This chapter discusses Omentectomy, an integral part of many gynecological surgical procedures for aberration inside the peritoneal cavity, be it infection, inflammation hemorrhage, intestinal leaks. Omental ‘J’ flap qualifies as an ideal interposition flap because of it’s rich blood supply and lymphatic drainage. An interposition flap is used in reconstructions as it increases success rate by increasing neovascularity, facilitating granulation formation, and providing cover/barrier layer as in VVF repair. Reconstruction after major oncological resections is a challenge. Transverse rectus abdominis flap (TRAM) is a versatile flap which meets most of the demands of reconstruction following extensive pelvic tumor resection especially in a setting of previously irradiated pelvis. The TRAM flap provides a very large skin paddle which can result in very large skin defects of perineum, and can also be used bilaterally.