Divide-and-Resect: A Two-Piece Infra-Colic Omentectomy Technique

Omentectomy, the surgical removal of part or all of the omentum, is a fundamental component of FIGO staging and cytoreductive surgery for various gynecologic malignancies. Although historically performed via laparotomy, minimally invasive techniques have gained increasing acceptance, offering the potential benefits of reduced morbidity and faster recovery.

To present a novel laparoscopic technique designed to facilitate a safe, straightforward, and effective omentectomy.

Laparoscopic omentectomy performed as part of an interval cytoreductive surgery.

A 66-year-old woman with advanced High-grade serous carcinoma of tubo-ovarian origin, following neoadjuvant chemotherapy.

The procedure begins with placement of the laparoscopic camera through a suprapubic trocar, directed cranially toward the upper abdomen to optimize visualization. The omentum is divided at the midline and dissected toward the transverse colon, separating it into left and right segments. Dissection is performed in a medial-to-lateral direction, beginning on the left side and followed by the right, ensuring controlled traction and clear identification of tissue planes.

This approach enables complete upper abdominal omental resection safely and efficiently while maintaining the advantages of minimally invasive surgery.

1-5.