Salpingo-Oophorectomy is a procedure used for removing ovaries and fallopian tubes. When just one ovary and fallopian tube are removed, the process is called a unilateralsalpingo oophorectomy. When both the ovaries and the fallopian tube are removed, it is known as a bilateral salpingo-oophorectomy.

Mostly, it is used for the treatment of conditions like ovarian cancer. Sometimes, women who are at high risk of developing ovarian cancer get their healthy ovaries and fallopian tubes removed. This process is called risk-reduced salpingo-oophorectomy. This process also lowers the risk of breast cancer.

In this procedure, the uterus is not removed. However, many people get salpingo-oophorectomy and hysterectomy done together.

Who should do it?

A salpingo-oophorectomy can be used to treat the following conditions:

  1.    Ovarian cancer – In this condition, instead of just the tumor or growth, the entire ovary and the fallopian tube is removed.
  2.    Ovarian mass – This includes benign tumors, abscesses or the cysts. If the mass is putting pressure on nearby organs resulting in pain, the entire ovary and fallopian tube might have to be removed.
  3.  Endometriosis – This is a condition that develops when endometrial tissues start growing outside the uterus, on the ovaries and the fallopian tubes resulting in severe pain and discomfort. This might require the removal of ovaries, fallopian tubes, and uterus.
  4.    Ectopic pregnancy – In this condition, instead of the uterus, the fertilized egg gets implanted into some other location. This requires immediate removal of the implanted embryo. Also, if the egg is implanted in the fallopian tube, the entire tube has to be removed.
  5.    Ovarian torsion – Sometimes, the ligament that supports the ovary forms a knot. This can cut off the blood and the nerve supply. In this condition, a salpingo-oophorectomy needs to be performed soon so that the blood flow can be restored and the ovary can be prevented from dying.

Women who carry the BRCA gene mutations are at a higher risk of having breast and ovarian cancer. In such cases, getting a salpingo-oophorectomy to reduce the risk of cancer is a viable and cost-effective option.

However, it is important to consider if you want to conceive a child or not because after the procedure, you will be infertile.

How do I prepare?

Before the procedure

After you undergo the procedure, you won’t be able to get pregnant. So, if you are thinking of conceiving a child, discuss it with your doctor beforehand. Also, you would need to get hormone replacement therapy since with your ovaries removed; there will be a serious deficiency of estrogen and progesterone.

Before the procedure, make sure that your doctor knows about all your previous health conditions and all the medications that you are currently taking.

You should meet a fertility expert before scheduling the procedure. The sudden loss of estrogen in the body due to the removal of ovaries will lead to full menopause. You need to talk to your doctor about these changes and how can you prepare for them.

Also, before the procedure, make sure that you take care of the following tips:

  1.   Line up a ride in advance to get yourself home from the hospital as you won’t be able to drive.
  2.    You won’t be able to perform errands, household chores and childcare for a few weeks. So, arrange help for that.
  3.    You won’t be able to make it work for some time. Arrange time off with your employer.
  4.    Prepare your kitchen and stock it well with all the necessities. You can also prepare meals for a few days and store them.
  5.    Make a hospital bag for yourself that has slippers, socks, robe, and a few toiletries. Also, get some loose clothes to put on after the procedure.

During the procedure

There are various ways in which a salpingo-oophorectomy can be performed. The whole procedure takes about 1 to 4 hours depending on your condition:

  1.    Open abdominal surgery

This is the traditional kind of surgery performed using general anesthesia. An incision is made in the abdomen and the ovaries and fallopian tubes are removed. The incision is then stitched, glued, or stapled.

  1.    Laparoscopic surgery

Performed using general or local anesthesia, this procedure uses a laparoscope (tube with a light and camera) so that the doctor can view the pelvic organs without making a large incision. Several small incisions are made to make the ovaries and the fallopian tubes accessible. Once they are removed through the small incisions, the incisions are closed.

  1.    Robotic surgery

It is the same as the laparoscopic surgery. The only difference is that in this procedure, a robotic arm is used instead of a laparoscope. The robotic arm has a camera and is able to give high-definition visualizations. Also, removal of ovaries and fallopian tubes becomes easy as the robotic arm allows the doctor to precisely locate the organs.

After the procedure

If you had a laparoscopic or robotic procedure, you might have to stay in the hospital for the night. However, if you had the open abdominal procedure, you might have stayed in the hospital for a couple of days. Here is what you can expect after the procedure.

  •    You will have bandages all over your incisions which you are not allowed to remove until your doctor says so. Make sure that you don’t put any ointments or lotions on the incisions.
  •    You might need some antibiotics to prevent any infection and painkillers to ease up the pain.
  •    After you wake up and feel comfortable, try getting up and walking. This will help in preventing the formation of the blood clots.
  •    Avoid lifting or engaging in strenuous activities for a few days.
  •    There might be some vaginal discharge after the procedure but do not use any tampons or try douching.
  •    Wear only loose and comfortable clothes.
  •   Your doctors will give you instructions regarding showering, bathing, and when you can resume sexual activity.

Recovery

How you recover after the surgery depends on your general medical condition, the type of surgery you had, and whether or not you had started the hormonal replacement therapy. Usually, open surgery takes more time to recover from a robotic or laparoscopic procedure. For the open surgery, the recovery time can take about 6 weeks and the laparoscopic procedure takes about 2 weeks to recover.

Here is how you can speed up the recovery process:

  1.    Wear loose and comfortable clothes for the following weeks.
  2.   Get someone to help you prepare your meals. You can also prepare your meals in advance. Make food that can be easily reheated.
  3.    Avoid foods like broccoli, Brussel sprouts, beans or anything else that can make you gassy.
  4.    Set up a recovery area in the bed with a bed or a comfy chair where you can comfortably read a book and everything that you might need is within reach.
  5.    Always have anti-gas medications stocked up in your home. You should also have stool softeners, peppermint tea, and painkillers.
  6.    Avoid bending. Use a straw for drinking.
  7.    Do not perform any physical tasks.
  8.    Take as much time as you need for recovery. Ask your doctor any additional information that you might need during the recovery.

Salpingo-oophorectomy is routine surgery. At the Apollo Cradle Kondapur, we have highly qualified and experienced doctors who have years of experience with this type of procedure.