Medical Oncologist
CION Cancer Clinics
Omentectomy: why the omentum is removed, and what changes without it | CION Cancer Clinics
The omentum is a fatty apron that hangs from the stomach over the bowel. It is removed in ovarian cancer surgery, and in some stomach and bowel cancer operations, because it is the most common place for cancer cells to settle. It comes out even when it looks normal, so the pathologist can check it for deposits too small to see. You can live a normal life without it. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
17+specialists on panel
15,000+patients treated
35+centres across Telangana & AP
4.8★ / 800+Google rating
On this page
- Why is the omentum removed in cancer surgery?
- What changes when the omentum is gone, and what does not
- How is the omentum actually removed?
- Words about the omentum you will meet on your papers
- Four things families ask about the omentum, and what is true
- What this page cannot tell you, and what to ask your surgeon
- Common questions about omentectomy
The short answer
Why is the omentum removed in cancer surgery?
The omentum is removed because it is the most common place for cancer from the ovary, and from some stomach and bowel cancers, to settle. It is taken out even when it looks normal, because deposits too small to see are often found in it under the microscope. You can live a normal life without it.
What the omentum is
It is a sheet of fatty tissue that hangs from the stomach like an apron and drapes over the bowel. It carries blood vessels and immune cells, and it moves towards areas of infection or injury in the abdomen to wall them off. That same habit is why cancer cells floating in the abdomen so often lodge in it.
Why removing it helps
Removing it does two things. It clears cancer that is already there, which is part of debulking. And it lets the pathologist check the whole sheet for tiny deposits, which decides the stage of the cancer. The chemotherapy plan is built on that stage.
Who it is done for
Omentectomy is a standard part of surgery for ovarian, tube and primary peritoneal cancer at any stage. It is also done for many stomach cancers and for some bowel cancers that have spread to the lining of the abdomen.
On your report the operation is written as omentectomy. Infracolic means the part below the bowel was removed; total or supracolic means the part near the stomach was taken too.Life without it
What changes when the omentum is gone, and what does not
Families often worry that an organ this large must be doing something you cannot manage without. It is not.
Digestion
Nothing changes. The omentum does not digest food or absorb it. The stomach and bowel carry on exactly as before, unless part of the bowel was also removed in the same operation.
Infection
The omentum helps wall off infection inside the abdomen. Without it, an infection after surgery may take a little longer to settle, which is one reason the team watches your temperature closely in the first days.
Tell the ward if
- A fever starts after you go home
- Belly pain gets worse rather than better
Weight and shape
The omentum stores fat, so some people notice their belly looks slightly different afterwards. Weight loss after this surgery comes from eating less, which needs attention.
Scar tissue
Any abdominal operation can leave bands of scar tissue inside, and without the omentum to cushion the bowel these can occasionally cause cramping or a blockage years later. It is uncommon, but worth knowing the signs.
Signs of a blockage
- Cramping pain that comes in waves
- Swelling of the belly and vomiting
- No wind or motion passed
Not sure whether this applies to you?
Ask an oncologistInside the operation
How is the omentum actually removed?
-
Reaching it
In a full debulking operation the abdomen is opened down the middle. The omentum is the first thing the surgeon sees, lying over the bowel like a blanket.
-
Lifting it away from the bowel
The surgeon separates the sheet from the large bowel it is attached to, sealing the small blood vessels as they go. This is careful work because the bowel wall sits just underneath.
-
Freeing it from the stomach
If the whole omentum is to be removed, the upper edge is freed from the curve of the stomach. Where cancer sits close to the stomach or spleen, this step takes longer.
-
Sending it to the laboratory
The whole sheet goes to pathology, where it is sliced and examined for deposits too small to see. The result appears on the pathology report as omentum, with either no tumour seen or the size of what was found.
On your report
Words about the omentum you will meet on your papers
- Omental cake
- What a scan report calls the omentum when it is thickened by cancer into a firm slab. It is a common finding in advanced ovarian cancer and is exactly what omentectomy removes.
- Infracolic omentectomy
- Removal of the part of the omentum below the large bowel. This is the usual operation when the omentum looks normal.
- Total or supracolic omentectomy
- Removal of the whole sheet, including the part attached to the stomach. Done when cancer is visible in the upper part.
- Omental biopsy
- A small piece taken rather than the whole sheet. Sometimes done in a keyhole operation to confirm the diagnosis before a bigger operation.
- Microscopic disease
- Cancer cells found in the omentum under the microscope that could not be seen during the operation. This can raise the stage of the cancer.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Commonly believed
Four things families ask about the omentum, and what is true
"The scan showed the omentum was normal, so why remove it?"
Scans cannot see deposits smaller than a few millimetres, and the omentum is the most common place for them to hide. Leaving it means leaving cancer in many patients, and it means the stage is guessed rather than measured.
"Removing the omentum will ruin her digestion."
The omentum plays no part in digesting or absorbing food. Eating after the operation is affected by the anaesthetic, pain medicines and any bowel surgery, not by the missing omentum.
"An omental cake means it is too late for surgery."
An omental cake is common in advanced ovarian cancer and is usually removable. Whether surgery comes first or after chemotherapy depends on how far the cancer has spread elsewhere, not on the omentum alone.
"If the omentum was clear, the cancer had not spread."
A clear omentum is good news, but the stage also depends on the lining of the abdomen, the lymph nodes and any fluid that was tested. Your oncologist puts all of these together before telling you the stage.
Did you know
Surgeons sometimes call the omentum the policeman of the abdomen, because it moves towards trouble and wraps itself around it. The same instinct that makes it useful against infection is what makes it collect cancer cells, and why it is removed.
Being straight with you
What this page cannot tell you, and what to ask your surgeon
This page cannot tell you whether your omentum will be removed, how much of it, or whether the rest of the operation will go as planned. Those depend on what the surgeon finds once the abdomen is open. It also cannot tell you the stage of your cancer, which comes from the pathology report some days after surgery.
Who the operation does not suit
Omentectomy on its own is a modest operation, but it is rarely done on its own. It sits inside a long debulking surgery, and the question is whether that whole operation is right for you. If the heart or lungs are weak, or the cancer is spread too widely to clear, your team may suggest chemotherapy first.
What to ask before you sign
Ask whether the whole omentum or only the lower part is planned. Ask whether the spleen might need to come out with it, because the two sit close together. Ask when the pathology report on the omentum will be back and who will explain it. Ask what to watch for at home in the first weeks, especially fever and belly pain.
Keep the discharge summary. It will say whether the omentum was removed and what the pathologist found, and every later doctor will ask for it.Questions we are asked
Common questions about omentectomy
Can you really live without the omentum?
Yes. It is removed in thousands of cancer operations every year and people go on to eat, work and live as before. It has no part in digestion. Its job of walling off infection is taken over by the rest of the abdominal lining,.
Is the omentum removed for every ovarian cancer?
For almost every one, including early-stage cancers, because checking it under the microscope is part of setting the stage. Even when a young woman keeps her womb and one ovary to have children later, the omentum is usually still removed and examined.
Does omentectomy add much to the operation time?
Not a great deal when the omentum looks normal. When it is thickened with cancer or stuck to the stomach, spleen or bowel, it takes longer and adds some risk of bleeding. Your surgeon can tell you which of these they expect from your scan.
Will I need a special diet afterwards?
Not because of the omentectomy. You may be asked to eat small, frequent meals in the first weeks after a long abdominal operation, and the ward dietitian will guide you. If part of the bowel was also removed, the advice will be different and specific to that.
The scan says omental cake. What does that mean?
It means the omentum has been thickened by cancer into a firm mass that looks like a slab on the scan. It is a common sign of ovarian cancer that has spread within the abdomen, and it is one of the things debulking surgery removes.
Can the omentum be removed by keyhole surgery?
In some early cancers, yes, as part of a keyhole staging operation. In advanced disease, where the omentum is heavy with cancer and other organs are involved, it is done through an open cut. Ask your centre which approach they are planning and why.
Why does the spleen sometimes come out with it?
The upper edge of the omentum is attached near the spleen. When cancer sits in that corner, separating the two safely is not always possible, and the spleen is removed as well. If this is a possibility, it will be on your consent form and you will be offered vaccines afterwards.
What if the pathology report finds cancer in the omentum?
It means the cancer had spread beyond the ovary, which sets the stage and shapes the chemotherapy plan. It is not a surprise to the team in most advanced cases. Ask your oncologist what the finding changes, because it is often less than families fear when they first read the word.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
Sources
- Cancer Research UK — Surgery for ovarian cancer
- American Cancer Society — Surgery for ovarian cancer
- National Cancer Institute — Ovarian epithelial, fallopian tube, and primary peritoneal cancer treatment (PDQ)
- Macmillan Cancer Support — Ovarian cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
What Debulking Surgery Actually RemovesThe full list of organs on a debulking consent formSplenectomy as Part of DebulkingWhy the spleen sometimes comes out with the omentumPeritonectomy and Stripping the DiaphragmThe other lining that is peeled away in the same operationThe Pathology Report After SurgeryWhere the finding on the omentum will appearComplications and Red FlagsFever and belly pain after you go home
Talk to us
Omentectomy on your consent form?
Send us the scan report or call the helpline. A surgical oncologist will explain what is planned, why, and what to ask before the operation.