Management of early-stage ovarian cancer

INCISION SELECTION AND MANAGEMENT Abdominal Wall Anatomy A detailed knowledge of the abdominal and pelvic anatomy is crucial to the success of a gynecologic surgeon. The layers of the abdominal wall include skin, superficial fascia, external oblique, internal oblique, transverse abdominis muscles and aponeuroses, transversalis fascia, preperitoneal fat, and parietal peritoneum (Fig. 1). The combination of aponeuroses and muscles cross each other in such a way that strengthens the anterolateral abdominal wall. The three flat muscles of the Table 1 FIGO Staging for Primary Carcinoma of the Ovary Stage Description I Growth limited to the ovaries IA Growth limited to one ovary; no ascites. No tumor on the external surface; capsule intact IB Growth limited to both ovaries; no ascites. No tumor on the external surfaces; capsule intact IC Tumor either stage IA or IB, but with tumor on surface of one or both ovaries; or with capsule ruptured; or with ascites present containing malignant cells or with positive peritoneal washings II Growth involving one or both ovaries with pelvic extension IIA Extension and/or metastases to the uterus and/or tubes IIB Extension to other pelvic tissues IIC Tumor either stage IIA or IIB, but with tumor on surface of one or both ovaries; or with capsule or capsules ruptured; or with ascites present containing malignant cells or with positive peritoneal washings III Tumor involving one or both ovaries with peritoneal implants outside the pelvis and/or positive retroperitoneal or inguinal nodes.