Salpingo-oophorectomy (Ovary removal surgery) in Delhi, India

Depending upon the reason for the surgeon to remove an ovary, doctors can choose one of the following types of oophorectomy procedures:

• Unilateral oophorectomy: One ovary (on either side) is removed
• Bilateral oophorectomy: Both ovaries (both sides) are removed
• Salpingo-oophorectomy: Ovary and fallopian tube are removed
• Bilateral salpingo-oophorectomy: Both fallopian tubes and ovaries are removed
• Bilateral salpingectomy: Both fallopian tubes are removed during Hysterectomy to reduce the risk of ovarian cancer
• Hysterectomy with salpingo-oophorectomy: Uterus is simultaneously removed with one or both tubes/ovaries

An Salpingo-Oophorectomy may be performed for:

1. A tubo-ovarian abscess (a pus-filled pocket that involves the fallopian tube and an ovary)
2. Cancer of the ovaries
3. Endometriosis
4. Benign ovarian tumors or cysts/dermoid
5. To lower the risk of ovarian or breast cancer in those at increased risk (family history)
6. Ovarian torsion - the twisting of an ovary
7. Ectopic pregnancy

Salpingo-oophorectomy can be approached in several ways. The surgical procedure usually takes between 1 to 4 hours, depending on the primary aetiology and surgery plan. It can be performed in the following ways:

1. Open abdominal surgery

   Traditional surgery requires general/regional anaesthesia. An incision is made on the abdomen (vertical or transverse depending on the disease), and the tubes and ovaries are removed. The open wound is then closed with sutures or staples.

2. Laparoscopic surgery

   Laparoscopic surgery can be carried out under general anaesthesia. A laparoscope is a tube with a light and a camera that is passed through a small incision. The tubes and ovaries are removed through these small incisions using tiny tools. Laparoscopy is beneficial since it provides faster recovery and patients experience lesser pain.

3. Robotic surgery

   Robotic surgery is also done through small incisions. In addition, the surgeon uses a robotic arm instead of a laparoscope. The laparoscope is equipped with a camera and a robotic arm that allows for high-definition visualization of the area to be operated. Precise movements of the robotic arm permit the surgeon to locate, access and remove the ovaries and fallopian tubes. 

The candidates for Salpingo-oophorectomy include the following:

1. Elective: Removal of normal-appearing ovaries and tubes after a concurrent surgery such as Hysterectomy. This may be done for a benign disease to lower the risk of developing ovarian pathology. Also, this decreases the need for future procedures.
2. Risk-reducing: Removal of ovaries and tubes in women who are genetically susceptible to ovarian cancer
3. Benign adnexal mass
4. Adnexal torsion
5. Cancer: Ovarian cancer, uterine cancer, or metastases to ovaries from a distant primary malignancy such as gastrointestinal, breast, lung carcinoma
6. Tubo- ovarian abscess
7. Ectopic pregnancy
8. Endometriosis

1. Inform the doctor about any ongoing healthcare supplements or prescribed medications being taken.
2. Before the operation, the doctor may stop certain medications such as blood thinners and NSAIDs.
3. Laxatives are usually advised before the day of surgery to evacuate the bowel.
4. Follow fasting for 6-8 hours before the surgery to avoid the side effects of anaesthesia.
5. One must go for the surgery with an empty bladder.

Salpingo-oophorectomy surgery is relatively a safe procedure, but as with any surgery, it carries some risks. These include:

• Blood clots in the legs may travel to other body parts and risk the life of the patient
• Bleeding
• Infection
• Adverse reaction to anaesthesia
• Injury to your urinary tract, bowel or surrounding organs

Concerns That May Arise Post-Surgery

• A woman cannot conceive naturally after the removal of both ovaries and tubes. Post-procedure pregnancy options should be discussed with the experts if indicated.
• If both ovaries are removed before approaching menopause, immediate side effects associated with this transition may include:
  • Hot flashes
  • Difficulty sleeping
  • Night sweats
  • Vaginal dryness
  • Anxiety and depression

In the long term, menopause increases the risk of heart disease and osteoporosis.

1. Redness or swelling at the incision site
2. Excessive vaginal bleeding
3. Fever
4. Difficulty urinating or passing flatus/motion
5. Foul-smelling discharge
6. Nausea or vomiting
7. Increasing abdominal pain
8. Shortness of breath
9. Chest pain
10. Fainting

Doctors advise the following to make a recovery for patients more comfortable:

1. Wear loose and comfortable clothing in the weeks that follow.
2. Arrange home help in advance
3. Some vaginal discharge may occur following surgery, but avoid tampons and douching.
4. Keyhole surgeries tend to cause less pain and scarring than an abdominal incision.
5. Normal activities can be resumed within six to eight weeks
6. Keep stool softeners, analgesics and antacids at home
7. Avoid bending, prolonged cough, constipation and lifting heavy weight for six weeks
8. Take adequate rest and stay hydrated

Reviewed by Dr. Ankita Singh, Senior Consultant, Obstetrics And Gynaecology on 29-Aug-2022

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3. Ovarian Cyst
4. Can Ovarian Cancer Be Prevented?
5. Role Of Laparoscopy In Treating Infertility
6. 10 Questions and Answers for Ovarian Cancer
7. Scarless and Stitchless Single Incision Laparoscopic Surgery (SILS)- A boon for Female Patients