Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Salpingo-oophorectomy


Related Terms

  • Adnexal Surgery
  • Excision of Fallopian Tube and Ovary

Specialists

  • Gynecologist
  • Obstetrician/Gynecologist

Comorbid Conditions

  • Allergies to anesthesia
  • Allergies to pain medications
  • Heart and lung conditions
  • Obesity
  • Previous abdominal surgeries

Factors Influencing Duration

Length of disability may be influenced by type of procedure (laparoscopy, minilaparotomy, laparotomy, or colpotomy), reason for the procedure, and complications related to the surgery and anesthesia.

Medical Codes

ICD-9-CM:
65.41 - Laparoscopic Unilateral Salpingo-oophorectomy
65.49 - Other Unilateral Salpingo-oophorectomy
65.61 - Other Removal of Both Ovaries and Tubes at Same Operative Episode
65.62 - Other Removal of Ovary and Tube
65.63 - Laparoscopic Removal of Both Ovaries and Tubes at Same Operative Episode
65.64 - Laparoscopic Removal of Remaining Ovary and Tube

Overview

© Reed Group
Salpingo-oophorectomy is a surgical procedure involving the removal of one or both of the fallopian tubes (salpingectomy) and one or both ovaries (oophorectomy).

In a unilateral salpingo-oophorectomy procedure, only one fallopian tube and one ovary are removed. In the bilateral procedure, both fallopian tubes and both ovaries are removed. In premenopausal women, an attempt is made whenever possible to preserve ovarian function by removing only one ovary or a part of one ovary.

Source: Medical Disability Advisor



Reason for Procedure

A salpingo-oophorectomy may be performed to remove fluid-filled sacs (ovarian cysts) that do not respond to conservative treatment, benign tumors (fibromas or teratomas), or abscesses. It is also done to treat chronic inflammation of the fallopian tubes (chronic salpingitis or tuberculous salpingitis), infections caused by pelvic inflammatory disease, and endometrial cells in the pelvic cavity (endometriosis). The procedure is used to remove the results of a pregnancy that develops in a fallopian tube rather than in the uterus (ectopic pregnancy), if a simple incision into the fallopian tube to remove the pregnancy (salpingostomy) cannot be performed.

Salpingo-oophorectomy is used to treat ovarian cancer and may also be performed with a hysterectomy as a part of the treatment for uterine cancer or for treatment of a cancerous tumor derived from placental tissue (choriocarcinoma). Salpingo-oophorectomy is used in breast cancer cases when the physician considers that a reduction in the amount of hormones produced by the ovaries (estrogens) may slow the growth of the cancer. Besides treating existing ovarian cancer, the procedure is sometimes used to remove healthy ovaries as a preventive (prophylactic) measure in reducing the risk of breast or ovarian cancer in high-risk women.

Source: Medical Disability Advisor



How Procedure is Performed

The salpingo-oophorectomy procedure is performed in a hospital or outpatient clinic under regional or general anesthesia. Laparoscopy is the most common method and begins with inflating the abdominal cavity with carbon dioxide gas (pneumoperitoneum) to allow visualization of the abdominal contents, provide an open work space, and reduce the incidence of complications. The gas is injected into the abdominal cavity through a needle (Veress needle). A tiny incision is made in the abdomen in or near the navel. The surgeon inserts a slender, lighted, telescope-like instrument (laparoscope) through the incision. A second small incision is made just above the pubic hairline, and a probe or other instruments are inserted to locate and remove the ovaries and fallopian tubes.

Another often-used method is called the minilaparotomy. It requires an incision about 2 inches long in the lower abdomen and does not employ a viewing instrument. The incision provides direct access for the removal of the ovaries and fallopian tubes.

A third, less common, more invasive method is called laparotomy and requires a horizontal or vertical incision in the lower abdomen. Laparotomy is used when there is widespread internal scar tissue (adhesions) from previous surgeries, when there is an ovarian cyst larger than 10 centimeters or a solid mass larger than 5 centimeters, and when the ovaries and fallopian tubes need to be removed intact, as in the case of cancer (DeSimone).

Two other procedures called magnified visual inspection (culdoscopy) and surgical incision in the vagina (colpotomy), respectively, facilitate reaching the ovaries and fallopian tubes through the vagina rather than the abdomen. Neither of these procedures is often used due to the increased risk of infection and limited exposure of the surgical site.

Decisions regarding the most appropriate method to be used depend on the woman's age, weight, previous lower abdominal surgeries, suspicion of cancer (malignancy), heart and lung conditions, and other considerations.

Source: Medical Disability Advisor



Prognosis

The predicted outcome after salpingo-oophorectomy depends on the reason for the procedure (i.e., removal of cysts, benign tumors, or abscesses; or treatment of endometriosis, pelvic inflammatory disease, or ovarian or breast cancer), the method used (laparoscopy, minilaparotomy, laparotomy, or colpotomy), and whether the procedure was unilateral or bilateral.

If the procedure is done to remove cysts, benign tumors, and abscesses located in or on the ovaries or fallopian tubes, removal of the ovaries and fallopian tubes in most cases produces a successful outcome. If the purpose of the procedure is to treat endometriosis, a condition in which the inner lining of the uterus (endometrium) grows in or on the fallopian tubes and ovaries as well as in the uterus, removal of the tubes and ovaries may also lead to a successful outcome if the endometriosis is localized. If, however, endometrial growth has occurred at other body sites, such as the intestines, bladder, and rectum, then treatment with salpingo-oophorectomy will not be completely successful.

If ovarian cancer is the reason for the procedure, the success of the procedure depends on the stage of the cancer. If the cancer has spread outside the ovaries and fallopian tubes, a salpingo-oophorectomy provides only partial treatment. It delays the spread of the cancer and alleviates symptoms but is not a cure. Similarly, if the procedure is being done to treat pelvic inflammatory disease and the inflammation has spread to sites other than the fallopian tubes and ovaries, the treatment will not be completely successful.

In general, most individuals recover fully, experiencing no problems from the anesthesia or the surgery with any of the methods. Individuals treated with the laparoscopic method recover more quickly with fewer problems than those treated with laparotomy. Whether the procedure is unilateral or bilateral usually does not affect the outcome, because the effect of the procedure and the healing from the surgery occur at much the same rate for removal of one or both fallopian tubes and ovaries. However, hormonal complications for premenopausal women may arise if both ovaries are removed. After bilateral oophorectomy, the woman will be at increased risk for osteoporosis, coronary heart disease, lung cancer, and cognitive impairment (dementia) unless hormone replacement therapy is implemented, and will become infertile.

Source: Medical Disability Advisor



Complications

As with any procedure performed under general anesthesia, reaction to the anesthesia and breathing problems are possible complications. Other complications include bleeding (hemorrhage), infection, blood clots (thromboembolism), or bands of scar tissue (adhesions) that can cause pain, infertility, and / or intestinal blockage. On rare occasions, the bowels or vessels may be injured during surgery and require additional surgical repair.

Longer-term complications occur when ovaries are removed prior to menopause. When unilateral salpingo-oophorectomy is used for premenopausal women, normal hormone production continues in the remaining ovary. However, when bilateral salpingo-oophorectomy is used for premenopausal women, normal hormone production is halted. Bilateral salpingo-oophorectomy causes acute menopause, a condition that often requires hormone replacement therapy. Since estrogen levels in premenopausal women are higher than those in postmenopausal women, premenopausal women require a much higher dose of estrogen or hormone replacement than women entering menopause naturally.

Following bilateral salpingo-oophorectomy, the woman will be infertile.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Extended sick leave may be necessary, depending on the procedure. The length of sick leave is contingent on the age of the woman, surgical complications, and resulting diagnoses and prognoses.

Most individuals treated with laparoscopies can return to work or resume previous activities with minor restrictions, such as refraining from strenuous exercise or heavy lifting for 2 to 4 weeks. Individuals treated with more invasive procedures (mini-laparotomy and laparotomy) usually require a longer leave of absence from work and stricter restrictions for 4 to 6 weeks ("Salpingo-oophorectomy").

Allowances may also have to be made for rest periods at work, shorter work hours, and / or fewer workdays per week. Additional sick leave may be necessary if postsurgical treatment includes chemotherapy and radiation. Use of prescribed medications for management of pain and inflammation may require review of drug policies. Safety issues may need to be evaluated.

Source: Medical Disability Advisor



References

Cited

"Salpingo-oophorectomy." Encyclopedia of Surgery. Advameg, Inc. 31 Jul. 2009 <http://www.surgeryencyclopedia.com/Pa-St/Salpingo-Oophorectomy.html>.

DeSimone, Christopher P., and Frederick R. Ueland. "Gynecologic Laparoscopy." Surgical Clinics of North America 88 2 (2008): 319-341. MD Consult. Elsevier, Inc. 31 Jul. 2009 <http://www.mdconsult.com/das/article/body/152227320-3/jorg=clinics&source=MI&sp=20695541&sid=869515493/N/646844/1.html?issn=0039-6109>.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.