Bilateral Salpingo-Oophorectomy

The Bilateral Salpingo-Oophorectomy is a procedure involving surgical removal of the ovaries and the fallopian tubes in women. It is usually performed to eliminate fertility, treat ovarian cysts, or some types of gynecologic cancer, notably ovarian cancer. This procedure has proven to reduce the risk of ovarian and breast cancer significantly. The Bilateral Salpingo-Oophorectomy usually treats the following conditions:

• Ovarian twisting or torsion
• Endometriosis
• Ovarian cancer
• Benign tumors, abscesses, or cysts
• Ectopic pregnancy
• Pelvic infections.

Alternate Name

The procedure is also called BSO. 

Body Location:

The Bilateral Salpingo-Oophorectomy is performed in the abdomen. 

Procedure Type of Bilateral Salpingo-Oophorectomy:

Surgical or Minimally invasive (for Robotic and Laparoscopic procedures).

Preparation for Bilateral Salpingo-Oophorectomy:

• Inform the doctor of your medical records and undergo any necessary physical and diagnostic tests. Follow the doctor's instructions for any diagnostic testing.
• Some drugs must be discontinued before surgery. At your pre-operative appointment, you will be given a medicine list.
• Fasting for a minimum of 8 to 10 hours is essential. Bowel-clearing medicines and an enema are provided before the surgical procedure.
• Additionally, it is recommended to pack your possessions for 2–3 days.
• For the next few days after surgery, you may require the assistance of a family member or friend with your daily routines. So, it is advised to bring an adult with you on the day of getting admitted to the medical facility.

How Bilateral Salpingo-Oophorectomy is Performed:

There are numerous approaches to salpingo-oophorectomy. Depending on the procedure, it can take one to four hours to complete. 

In the case of traditional surgery, general anesthesia is needed. The fallopian tubes and ovaries are removed through a cut in your belly. The incision is then glued, stapled, or stitched. 

The Bilateral Salpingo-Oophorectomy can be performed using a laparoscopic method. A laparoscope is a device with a camera and a light that your surgeon uses to look at the pelvic organs without having to make a major incision. The surgeon's tools are inserted into many small incisions to access the fallopian tubes and ovaries. The little incisions are used to remove them. The incisions are then closed. 

The procedure can also be performed using robotic technology. Instead of a laparoscope, the surgeon utilizes a robotic arm in this case. These robotic arms, equipped with a camera, enable high-definition visualization. The surgeon can identify and remove the fallopian tubes and the ovaries using the robotic arm's precise movements. The incisions are subsequently stitched together. 

Follow up

Follow-up visits are required after surgery to monitor the effectiveness of the procedure. A postoperative appointment with your doctor should be scheduled between four to six weeks after surgery. However, seek immediate medical attention if you experience high fever, nausea, vomiting, heavy vaginal discharge, or painful urination. 

The immediate decrease in estrogen levels in the body when ovaries are surgically removed can feel more severe, and it comes with higher health concerns, especially for pre-menopausal women. If you haven't gone through menopause yet, it's vital to talk to your doctor about the risks of surgically induced menopause. During your follow-up visit, the physician may be able to assist you with some medications or treatments to alleviate some of the symptoms arising post-surgery. 

Risks of Bilateral Salpingo-Oophorectomy

• The abrupt drop in estrogen in the body caused by surgical elimination of the ovaries can worsen the adverse effects of menopause. Menopausal symptoms such as hot flashes and night sweats are typical as estrogen levels drop.
• Other symptoms associated with the sudden change in the estrogen level include depression, vaginal dryness, sexual dysfunction, and insomnia.
• This surgical procedure comes with health risks like cancer, stroke, osteoporosis, Coronary Artery Disease (CAD), and psychiatric disorders.

Recovery of Bilateral Salpingo-Oophorectomy

You'll be advised to walk often soon after your surgery. Blood clots can be avoided by moving around frequently. You'll also be told not to lift heavy things or engage in intense activity for a few weeks. 

In the case of open surgery, you may require analgesics or pain killers. To avoid infection, your doctor will most likely prescribe antibiotics. Bandages may be applied to your incisions following surgery. Your doctor will advise you on when to remove them. Applying lotions or ointments to the wounds is not a good idea.

Robotic and laparoscopic procedures, in general, result in less postoperative pain and scarring than abdominal incisions. Compared to abdominal surgery, which takes 6- 8 weeks, you may be ready to continue normal activities in 2 to 3 weeks.