Generally, no. Surgeons do not remove visceral fat around organs as an add-on during other operations. They remove only what is necessary for the planned procedure or an urgent, life-threatening problem that arises, and only with informed consent or under an emergency exception. Extra removal increases operative time and risk without medical benefit, so it is not done for weight loss or cosmetic reasons.
What is visceral fat?
Visceral fat is the internal fat stored deep in the abdomen that surrounds organs like the liver, intestines, and pancreas. It is different from subcutaneous fat, which sits under the skin.
Visceral fat is metabolically active fat inside the abdominal cavity around your organs, and it is linked to higher risks of diabetes, heart disease, and other conditions (Cleveland Clinic).
Do surgeons remove visceral fat during unrelated surgeries?
No. Surgery is planned around a specific diagnosis and a specific consent. Removing extra tissue that is not part of that plan offers no benefit, adds bleeding and infection risk, and lengthens anesthesia time. Longer operations are independently associated with more complications and higher surgical site infection risk (CDC SSI Guideline).
There is also a legal and ethical boundary: outside of emergencies, clinicians must obtain informed consent before initiating additional treatment that a reasonable person would consider material to their decisions. Performing an added procedure without consent can constitute medical battery (AMA Code of Medical Ethics, AMA Journal of Ethics).
Except in emergencies when a patient cannot consent and immediate intervention is necessary to prevent death or serious harm, physicians must obtain the patient’s informed consent before treatment (AMA).
When do surgeons remove fat or the omentum?
Fat is often part of the normal anatomy encountered in surgery, and some fat is removed when it is inseparable from the target or contains critical structures. For example:
- Exposure and safety: Surgeons may remove a small amount of fat to safely access the organ being operated on.
- Vessels and lymph nodes run in fat: The major blood supply and lymph nodes of organs often course through fatty tissue. In cancer operations, surgeons remove fat that contains lymph nodes and vessels as part of an oncologic resection.
- Omentectomy: The omentum is a sheet of visceral fat that can harbor tumor spread. It is routinely removed in specific cancers, such as ovarian or gastric cancer, for staging and treatment (NCI ovarian cancer treatment).
These removals are not for weight loss, they are part of treating the underlying disease and are covered by the consent for that operation.
Are there any “while we are in there” exceptions?
There are limited situations:
- Pre-consented possibilities: Before surgery, your consent may cover reasonable add-ons if found, for example sampling a suspicious lymph node or removing a diseased appendix discovered during a planned abdominal operation.
- Urgent findings: If the team discovers an immediately life-threatening problem, they may act under the emergency exception to consent if you cannot be consulted and delay would risk death or serious harm.
- Non-urgent incidental issues: If an unrelated problem is found that is not emergent, the standard is to stop, wake you, and obtain consent for a second operation or a broadened procedure at a later time.
In short, surgeons do not “clean up” extra fat or remove additional organs on the fly. Any deviation from the plan must be medically necessary, consented, and safe.
Can surgery remove visceral fat for weight loss?
Not directly. Cosmetic fat-removal procedures like liposuction target subcutaneous fat under the skin, not the internal visceral fat around organs.
Liposuction removes fat between skin and muscle, it does not remove intra-abdominal visceral fat and is not a weight-loss treatment (Cleveland Clinic).
Bariatric surgery promotes weight loss and metabolic improvement by changing the stomach or intestines, which reduces calorie intake and alters hormones. As patients lose weight, both subcutaneous and visceral fat decrease over time, but the fat is not cut out directly (NIDDK bariatric surgery overview).
Removing large amounts of visceral fat as a stand-alone strategy is not a standard or recommended practice. Trials that added surgical removal of the omentum to bariatric procedures have not shown clear added metabolic benefit, so omentectomy is not routinely performed for weight loss.
What this means for patients
- Ask your surgeon exactly what the operation includes and what potential findings they are authorized to treat during the same anesthesia.
- If you have concerns about future issues, discuss them before surgery so consent can reflect your preferences.
- For reducing visceral fat, focus on treatments proven to improve health, such as lifestyle changes and, when appropriate, bariatric surgery. There is no safe shortcut to remove visceral fat during unrelated operations.