Ovarian Cancer Surgery

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gynecologic cancers are often diagnosed
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at a very advanced stage once they have
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already invaded surrounding organs and
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tissue in cases such as this the
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debulking surgery may be the best
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treatment option debulking surgeries are
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performed in an effort to remove as much
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of the tumor as possible with the hope
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of improving patient prognosis and
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making them better candidates for
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chemotherapy many patients with advanced
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ovarian cancer often have severe ascites
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as seen here in this case a large
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malignant tumor was noted to have
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invaded the omentum after blunt
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dissection a vessel sealer was used to
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cauterize a blood supply and then the
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tumor and part of the omentum were
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removed and sent for pathologic
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evaluation
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a Bookwalter retractor was then set up
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to hold the abdominal walls apart the
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uterus ovaries and any overlying tumors
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were then isolated with clamps sharp and
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blunt dissection was used to separate
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the entire specimen from the surrounding
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tissue and then the entire specimen is
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carefully removed from the abdominal
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pelvic cavity a large tumor is seen on
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the right ovary and the body of the
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uterus is noted to be extremely firm to
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palpation when the uterus is cut open
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its body is noted to have a fleshy
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consistency which is suggestive of a
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fibroid however the tumor on the right
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ovary is highly suspicious for
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malignancy
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another tumor was visualized on the
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small intestine after attempting to
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manually dissect it it was determined
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that a small bowel resection would be
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necessary in order to optimally debulk
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the tumor a GI a stapler was first used
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to divide the affected portions of the
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small intestine and once a tumor was
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isolated from the small intestine
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hemostasis was achieved using a large
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vessel cautery device the tumor was then
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removed and sent to pathology
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the remaining end of the small intestine
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are then carefully aligned and
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approximated using multiple alice clamps
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a GI a stapler was then used to create a
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side-to-side and nasty Moses
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prior to closing the anastomosis is
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thoroughly inspected to ensure proper
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alignment