omentectomy

Omentectomy is the surgical removal of part or all of the omentum, most commonly the greater omentum, a large apron-like fold of peritoneum that drapes over the abdominal viscera from the stomach. The omentum can be removed partially (partial omentectomy) or completely (total omentectomy) depending on the indication. The lesser omentum is a separate peritoneal structure and is not the typical target of an omentectomy.

Indications include oncologic surgery, notably during gastrectomy for gastric cancer when omental metastases are suspected or for cytoreduction in ovarian cancer. Omentectomy is also performed for diagnostic or therapeutic reasons in inflammatory or necrotic omentum conditions, such as omental infarction or torsion, when conservative management is not feasible or has failed.

Techniques: the procedure is performed via open or laparoscopic access. The omentum is dissected away from the stomach and transverse colon, with division of the gastroepiploic vessels in partial omentectomy, or complete detachment for total omentectomy. Care is taken to control blood vessels and to avoid injury to adjacent organs.

Risks and complications include bleeding, infection, injury to the stomach, spleen, pancreas, or colon, as well as postoperative ileus, adhesions, and lymphatic leaks. Recovery and prognosis depend on the underlying disease and extent of resection.

Outcomes: in gastric cancer, omentectomy is part of standard surgical approaches in some settings but its survival benefit remains a subject of study; in ovarian cancer, total omentectomy is commonly included in cytoreductive procedures to improve staging and potential outcomes.