Omentum removal...what's left?

when I had the debulking surgery I was told the surgeon removed the omentum so I assumed they removed it all but apparently she just removed the large omentum but left the small omentum in tact. Does anyone know if this is the normal procedure? The surgeon I have now said, we cant take it all out....I'm a bit confused with this surgeon. there were nodes left on my bowel because they were small and I was told "the chemo" would take care of those nodes along with the others left behind....Yea right...then why are they getting bigger?..Did anyone have this experience. Just wondering...I wonder if they would do a second operation?

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  • I was also told I had full tah but when return to hospital to have ovary he couldnt get out found he had only taken one ovary first time and left the rest, So speak to your surgeon and ask what the heck he is doing, he needs to give your answers

  • Yes they leave the lesser omentum and take the greater omentum. Two separate pieces. I didn't know that myself until late Jan. This is quite normal but they don't think to tell us.

    So two parts: the Greater omentum which is the large 'curtain'....that comes out.

    I found a good drawing on the Internet which explained it too.

    Guess it's too much for them to actually explain it to us!

    Take care

    Clare xx

  • I find it helpful to ask for a copy of the scan report. Then you can keep it and find pics of what you need to search out more. My onc always gives me a printed scan report when I ask and reads it through with me explaining all the terminology.

  • I had cancer bebulking surgery which included removing my greater omentum. I can't tell any difference having my omentum removed. I was hoping for a supermodel tummy :-) If they didn't tell me it was removed I wouldn't know it was missing. I'm wondering if it's safer to leave the nodes on your bowel alone, and letting chemo take care of them, instead of risking a perforated bowel with surgery. I had 3 months of chemo prior to my surgery, and when I had the surgery they could see some scar tissue on my bowel from where the cancer had been.

  • Suellen I've only learned this two omentum stuff myself, like Clare I feel a bit let down by the surgeons not explaining fully. I also have "granularity/nodularity" in what is left. Not sure if this is contributing to the rise in CA125 but I wish they would treat us like grown ups and tell us the whole story. I suspect they can't take the remaining bit out and don't want to worry us after the op. I hope you get some clear answers from your team and send you good wishes.

    Netti

  • Yes that's what I have left..nodularity and granularity...through the peratonium...sp?..on the bowel ..up by the liver and a few other places....they think chemo gets the small stuff but it doesn't..I have nodes left and some are growing some are shrinking...wish they'd come up with something that would wipe it out altogether.

  • Absolutely agree with you there.

    Netti x

  • I had debulking surgery at the end of October last year, but my surgeon only removed my greater omentum which is where my tumour was (my diagnosis is Primary Peritoneal Cancer which is a type of Ovarian Cancer). He rummaged through all my organs but could only find cancer on the outside wall of my stomach and on the blood vessels to my stomach which he felt were too dangerous to operate on. I was rather surprised when I woke from surgery that he hadn't done a hysterectomy etc, but he felt chemo was my best bet and should be restarted as quickly as possible. Last month I was told that there is no evidence of disease. I am having three weekly Avastin until January next year which should keep the beast at bay.

    If you feel your consultants are not giving you enough information, speak to your CNS - they can tell you what they know and speak to the consultants for you.

    Hope all goes well Suellen

    Ali x

  • thank you...I am on weekly taxol and it seems to be stabilizing the disease for now...I was thinking about avastin but am waiting for my province to pay for recurrent treatment...it would be 3,500 every three weeks out of pocket and the disease seems to be stabilized for now...This is the 4th type of chemo Ive had...so I'll see what happens. Hope all goes well with you....

  • Hello. I can't help much and I thought the omentum was one thing but it must be more complicated. Isn't everything? I have seen posts from people who have had a second op but they are very few. The docs say chemo gets the small bits of cancer that are too hard to see and cut out. If it's scattered about they can't get rid of it all with surgery.

  • Hi Suellen

    According to Wikipedia the lesser omentum is comprised of two layers. Between the two layers of the lesser omentum, close to the right free margin, are the hepatic artery, the common bile duct, the portal vein, lymphatics, and the hepatic plexus of nerves—all these structures being enclosed in a fibrous capsule.

    If I have understood this correctly, I imagine that to try and remove this would likely cause damage to the things enclosed within it.

    Hope this helps

    T

  • Yes thank you for that information..it explains the situation better...its helpful to understand why and why not....

  • Hi Suellen, I had many nodes on my bowel so the doctor removed 14" of my sigmoid colon during TAH to get rid of them!!!! I had a temporary colostomy for 7 months and then had it reversed. Details on my profile. My surgeon was EXTREMELY aggressive, but then I was extremely ill. I'm fine now. Currently NED 7+ months.

  • I never knew there were 2 Omentums until you ladies just informed me and I thought I had done thorough research!

    Like Alifit I also was DX PPC with some seeding throughout my abdomen. They decided to do a hysterectomy when a tiny tumor was found in my Ovary. But surprise, a tumor was then found in my Fallopian tube, kind of confusing the issue in what kind of cancer I had. PPC is one cancer, Fallopian tube is another but Fallopian tube cancer can metastasis to the abdomen so..

    Anyway, my opinion only, is that they should always look at the reproductive organs, quite closely, when any kind of Ovarian type cancer is found in the abdomen.

  • I was surprised to wake up with my ovaries, Fallopian tubes and uterus in tact, but my surgeon is extrememly experienced and my hospital is a centre of excellence so I have faith in their judgement. I have had my 5th dose of Avastin today and have been told my CA125 is still reducing - 30 now, it was over 400 in August. I'm under no illusions as to what can happen, but I consider myself lucky to be in this position today. I have, however, just had all the downy hair I grew after chemo removed from my face by waxing - ouch!! Possible more painful than post surgery, but Oramorph seems a bit drastic, so ice pack it is!

    Love and best wishes to all, Ali x

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