Ultrasound Staging with Corresponding Surgical Videos and Risk Prediction of Complications After Surgery for Advanced Ovarian Cancer

This video presents ultrasound imaging of advanced ovarian cancer together with corresponding real surgical videos. Following conditions are shown: small bowel mesentery infiltration and retraction versus small bowel carinomatosis only; small carcinomatosis on the right diaphragm versus bulky tumors infiltrating full thickness diaphragm with bulky tumors protruding to the right pleural cavity; bulky periaortic, prespinal lymph nodes; omental cake; rigid infiltration of ligamentum teres of the liver versus carcinomatosis on this ligamentum only; spleen hilum and parenchymal involvement; visceral and parietal carcinomatosis in the pelvis. The aim of the imaging performed on patient suspected for advanced ovarian cancer is to correctly plan the treatment and answer two questions: first, what type and how many surgical procedures will have to be done, and second, is the patient fit enough to survive the multivisceral surgery. The treatment of choice for advanced ovarian cancer is primary cytoreduction with the goal of no macroscopic disease. In order to plan the surgery we need to have good imaging. In order to calculate the risk of severe complications after debulking surgery we need to know everything about the patient - how she walks, how she eats, what are her co-morbidities, what are results of additional tests. The risk calculation model designed and published (Gynecol Oncol. 2016 Jan;140(1):15-21) by doctors from Mayo Clinic, Rochester USA, can be helpful, and the usage of this model is presented in the video. The video was presented during International Video Workshops for Gynecologic Oncology in Prague 2018.