Common Surgical Procedures for Abdominal Cancer
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This guide outlines common surgical procedures for abdominal and peritoneal cancers, detailing targeted organs, post-surgery expectations, and specialized treatments like HIPEC. It clarifies medical terminology to help patients navigate their treatment plans.
Surgery is an important part of treatment for many cancers that start in or spread to the abdomen. Depending on the type and location of the cancer, surgery may involve removing the tumor itself, part or all of an affected organ, or tissue surrounding the tumor.
Some patients need only one procedure, such as an appendectomy, hemicolectomy, or hysterectomy. Others may need several procedures during the same operation, particularly when cancer has spread to the lining of the abdominal cavity, called the peritoneum.
When surgery is performed to remove visible tumors from the abdominal cavity, it may be called cytoreductive surgery (CRS). CRS is not one specific operation. Instead, it may involve several different surgical procedures depending on where the cancer is located. For example, a patient undergoing CRS might also need removal of part of the colon, the spleen, gallbladder, ovaries, omentum, or areas of the peritoneal lining.
For some cancers involving the peritoneum, CRS may be combined with treatment delivered directly into the abdominal cavity. These treatments may include:
HIPEC (Hyperthermic Intraperitoneal Chemotherapy): heated chemotherapy circulated throughout the abdominal cavity during surgery after visible tumors have been removed.
EPIC (Early Postoperative Intraperitoneal Chemotherapy): chemotherapy delivered directly into the abdominal cavity during the first several days after surgery through temporary tubes or catheters.
PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy): chemotherapy delivered into the abdominal cavity as a pressurized aerosol during a minimally invasive procedure.
Not every patient with abdominal or peritoneal cancer needs CRS, HIPEC, EPIC, or PIPAC. Your surgical plan depends on your cancer type, where it is located, whether it has spread, your overall health, and the goals of treatment.
This guide explains some of the surgical terms and procedures you may encounter, what is removed, and how the procedure may affect life afterward.
Understanding Surgical Procedure Names
Surgical terms can be confusing, but their endings often tell you what kind of procedure is being performed.
-ectomy means removal of an organ or tissue.
Examples: appendectomy (removal of the appendix), colectomy (removal of the colon), splenectomy (removal of the spleen).
-otomy means making an incision or opening into an organ or body area, without necessarily removing it.
Example: laparotomy is an operation in which the surgeon makes an incision in the abdomen to access the abdominal organs.
-ostomy means creating a new opening between an organ and the outside of the body.
Examples include a colostomy or ileostomy, in which part of the intestine is brought through the abdominal wall so stool can leave the body into an ostomy pouch.
-oscopy means looking inside the body using a camera or viewing instrument.
Examples include colonoscopy, endoscopy, and laparoscopy.
These terms appear frequently in cancer care, so understanding them can make surgical discussions and medical records easier to follow.
Gastrointestinal and Abdominal Procedures
Appendectomy
What it is
An appendectomy is removal of the appendix, a small tube-shaped structure attached to the beginning of the large intestine.
Appendectomy is commonly performed for appendicitis, but it can also be part of treatment for an appendiceal tumor. Some appendiceal tumors produce a jelly-like substance called mucin. If mucin and tumor cells spread through the abdominal cavity, they may cause a condition called pseudomyxoma peritonei (PMP).
In patients with appendiceal cancer or PMP, appendectomy may be performed alone or as one part of a larger operation such as CRS.
Organs involved
The appendix is removed. Depending on where the tumor is located and how much of the surrounding bowel is involved, the surgeon may also need to remove part of the cecum or right side of the colon.
Life after
The appendix is not essential for normal digestion, and most people do not need to make permanent diet or lifestyle changes after an appendectomy alone.
If the appendectomy is part of a larger cancer operation, recovery and long-term effects will depend mainly on the other procedures performed.
Cecectomy
What it is
A cecectomy is removal of part or all of the cecum. The cecum is the first pouch-like portion of the large intestine and is located where the small intestine connects to the colon.
A cecectomy may be performed when a tumor involves the cecum, appendix, or nearby ileocecal region. Depending on the extent of disease, the procedure may be limited to the cecum or may be part of a larger bowel resection.
Organs involved
The cecum and usually the appendix are removed. Sometimes a small portion of the end of the small intestine, called the terminal ileum, is removed as well.
The remaining small and large intestine can usually be reconnected.
Life after
Removing a small portion of the cecum usually causes little long-term change in digestion. Some patients experience temporarily looser or more frequent bowel movements.
Removing this short segment usually has minimal long-term impact. Some patients notice looser or more frequent stools. If a significant portion of the terminal ileum is removed, absorption of vitamin B12 and bile acids can be affected. This can sometimes lead to vitamin B12 deficiency or persistent diarrhea. Your healthcare team may recommend blood tests, dietary changes, supplements, or medications if these problems develop.
Cholecystectomy
What it is
A cholecystectomy is removal of the gallbladder.
The gallbladder stores bile produced by the liver and releases it into the intestine to help digest fats. Although cholecystectomy is commonly performed for gallstones or gallbladder inflammation, it may also be necessary during abdominal cancer surgery if the gallbladder itself or nearby tissues are involved by tumor.
During CRS, for example, tumor deposits may be present around the gallbladder or on the nearby surface of the liver.
Organ involved
The gallbladder is removed. The liver continues to produce bile after surgery.
Life after
You can live normally without a gallbladder. Instead of being stored in the gallbladder, bile flows directly from the liver into the intestine.
Most people can eventually return to a normal, balanced diet. Some people temporarily have difficulty tolerating fatty foods or develop loose stools or diarrhea. Persistent diarrhea can sometimes be related to bile acids and may be treated with medication.
No routine vitamin or hormone replacement is needed simply because the gallbladder has been removed.
Colectomy
What it is
A colectomy is removal of part or all of the colon, also called the large intestine.
The amount removed depends on the location and extent of the cancer. A colectomy may be the main operation used to treat colon cancer, or it may be one component of a larger operation when another abdominal cancer has spread to or involves the colon.
After removing the affected bowel, the surgeon will often reconnect the two healthy ends. This connection is called an anastomosis.
In some cases, making an immediate connection is not safe or possible. The surgeon may instead bring part of the bowel through an opening in the abdominal wall. This is called an ostomy. An ostomy created from the colon is called a colostomy, while one created from the small intestine is called an ileostomy.
Organs involved
A portion of the colon—or, less commonly, the entire colon—is removed. Nearby lymph nodes may also be removed when the operation is being performed to treat colon cancer.
Life after
Bowel function often changes after a colectomy, particularly during the first weeks or months. You may notice:
more frequent bowel movements
looser stools
greater urgency
increased gas or bloating
Your surgical team may temporarily recommend changes in the amount or type of fiber you eat while the bowel heals. Staying well hydrated is especially important, particularly for patients with an ileostomy.
One important early complication is an anastomotic leak, which occurs when a new bowel connection does not heal completely and intestinal contents leak outside the bowel. Your surgical team monitors closely for signs of this complication after surgery.
An ostomy may be temporary, allowing a bowel connection time to heal before the ostomy is reversed, or permanent if reconnecting the bowel is not possible or appropriate.
If there is a possibility that you will need an ostomy, your surgeon should discuss this with you before surgery whenever possible so that you can understand and prepare for either outcome.
Hemicolectomy
What it is
A hemicolectomy is removal of approximately one side of the colon.
A right hemicolectomy removes the right side of the colon and is commonly performed for cancers involving the cecum or ascending colon. A left hemicolectomy removes part of the left side of the colon.
These procedures may be performed as the main surgery for colon cancer or as part of a larger abdominal cancer operation.
Organs involved
The affected portion of the colon and usually its associated lymph nodes are removed. The remaining bowel is usually reconnected.
During a right hemicolectomy, the end of the small intestine—the terminal ileum—may also be removed.
Life after
Most patients are eventually able to return to a regular diet, although bowel movements may initially be more frequent or looser.
If a significant amount of terminal ileum is removed during a right hemicolectomy, some patients can develop problems absorbing bile acids or vitamin B12. Your healthcare team can evaluate persistent diarrhea or vitamin deficiencies and recommend treatment if necessary.
Peritonectomy
What it is
A peritonectomy is removal of part of the peritoneum, the thin membrane that lines the inside of the abdomen and covers many abdominal organs.
Cancers involving the peritoneal surface may form tumor deposits on this lining. Rather than removing the underlying organ, surgeons can sometimes remove the affected layer of peritoneum itself.
Peritonectomy is commonly one of the procedures used during cytoreductive surgery, although the amount removed varies considerably from patient to patient.
Tissues involved
Different areas of the peritoneal lining may be removed depending on where cancer is found. These may include the lining of the pelvis, abdominal wall, diaphragm, or other surfaces.
Life after
The peritoneum does not need to be replaced after it is removed. The operated surfaces heal naturally. Recovery depends much more on how extensive the overall surgery was and what other procedures were performed than on removal of the peritoneum itself.
Because peritonectomy can involve large areas of the abdomen, patients may experience significant fatigue, pain, changes in bowel function, and reduced appetite during the early recovery period.
Omentectomy
What it is
An omentectomy is removal of part or all of the omentum.
The omentum is a fatty, apron-like layer of tissue that hangs down from the stomach and covers portions of the abdominal organs. Cancer cells can spread to the omentum, making it a common site of disease in ovarian, appendiceal, colorectal, gastric, and other cancers involving the peritoneum.
Omentectomy is commonly performed as part of ovarian cancer surgery and may also be performed during CRS or other abdominal cancer operations.
Tissue involved
Part or all of the omentum is removed.
Life after
The body can function normally without the omentum, and its removal alone generally does not require permanent dietary changes, medications, or supplements.
When an omentectomy is part of a larger cancer operation, recovery will depend mainly on the other organs and tissues removed.
Diaphragm Resection or Diaphragmectomy
What it is
The diaphragm is the large muscle separating the chest from the abdomen and is the main muscle used for breathing.
Cancer involving the peritoneum can spread to the lining underneath the diaphragm, particularly on the right side above the liver.
If disease is limited to the surface, the surgeon may perform diaphragmatic peritonectomy or stripping, removing the affected lining while preserving the muscle.
If tumor extends more deeply, a portion of the diaphragm itself may need to be removed. This is sometimes called full-thickness diaphragm resection or diaphragmectomy.
Structures involved
The peritoneal lining over the diaphragm, the diaphragm muscle itself, or both may be removed.
If a full-thickness section of diaphragm is removed, the opening is closed with stitches or, for larger defects, may be repaired using a surgical patch.
Life after
Because the diaphragm lies directly beneath the lungs, temporary chest-related symptoms can occur after surgery.
These may include:
shortness of breath
shoulder-tip pain
fluid around the lung, called a pleural effusion
the need for temporary drainage of fluid or air from the chest
For most patients, the diaphragm heals and the remaining muscle continues to perform its breathing function.
Gastrectomy
What it is
A gastrectomy is removal of part or all of the stomach.
A partial or subtotal gastrectomy removes only part of the stomach. A total gastrectomy removes the entire stomach, and the esophagus is then connected directly to the small intestine.
Gastrectomy may be performed to treat stomach cancer itself or when another abdominal cancer directly involves the stomach.
Organs involved
Part or all of the stomach is removed. When surgery is performed for stomach cancer, nearby lymph nodes and sometimes other involved tissues may also be removed.
Life after
Gastrectomy can have a significant effect on eating and nutrition because the stomach normally stores food and releases it gradually into the small intestine.
After surgery, patients generally need to eat smaller meals more frequently and eat slowly. Weight loss can occur, especially during the first several months.
Some patients develop dumping syndrome, in which food moves into the small intestine too quickly. Symptoms may include:
abdominal cramping
nausea
diarrhea
dizziness or weakness
sweating
a rapid heartbeat
Eating smaller meals and limiting foods that trigger symptoms, particularly foods high in simple sugars, can help. Drinking most fluids between meals rather than with meals may also be recommended.
Nutritional monitoring is especially important after gastrectomy. Iron, calcium, vitamin D, folate, and other nutrients may need to be monitored.
After total gastrectomy, the body can no longer absorb vitamin B12 normally because the stomach is no longer present to produce the intrinsic factor needed for normal B12 absorption. Lifelong vitamin B12 replacement is therefore required.
A dietitian who specializes in cancer or gastrointestinal surgery can be an important member of the care team after gastrectomy.
Splenectomy
What it is
A splenectomy is removal of the spleen.
The spleen is located in the upper left side of the abdomen near the stomach. It helps filter the blood and plays an important role in the immune system.
During abdominal cancer surgery, the spleen may need to be removed if it is directly involved by tumor or if disease involving nearby structures cannot otherwise be safely removed.
Organ involved
Part or all of the spleen may be removed.
Life after
You can live without a spleen, but the spleen plays an important role in protecting the body against certain bacterial infections. People without a functioning spleen therefore have a lifelong increased risk of some serious infections.
Special vaccinations are recommended to reduce this risk, including vaccines that protect against pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib) infections. The exact schedule depends on your previous vaccinations and medical history. When a splenectomy is planned in advance, some vaccines are ideally given before surgery.
Your healthcare team will explain what vaccinations and boosters you need and what to do if you develop a fever or signs of infection after your spleen has been removed.
Gynecologic Procedures
Some abdominal and peritoneal cancers may involve the uterus, ovaries, or fallopian tubes. These organs may need to be removed when the cancer starts in the gynecologic organs themselves or when another cancer has spread to or directly involves them.
Gynecologic procedures may be performed on their own or as part of a larger abdominal operation, including cytoreductive surgery. The effect on hormones, fertility, and menopause depends on which organs are removed.
Hysterectomy
What it is
A hysterectomy is removal of the uterus.
It may be performed to treat a cancer that begins in the uterus or cervix, as part of surgery for ovarian cancer, or when another abdominal or peritoneal cancer involves the uterus.
A hysterectomy may also be one component of cytoreductive surgery when removing the uterus is necessary to completely remove visible disease.
Organs involved
Exactly what is removed depends on the operation.
A total hysterectomy removes the uterus and cervix. Removal of the ovaries or fallopian tubes may be performed at the same time but represents separate procedures.
Life after
After hysterectomy, menstrual periods stop and pregnancy is no longer possible.
Removing the uterus itself does not necessarily cause menopause. If the ovaries remain in place and continue functioning, they can continue producing hormones.
If both ovaries are removed at the same operation, however, menopause occurs immediately in patients who have not already gone through menopause.
Recovery also depends on the surgical approach and on whether the hysterectomy was performed alone or as part of a larger abdominal operation.
Oophorectomy
What it is
An oophorectomy is removal of one or both ovaries.
A unilateral oophorectomy removes one ovary, while a bilateral oophorectomy removes both.
The ovaries may be removed because cancer begins in the ovary or because another abdominal or peritoneal cancer has spread to or directly involves them.
Organs involved
One or both ovaries are removed.
The fallopian tube may also be removed together with the ovary. Removal of an ovary and fallopian tube together is called a salpingo-oophorectomy.
Life after
If only one ovary is removed and the other remains healthy, the remaining ovary can usually continue producing hormones and releasing eggs.
Removal of both ovaries before natural menopause causes immediate surgical menopause because the body's main source of estrogen and progesterone is removed.
Possible symptoms include:
hot flashes
night sweats
vaginal dryness
sleep changes
mood changes
Over the longer term, loss of ovarian hormones can also affect bone and cardiovascular health.
Removal of both ovaries also affects fertility. For patients who may want to have children in the future, fertility considerations should be discussed before surgery whenever the clinical situation allows.
Whether hormone replacement therapy is appropriate depends on factors such as age, cancer type, and individual medical history and should be discussed with the oncology team.
Salpingectomy
What it is
A salpingectomy is removal of one or both fallopian tubes.
It may be performed as part of treatment for ovarian, fallopian tube, uterine, or other pelvic cancers, or when a fallopian tube is involved by cancer spreading within the abdomen.
Removal of an ovary and its fallopian tube together is called a salpingo-oophorectomy.
Organs involved
One or both fallopian tubes are removed.
Life after
The fallopian tubes do not produce hormones, so removal of the tubes alone does not cause menopause if the ovaries remain in place.
Removal of both fallopian tubes prevents pregnancy from occurring naturally because an egg can no longer travel from the ovary to the uterus. However, the ovaries can continue producing hormones and eggs, and pregnancy may still be possible through assisted reproductive techniques such as in vitro fertilization (IVF), depending on the individual situation.
Every Surgical Plan Is Different
Two patients with the same type of cancer may have very different operations. The procedures your surgeon recommends depend on factors such as:
where the cancer started
which organs or tissues are involved
how far the cancer has spread
whether all visible disease can safely be removed
previous surgeries or treatments
your overall health
the goals of treatment
When several procedures are combined during cytoreductive surgery or another major abdominal operation, recovery is usually determined by the combined effect of the entire operation, rather than by any one procedure.
Before surgery, it can be helpful to ask your surgical team:
Which organs or tissues might need to be removed?
Will any part of my stomach or intestine need to be removed?
Could I need an ostomy?
Could the surgery affect my diet or bowel function?
Will I need any long-term medications, vitamins, or supplements?
Could the surgery affect my hormones or fertility?
What changes should I expect during recovery?
Are any of these changes likely to be permanent?
Knowing the names of the procedures and what they mean can make conversations with your care team easier and help you feel more prepared for surgery and recovery.
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