Pelvic and Abdominal Tumor Debulking

Pelvic and Abdominal Tumor Debulking

Farr Nezhat MD1; Radu Apostol, DO2; Patrick Vetere, MD1; Michael Khalife, MD1

1Winthrop University Hospital, Mineola, NY; 2Mount Sinai - St. Luke's and Roosevelt Hospital System, New York, NY


Objective: To illustrate the technique of laparoscopic tumor debulking of the pelvis and abdomen in advanced staged ovarian cancer.

Methods and Procedures: We present the case of a 41 year-old G2P1 presenting with abdominal bloating and back pain of 3 months’ duration. Her medical history was significant for ulcerative colitis for which she underwent laparoscopic colectomy with rectal pouch anastomosis. On examination, she was found to have a 14-weeks gestation-size pelvic mass and a palpable right inguinal lymph node, which was found to be positive for malignancy. Imaging studies showed metastatic lesions in the spleen, upper abdomen and pelvis. Following extensive counseling regarding her condition, patient chose to undergo exploratory laparoscopy with tumor debulking.


Results: The feasibility of laparoscopic primary tumor debulking in advanced ovarian cancer is illustrated in this video presentation. Post-operatively patient received dose dense IV Taxol and Carboplatin, and remained NED at 1 year.


Conclusion: Despite improvements in imaging studies and tumor markers, resectability of intraperitoneal disease in ovarian cancer remains difficult to determine. Laparoscopy has been used to assess the status of disease and the possibility of cytoreduction, and has emerged as a feasible alternative to laparotomy in managing ovarian cancer.