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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.
We produced a step-by-step video demonstration of the technique.
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).
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.
As an important surgical procedure, laparoscopic infragastic greater omentectomy can be independently accomplished by gynecologists after training and practice.
Data availability statement
There are no data in this work.
Patient consent for publication
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.
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.