A salpingo-oophorectomy is a surgical procedure to remove the ovaries and fallopian tubes. It may be carried out for a variety of reasons, including treating cancer, endometriosis, or an ectopic pregnancy.
In this article, we look at the reasons for a salpingo-oophorectomy, as well as how to prepare for the surgery and ensure a smooth recovery.
A salpingo-oophorectomy is a surgical procedure, which involves removing a woman's ovaries and fallopian tubes.
A woman can have a bilateral salpingo-oophorectomy, where both ovaries and fallopian tubes are removed, or a unilateral salpingo-oophorectomy, where only one ovary and fallopian tube is removed.
A salpingo-oophorectomy can be performed independently or as part of a total hysterectomy where the uterus is also removed.
This procedure can be performed in a few different ways.
- Laparoscopically: A surgeon makes a small incision in the abdomen and inserts a laparoscope, which contains a small camera and light, into the pelvis. These instruments help the surgeon locate the ovaries and fallopian tubes, which they remove through a second incision at the top of the vagina. The surgeon will then close the two incisions. This type of procedure is less invasive and requires a shorter recovery time than open surgical procedures.
- Robotically: A robotic procedure is similar to a laparoscopic procedure, except that it uses a robotic arm to help the surgeon locate and remove the ovaries and tubes.
- Traditionally: A traditional or open surgical procedure requires a larger incision in the abdomen or pelvis. This opening allows the surgeon to see the organs and remove them by hand through the incision. Open procedures carry a greater risk for complications, such as infection, and tend to have a longer recovery time.
Regardless of which procedure is performed, removing the ovaries will cause a woman to go into menopause.
After the surgery, a woman may need to take hormone replacement therapy.
There are many reasons why a woman may need a salpingo-oophorectomy. It can be carried out to treat a disease or to prevent certain types of cancer from developing.
Women who know that they are high risk for ovarian cancer because of a strong family history may elect to have their ovaries removed once they have had their children.
The removal of the fallopian tubes and ovaries significantly reduces a woman's overall risk of developing this type of cancer; it can also reduce her risk for breast cancer.
When performing this type of surgery, the surgeon is especially careful to remove all of the affected tissue to prevent cancer from developing.
A salpingo-oophorectomy can be used to treat the following conditions:
- Ovarian cancer: Sometimes the doctor will recommend removing the entire ovary and fallopian tube, not just the tumor or growth.
- Ovarian mass: Benign (non-cancerous) tumors, cysts, or abscesses may require the removal of the entire ovary or fallopian tube, especially if the mass is putting pressure on nearby structures or is causing pain or pressure.
- Endometriosis: Endometriosis occurs when pieces of endometrial tissue grow in a location outside of the uterus, including on the ovary or fallopian tubes. This condition can cause severe pain and discomfort and sometimes requires the removal of the uterus, ovaries, or fallopian tubes.
- Ectopic pregnancy: An ectopic pregnancy happens when a fertilized embryo implants into a location outside of the uterus. This is an emergency situation and requires immediate removal of the implanted embryo. If it implants in the fallopian tube, the entire tube may need to be removed as well.
- Ovarian torsion: The ovary is connected to the pelvic wall by a thin ligament. Rarely, the ligament supporting the ovary twists or forms a knot, which can cut off blood and nerve supply. This requires emergency surgery to restore blood flow and prevent the ovary from dying.
Having a salpingo-oophorectomy can be a little overwhelming, and it can help to have an idea of what to expect. Typically, the procedure is performed by a gynecologic oncologist or gynecologic surgical specialist.
Before having the surgery, it is a good idea to make a list of questions for the doctor. It can be helpful to bring paper and a pen to write down the answers.
Some women prefer to bring a friend or family member with them so that they have someone else take notes or also pay attention. A few questions to think about:
- How will the surgery be performed — open, laparoscopic, or robotic — and why?
- What about family planning issues? Am I done having children or should I consider fertility preservation treatment?
- Am I a candidate for hormone replacement therapy? Why or why not? If not, how can I get ready for surgical menopause?
- Should I stop taking my medication or nutritional supplements?
- How long will the surgery take?
- Will I need to spend the night in the hospital?
- What is the expected recovery time?
- What restrictions will be in place after surgery?
The doctor should review and answer all of the questions before surgery and should also discuss the preparations a person may need to make before surgery.
Some people may need preoperative testing, especially if they have other health problems.
Though the doctor will give more specific information, someone having surgery may be required to:
- avoid eating for a period before the procedure (usually at least 8 hours)
- bring someone to drive them home afterward
- wear comfortable and loose-fitting clothing
- leave jewelry and personal belongings at home
It can also be helpful to prepare a hospital bag with a comfortable robe and socks, lip balm, toiletries, and a book or magazine.
A range of factors can affect the course of recovery, including the type of procedure, whether or not a woman starts hormonal replacement therapy, and the woman's general medical condition.
Typically, the recovery from a laparoscopic or robotic procedure is easier and quicker than open surgery.
A laparoscopic procedure may have a recovery time of about 2 weeks while recovering from an open surgery can take as long as 6 weeks.
There are a variety of things a person can do to make their recovery more comfortable, including:
- Wearing loose and comfortable clothing on the day of the surgery and in the weeks that follow.
- Preparing meals in advance, such as freezing several portions of soup or food that can be easily reheated, or asking a loved one to help with daily meals.
- Avoiding any foods that cause gas, such as beans, broccoli, or Brussel sprouts.
- Setting up a comfortable recovery area in the home. This may be a bed or a comfy chair with books or the remote within reach, a heating pad, and other essentials.
- Stocking up on anti-gas medications, peppermint tea, stool softeners, and painkillers.
- Using straws when drinking to avoid bending to take a drink.
- Asking a loved one to do any necessary physical tasks, such as taking children to school, cleaning, or walking the dog.
- Allowing as much time as needed for recovery.
The doctor should be able to provide additional information about what to expect.
Although a salpingo-oophorectomy is a routine surgery, it is essential to find a surgeon that is both highly qualified and experienced with this type of procedure.
The removal of the fallopian tubes and ovaries can significantly increase survival rate from some cancers and even prevent others from forming.