Retro peritoneal
tumor surgery

What is peritoneal cancer?

It is one of the rare forms of cancer that forms in the epithelial cells that line the abdominal wall. The name of this lining is peritoneum.

The peritoneum protects the following organs in abdomen by covering them:

  • Intestine
  • Bladder
  • Rectum
  • Uterus

What are the symptoms of

peritoneal cancer?

Following are the symptoms of peritoneal cancer:

  • Pain and bloating in the abdomen
  • Abdominal enlargement
  • Pressure in the abdomen or pelvis
  • Nausea and vomiting
  • Loss of appetite
  • Problem in bowel movements and urination
  • Sudden weight loss or gain
  • Fatigue and tiredness
  • Vaginal discharge
  • Back pain and indigestion

How is cancer

diagnosed?

CT scans, MRI scans and ultrasound are the imaging tests that are used to detect cancer.

Biopsy is one of the trusted and effective techniques in diagnosing any form of cancer; most doctors will ask patients to get it done.

Blood tests done to detect chemicals that may be elevated in peritoneal cancer, such as CA 125, a chemical made by tumor cells are also suggested.

What are the treatments

available?

There are non-surgical treatments like chemotherapy, where a combination of chemicals are used to act upon and kill the cancer cells.

Monoclonal antibody treatment in which the antibodies target the cancer cells which are responsible for cancer growth and kill them.

Use of PARP (poly-ADP ribose polymerase) inhibitors that block DNA repair.

Angiogenesis inhibitors are used to prevent blood vessel growth in tumors.

How to prepare for the

procedure?

The doctor will advise a full physical examination before the surgery, to check for any other complication that needs to be addressed before surgery.

Surgery

The surgery encompasses the following 

Hysterectomy – removal of the uterus

Oophorectomy -removal of the fallopian tube and ovaries

Omentum – removal of a layer of fatty tissue near the ovaries

There are two approaches to remove the tumor, a minimally invasive approach and an open procedure. Depending upon the condition of the individual the surgeon opts for which one to employ.

The surgery is carried out under the influence of general anesthesia. In an open approach the surgeon makes an incision in the middle region of the abdomen, moving the other tissues and muscles aside. Once the tumor is visible surgical instruments go in and the tumor is removed.

In a Laparoscopic approach, once the patient is asleep the process begins by making incisions near the belly button and a small device is inserted which is called a port; it creates an opening that will used be filled with gas (carbon dioxide) in the abdomen region.

Through these incisions a Laparoscope (a Laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the affected body part and through the other incisions that are made the damaged/affected (tumor) part is removed with the help of surgical equipment; after this the incisions are sealed using a surgical glue or staples.

How long does it take to recover and

what are the guidelines to be followed during the recovery?

The recovery time for Laparoscopic surgeries is very less and one can return to normal life within days of surgery, but they should avoid heavy lifting. The soreness after the surgery lasts for 48 hours and it can extend up to weeks depending upon the individual. If it’s an open procedure it will take longer for the patient to recover.

For a few weeks after the surgery the patient has to be in a highly sanitized area because he is susceptible to infections.

The patient will be discharged from the hospital in 6 to 8 days after the laparoscopic procedure and if it’s an open procedure the call to discharge will be taken by the doctor based on the condition of the patient.

If the pain in the incisional area persists the doctor will advise bed rest for a week.

One might feel nauseated post-surgery, this might be due to anesthesia administered for the purpose of the surgery.

Post-surgery one might feel shoulder pain because of the gas that was pumped in during the surgery, which will go away within 48 hours.

When to call a doctor if complications occur

post-surgery?

If one feels nauseated, develops fever, bleeding occurs through the incisions, inability to urinate, vaginal discharge etc. under these circumstances it is better to get in touch with the doctor who performed the operation.

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