Laparoscopic Oophorectomy (Ovary Removal Surgery)

Dr. Wei-Wei Wee-Stekly

Senior Consultant Obstetrician & Gynaecologist

MBBS (London), MRCOG (United Kingdom), MMed (O&G) (Singapore), FAMS (Singapore), FRCOG (United Kingdom)

The decision to remove one or both ovaries is not taken lightly. With modern surgical techniques, many women can now undergo this procedure through laparoscopic (keyhole) surgery, which involves small incisions, faster healing, and minimal scarring. A laparoscopic oophorectomy allows your gynaecologist to safely and precisely remove the affected ovary or ovaries, while reducing your recovery time and postoperative discomfort.

What Is a Laparoscopic Oophorectomy?

A laparoscopic oophorectomy is a minimally invasive surgical procedure to remove one or both ovaries using small incisions in the abdomen. A camera-equipped instrument called a laparoscope is inserted through one incision to provide a view of the pelvic organs, while surgical instruments are used through other tiny incisions to perform the surgery.

Depending on your condition, the procedure may involve:

• Unilateral oophorectomy – removal of one ovary
• Bilateral oophorectomy – removal of both ovaries
• Salpingo-oophorectomy – removal of the ovary along with the fallopian tube on one or both sides

The goal is to treat the underlying condition while minimising disruption to surrounding tissues and reducing recovery time.

When Is It Recommended?

Laparoscopic oophorectomy may be advised in the following situations:

• Persistent or complex ovarian cysts
• Ovarian torsion (twisting of the ovary)
• Endometriosis involving the ovaries
• Suspected or confirmed benign ovarian tumours
• Prophylactic (preventive) surgery for those with a high genetic risk of ovarian cancer
• As part of another procedure, such as hysterectomy or treatment of pelvic pain
• Early-stage ovarian cancer (after careful evaluation)

Your gynaecologist will perform imaging and other tests to determine whether laparoscopic surgery is the most suitable approach.

What Are the Benefits of the Laparoscopic Approach?

Compared to open surgery, laparoscopic oophorectomy offers several advantages:

• Smaller incisions with minimal scarring
• Reduced postoperative pain
• Shorter hospital stay (often same-day discharge)
• Faster recovery (typically 1–2 weeks)
• Lower risk of wound infection and complications
• Quicker return to work and daily activities

These benefits make laparoscopic oophorectomy the preferred method for most benign and selected early-stage conditions.

Who Is a Good Candidate for Laparoscopic Oophorectomy?

You may be a suitable candidate for laparoscopic oophorectomy if:

• Your ovarian condition is benign or confined to the ovary
• Imaging suggests no extensive pelvic adhesions or advanced disease
• You prefer a minimally invasive option
• You are fit for general anaesthesia

In some cases, an open abdominal approach may be necessary, such as when there is suspicion of widespread malignancy or very large ovarian masses.

What Happens Before Laparoscopic Oophorectomy?

Before the procedure, your doctor will carry out a detailed preoperative assessment, including:

• Pelvic ultrasound or MRI
• Blood tests (including cancer markers, if applicable)
• Review of your medical and surgical history
• Pre-anaesthesia evaluation
• Discussion of fertility, hormonal implications, and menopausal symptoms (if both ovaries are being removed)

You'll receive clear instructions on how to prepare for surgery, including fasting and which medications to stop or continue.

What Happens During Laparoscopic Oophorectomy?

Laparoscopic oophorectomy is performed under general anaesthesia and typically lasts 1 to 2 hours.

The main steps include:

• A small incision is made near the navel to insert the laparoscope
• Additional small incisions are made to insert surgical tools
• The ovary (and tube, if applicable) is carefully detached and placed in a special bag
• The tissue is removed through one of the small incisions
• Bleeding is controlled, and the incisions are closed with dissolvable sutures

If both ovaries are removed, this is discussed in advance. Any findings during surgery that were unexpected will be managed in accordance with preoperative consent.

What Is Recovery Like?

Recovery is typically quicker and less painful than open surgery. After the procedure, you can expect:

• Mild to moderate abdominal cramping or bloating
• Light vaginal spotting for a few days
• Shoulder discomfort from the gas used during surgery
• Fatigue in the first week

Most women can:

• Walk around the same day
• Resume light activity within 2–4 days
• Return to work in 1–2 weeks
• Avoid heavy lifting or vigorous exercise for about 4–6 weeks

Follow-up visits will be scheduled to check on your recovery and discuss any pathology results if tissue was sent for testing.

What If Both Ovaries Are Removed?

Removing both ovaries causes surgical menopause — a sudden drop in oestrogen and progesterone levels, regardless of your age.

This may lead to:

• Hot flushes and night sweats
• Mood swings or irritability
• Vaginal dryness
• Decreased libido
• Increased long-term risk of bone loss and heart disease

To manage these effects, your doctor may discuss hormone replacement therapy (HRT), especially if you are under the age of 50 and have no contraindications. Alternatives to HRT can also be considered based on your individual health needs.

How Does It Affect Fertility?

If only one ovary is removed, the remaining ovary can often continue to function normally, allowing for natural conception and regular menstrual cycles.

If both ovaries are removed, natural fertility is no longer possible. If you are considering future pregnancy, your doctor may discuss:

• Egg freezing prior to surgery
• Use of donor eggs or embryos with IVF
• Fertility-sparing surgical alternatives (where appropriate)

What Are the Risks?

Laparoscopic oophorectomy is a safe and well-established procedure, but all surgeries carry some risks, including:

• Bleeding
• Infection
• Damage to nearby organs such as the bladder or bowel
• Adhesions (scar tissue)
• Hernia at the incision site
• Hormonal symptoms if both ovaries are removed
• Rare need to convert to open surgery if complications arise

Your surgeon will explain these risks clearly and take steps to minimise them.

When Should You Consider Laparoscopic Oophorectomy?

You may benefit from this procedure if:

• You have a large or persistent ovarian cyst
• You experience pain or pressure due to an ovarian mass
• You have endometriosis involving the ovaries
• You are at high genetic risk for ovarian cancer
• Your doctor has identified suspicious findings that require removal
• You are undergoing another gynaecological surgery and ovary removal is part of your care plan

Early consultation allows your doctor to tailor the treatment to your specific health needs and personal goals.