Omental Procedures: Supracolic Omentectomy, Infracolic Omentectomy, Omental Biopsy

The omentum is a common site for metastases from a large variety of cancers. The commonest causes of omental metastases are ovarian cancer and primary peritoneal or tubal cancer, through transperitoneal or transcoelomic spread. Omentectomy is most often carried out in patients with epithelial ovarian cancers. Total omentectomy includes removal of the omentum which extends to the hilum of the spleen in addition to the parts removed by supracolic omentectomy. Infracolic omentectomy should be confined to the removal of normal-looking omentum for staging purposes. Omentectomy may result in a paralytic ileus, particularly if the operation is prolonged and there has been significant disturbance of the bowel. Omentectomy may result in paralytic ileus particularly if the operation is prolonged or if there has been significant disturbance of the bowel; in such situations, a nasogastric tube can be inserted at the time of the operation.