surgeon may want to perform an omentectomy to see how far the cancer may have spread. Staging the cancer helps your oncologist determine the next steps in treatment.

Other reasons an omentectomy may be needed:

  • as one part of a debulking procedure
  • to remove cancer that’s already reached your omentum
  • to delay tumor progression
  • to improve the effectiveness of chemotherapy and radiation therapy
  • to maintain your quality of life and prolong survival

This procedure can also help treat other cancers that have spread to your omentum, such as:

An omentectomy and related procedures can take several hours under general anesthesia. Your medical team will want to make sure you’re healthy enough for the procedure. That means you’ll need some pre-op testing, including tests to measure your heart and lung function.

There are a few ways to perform this surgery. Your surgeon may choose minimally invasive laparoscopic or robotic-assisted surgery. But if you’ve having multiple procedures, it’s more likely you’ll have traditional open abdominal surgery.

Although there may be some differences in how an omentectomy is done, you can typically expect the following if you have open abdominal surgery:

  • You’ll get an intravenous (IV) line in your arm for fluids and medications shortly before you’re taken to the operating room.
  • In the operating room, you’ll be given general anesthetic. An anesthesiologist will monitor your vital signs throughout the procedure.
  • The surgical team will sterilize the surgical site, and the surgeon will then make a long incision across your abdomen.
  • All or part of your omentum will be removed.
  • The surgeon will perform related procedures, such removing your ovaries, fallopian tubes, and uterus.
  • The surgeon might also perform peritoneal washing to see if there’s cancer in your peritoneal cavity — the part of your abdomen that holds your stomach, liver, and intestines. The surgeon will bathe the cavity with saline solution, then collect the fluid to test for cancer cells.
  • The surgical team will close the incision.

If you’re having laparoscopic surgery, the surgeon will make several smaller incisions, each about a half-inch wide. Remaining outside your abdomen, the surgeon will insert a tiny camera and long surgical instruments to complete this procedure.

Recovery

Recovery is different for everyone. You can expect to spend at least 2–4 days in the hospital. Total recovery time could be anywhere from 4–8 weeks, depending on how many other procedures you have at the same time. Your age and overall health can also play a role in your recovery.

Your omentum doesn’t affect normal body functions. You can live without one.

But related procedures, such as removal of your ovaries, can result in more short- and long-term side effects. Your oncology team will let you know what to expect when recovering from multiple procedures.

After surgery, you may need additional treatments, such a chemotherapy or radiation therapy.

The main benefit of an omentectomy is to remove cancerous tumors before they can spread elsewhere. Other potential benefits include:

  • staging the cancer and determining which treatments are most likely to be effective
  • helping to make systemic treatments, like chemotherapy, more effective
  • improving quality of life and survival time

As with any surgery, there are some potential risks and side effects, such as:

An omentectomy is the surgical removal of your omentum, a large layer of tissue that surrounds your abdominal organs. When ovarian cancer spreads, it often travels to your omentum.

An omentectomy can help stage or treat ovarian cancer. It can be a stand-alone surgery. But more often, it also includes the removal of other organs, such as your ovaries or uterus, as part of a debulking surgery. In most cases, you’ll still need chemotherapy or radiation therapy.

Although researchers don’t understand all the functions of your omentum, you can live a normal life without one. A doctor can review the potential benefits and risks of this surgery, so you’ll have a better idea what to expect.