What surgical procedures can be used for comprehensive staging of ovarian cancer

Ms. Pang, 40 years old this year, has been very troubled recently. Her menstruation, which used to be very regular, has not come for 65 days. She is not pregnant, so she went to the hospital for an ultrasound examination. The ultrasound description is: the uterus is tilted forward. The size of the uterus is 4.5×3.4×3.7cm, and the muscle layer has uniform echo. The endometrium is clear and 1.0cm thick. A slightly hypoechoic nodule with a diameter of 0.7cm is found on the left wall of the uterus. The size of the right ovary is 2.8*1.9cm, and the size of the left ovary is 4.6*3.4cm. A cystic echo with a diameter of 2.7cm is found inside. After further examination, the doctor inferred that it might be ovarian cancer and recommended that Ms. Pang undergo staging surgery to determine the extent of the tumor. The treatment principle of ovarian cancer is based on surgery, combined with a variety of treatment methods. Staging surgery can determine the growth of the tumor and the range of lesion spread. Standardized staging surgery for ovarian cancer mainly includes the following:

1) Abdominal longitudinal incision: from the pubic symphysis to 4 fingers above the navel to ensure adequate exposure;

2) Peritoneal cytology examination: ascites or lavage fluid from the pelvic cavity, collateral gutter, and upper abdomen, and comprehensive exploration of the pelvic and abdominal cavities;

3) Careful exploration and biopsy: adhesions, ligation and suspicious areas, especially the lateral gutter of the colon, diaphragm and mesentery;

4) Resection of the greater omentum: Resection of the greater omentum along the transverse colon/greater curvature of the stomach, paying attention to the resection of the hepatocolon, splenic colon, gastrocolic, and splenogastrostomy ligament;

5) Total hysterectomy and bilateral salpingo-oophorectomy, high ligation of the ovarian artery and vein;

6) Pelvic and para-aortic lymph node clearance.