Women have two ovaries in the pelvis, one on the left and one on the right. Ovaries are connected to the pelvis, the Fallopian tubes and the uterus by ligaments and blood vessels.
The ovaries are are highly active organs that produce and store the eggs needed for pregnancy, as well managing hormone regulation during puberty, the menstrual cycle and menopause.
In younger women, the ovaries are essential for falling pregnant naturally (i.e. without assisted reproduction). Removal of both ovaries during reproductive years results in premature menopause and the inability to fall pregnant naturally (because there is no ovulation). Therefore, amongst women of reproductive age, surgery involving the ovaries or female reproductive organs for non-cancerous reasons typically aims to preserve one or ideally both ovaries.
What is an Oophorectomy?
Oophorectomy (oo-for-rec-to-me) is a surgical procedure to remove one (unilateral) or both (bilateral) ovaries.
To perform an oophorectomy, a general anaesthetic is required. Through 5-10mm cuts on the abdomen, medical gas is circulated into the abdomen and pelvis. Key-hole ‘ports’ are inserted into the abdomen which act like a passageway for the thin surgical camera and instruments to enter into the abdomen so the procedure can be performed. The blood vessels and ligaments around the ovary are secured and divided using a surgical electrical instrument to precisely seal and cut. Once completed, the ovary is placed in an extraction bag and retrieved through one of the abdominal skin incisions. The tissue removed is then sent to the laboratory for microscopic assessment.
Dr Dunn typically performs oophorectomy using a minimally invasive, robotic assisted technique.
Why is an oophorectomy performed?
Typically, surgery aims to preserve the ovaries. An oophorectomy may be necessary in the following situations:
- Ovarian cancer
- Ovarian cysts or tumours
- Ovarian endometriosis (endometrioma)
- Infection – when the ovary is involved in a pelvic abscess involving the uterus and Fallopian tube
- Ovarian torsion — The ovary can twist on itself, blocking the blood supply to the ovary. During the operation to untwist the ovary, it may be observed that the ovary will not return to normal function and needs to be removed.
- Ovarian cancer risk reduction – women with an increased genetic risk of ovarian or breast cancer might choose to have their ovaries removed at the completion of their families. Additionally, women who are undergoing other pelvic surgery (such as hysterectomy) may elect to have their ovaries removed to reduce their ongoing risk of ovarian cancer or other problems.
- Retained ovary syndrome
Women might have different perspectives on removal or conservation of their ovaries. The decision to have an oophorectomy is personal, and is influenced by the reason for oophorectomy, the woman’s feelings about her ovaries and her age.
Removal of ovaries under the age of 50-65 years might be associated with an overall reduction in life expectancy. This risk might be minimised by using hormone replacement. This is because even after menopause, the ovaries continue to provide valuable hormones for the body to keep the brain, heart and bones healthy.
