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Laparoscopic infragastric omentectomy in surgery of gynecologic malignant tumor
  1. Xuhui Dong,
  2. Mo Chen and
  3. Liangqing Yao
  1. Gynecology of Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
  1. Correspondence to Dr Liangqing Yao, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, Obstetrics, China; yaoliangqing{at}163.com

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Objective

The omentum is one of the most common metastatic sites of gynecologic malignant tumors such as ovarian carcinoma.1 Omentectomy is an important surgical procedure to remove some or all of the omentum during cancer staging or cytoreduction.2 Laparoscopy is commonly used for early-stage ovarian carcinoma.3 Compared with laparotomy, there were several difficulties in laparoscopic omentectomy, especially for infragastric omentectomy. We demonstrated an instructional video of laparoscopic infragastric omentectomy in gynecologic malignant tumor.

Design

We produced a step-by-step video demonstration of the technique.

Setting

A 54 year old woman was diagnosed with an ovarian carcinoma due to elevated tumor markers and the findings of positron emission tomography (PET) and computed tomography (CT).

Interventions

After salpingo-oophorectomy, the frozen section showed adenocarcinoma. We then excised the uterus and the metastases on the rectum. After the surgeon and assistants repositioned themselves, the patient underwent laparoscopic infragastric omentectomy. First, we opened the omental sac and cut infracolic greater omentum along the retrocolon belt at the peritoneal transition. Then, we cut the infragastric greater omentum from right to left along the greater curvature. Finally, the gastrosplenic omentum were excised. It is important for the surgeon to maintain the tension between the omentum and the gastrointestinal tract during the operation to avoid gastrointestinal injury. Gastrointestinal decompression can reduce flatulence during the infragastric omentectomy. The surgery removed all metastasis and the patient recovered well with no complications. The patient continues to do well without recurrence.

Conclusion

As an important surgical procedure, laparoscopic infragastic greater omentectomy can be independently accomplished by gynecologists after training and practice.

Figure 1

We cut the infragastric greater omentum from right to left along the greater curvature. The branch vessel of the gastroepiploic artery was cut by Martin electrotome.

Video 1 The following is an instructional video of infragastric omentectomy in gynecologic malignant tumor. In this video, we demonstrated the detailed steps and key points of laparoscopic infragastric omentectomy in gynecologic malignant tumor.

Data availability statement

There are no data in this work.

Ethics statements

Patient consent for publication

Ethics approval

This study involves human participants and was approved by Obstetrics and Gynecology Hospital of Fudan University; Approval document of ethics committee: IRB Protocol Approval Number: 2018-17 Participants gave informed consent to participate in the study before taking part.

References

Footnotes

  • Contributors XD: surgery, video clip, reviewing the literature, drafting and revising the manuscript; MC: surgery, patient’s overall management and revision of the manuscript; LY: the conception and design of the study, final approval of the version to be submitted and critical review of the manuscript. LY is responsible for the overall content as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.