Second-look laparotomy

The second-look laparotomy has become an important means of assessing therapy response in ovarian cancer patients. This procedure enables the gynecologic oncologist to diligently search for small volume persistent disease, which often escapes detection by less invasive means. Subsequent treatment, if required, may then be tailored to the initial biologic response to therapy. However, many patients with negative findings at second look will develop recurrent disease, dampening enthusiasm for the operation. Although controversial, this procedure remains the gold standard for the detection of disease status following chemotherapy for ovarian cancer.