IF you were in the operating table as a surgeon for ovarian cysts. Then when you open her up, you notice there is some suspected cancer in her ovaries. But you just realize you forgot to tell your patient that it is located in her ovaries and you did not inform her yet if there is anything you may take everything out with her permissions. Will you go on to take everything out (2ovaries, 2 falopian tubes, ommentum, uterus and appendix) or will you close her back and tell her you are sorry? Or should you leave patient uterus and put her on Hormone replacement therapy so she can get her menstrual cycle again?
Biopsy the suspected mass....wake patient up and discuss findings and allow patient to make an informed decision. IMHO since the surgeon has opened her up instead of doing a laparoscopy I would have thought the possibility of cancer would have been discussed☺😷
Does the cysts size come into factor when deciding between laparatomy or laparascopy?
Madcurious I would say not but I am not a gyne nurse. A true cyst could be decompressed and therefore be done with a scope...
Another factor to consider is if the patient is within childbearing age she may wish to bank her eggs before chemo/TAG and absolutely should be given that option if she chooses
Patient is very young 28 yo. No pathology done, no biopsy done, no consent is done prior surgery.
So in any cases, the procedure should have a biopsy first? And she has the right to choose if its can be froze or not, before cutting it off and making it all in a parafin blocks?
Madcurious absolutely biopsy so all know exactly what the situation is !
Madcurious I am a neuro trauma nurse but I have been answering these as a fellow woman
The pathology result is, one ovary is borderline and the other one is clear. Do you think she should has the chance to save the ovaries?
If having children is important to patient I would salvage the one ovary. ..I personally would have TAH and choose the chance of life over future children
TAH. is a total abdominal hysterectomy removing bilateral fallopian tubes, both ovaries and cervix
You mean TAH alongside with frozen section as well? Or TAH and throw it all away.
Appendix is not necessary to remove but if there is obvious metastases then yes
I have a friend who just finished chemo for ovarian cancer with colon metastases small bowel metastases and diaphragm metastases she chose radical surgery ad ovarian cancer with Mets has a low survival statistics
The patient is only 1 ovaries which is lowgrade. The other ovaries is clear.
If it was me I would want biopsy. .wake up and be informed of results...and take out everything in the hope of survival..for others having children is important
Sadly she didnt given any choice and shes only 28. She was told it was only a cysts removal no ovaries involve. The surgeon didnt believe in biopsy and frozen section, so the doctor just removed everything and throw everything (leaving the uterus) and let her know 4 days afterthat.
