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While imaging and blood tests may indicate that a woman has ovarian cancer, surgery enables doctors to make a conclusive diagnosis. Any tumor or tissue removed is immediately evaluated for signs of cancer. This allows Perlmutter Cancer Center doctors to determine how far the cancer has spread, how much more tissue needs to be removed during the same surgery, and what other therapies might be needed after the procedure.
Because most ovarian cancers have already spread beyond the ovaries or fallopian tubes when it is found, surgery is usually open, or performed through a long incision in the abdomen. This allows doctors to examine the abdominal and pelvic areas thoroughly. The procedure requires general anesthesia.
Our gynecologic oncologists focus on aggressive surgery, meaning they plan to remove all of the cancerous tissue in a process called debulking or cytoreduction. Surgery can involve the removal of the ovaries, fallopian tubes, uterus, cervix, omentum—a layer of fatty tissue that covers the abdomen—nearby lymph nodes, and other tissues from the abdominal and pelvic areas.
This surgery can be complex. For this reason, our gynecological oncologists work closely with critical care physicians, cardiologists, and other specialists at NYU Langone, who ensure that surgery is as safe as possible. They closely monitor your overall health after the procedure.
Minimally Invasive Approaches
If imaging tests suggest there is a mass on the ovary but there are no signs of the spread of cancer to other reproductive organs, or other distant parts of the body such as the liver or colon, doctors may be able to remove the ovary and all other disease using small incisions. They use a minimally invasive approach, such as laparoscopy or robotic-assisted surgery.
The ovary is then sent for tissue evaluation by a pathologist. If the test results show the tumor is benign, no more surgery is needed. If cancer is detected, either minimally invasive or open surgery is performed to further evaluate surrounding tissue, often during the same surgical procedure.
Laparoscopic surgery is performed through several small incisions in the lower abdomen and pelvic area. Surgeons inflate the abdomen with air to create a working space. Then they place a laparoscope, a lighted tube with a tiny camera on it, through one of the incisions to look inside the pelvic area. Through the remaining incisions, they insert small tools to remove the ovary.
Laparoscopic surgery can reduce recovery time and result in less scarring than open surgery, which requires a larger incision.
Doctors at NYU Langone’s Robotic Surgery Center may use a robot-assisted laparoscopic system to perform surgery. This system consists of tiny surgical instruments mounted on three separate robotic arms. The fourth arm contains a camera, which creates magnified, three-dimensional images on a computer monitor to guide the surgeon during the procedure.
The surgical tools and camera are inserted through small, quarter-inch incisions in the abdomen and pelvis, and the surgeon controls them from a console in the operating room. Similar to laparoscopic surgery, robotic surgery can reduce recovery time and result in less scarring than open surgery.
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