Appearance of both ovaries, whether the ovarian capsule was ruptured before or during the procedure, extent of involvement of other abdominal organs (adnexae, pelvic wall, pelvic tissues), seeding, talcum powder appearance, implants, encasement, nodularity of viscera, frozen pelvis, any tumor on or in the liver that is not biopsied, nodules or evidence of tumor on the diaphragm that is not biopsied, which organs were removed, amount of tumor not resected (to estimate residual tumor bulk), areas where tumor was not removed.
Adequate staging procedures during laparotomy should include evaluation of the undersurface of the diaphragm, pelvic and abdominal peritoneum biopsies, pelvic and paraaortic lymph node biopsies, peritoneal washings, and biopsies of any suspicious nodules or masses. The surgeon's report should reflect the results of these procedures.
- Intraoperative Evaluation of Diaphragm:
Visual and manual inspection of the diaphragm, particularly the right leaf, during laparotomy for treatment of ovarian cancer. Optimally, the intraoperative evaluation of the diaphragm should occur prior to any dissection of pelvic organs. Evaluation of the diaphragm is an important part of accurate staging of ovarian cancer.
Surgical removal of the omentum, the fatty covering in the anterior abdomen. The omentum can then be examined for nonpalpable metastases. This may be either a partial (infracolic) or complete omentectomy.
- Examination Under Anesthesia (EUA):
Bimanual examination of the pelvis and external abdomen while patient is anesthetized, using one hand in the pelvis and the other hand to press on the organs externally.
Click here to view the Operative Report page of the Diagnostic Tests module for more information.