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Step-By-Step Information on Operation Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Posted on: October 15, 2023 *Updated on: May 27, 2024

This article outlines the operation cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). The following is the sequence of the procedure.

  1. Incision: The laparotomy incision provides a wide access to the abdominal cavity, allowing the surgeon to thoroughly assess and remove tumors.
  2. Cytoreduction: The objective is to remove all visible tumor, termed a “complete cytoreduction.” The omentum, which is a large fatty structure that drapes over the intestines, is often involved with tumor and is thus removed.
  3. Peritonectomy: Not all patients undergo peritonectomy. The decision is based on disease involvement and the potential benefits vs. risks.
  4. Removal of other organs: Depending on tumor spread, sometimes portions of organs or entire organs (like the spleen, parts of the intestines, gallbladder, etc.) may need removal to achieve complete cytoreduction.
  5. HIPEC Preparation: This is pivotal for the chemotherapy delivery. Ensuring that the catheters are correctly placed is vital for even distribution of the chemotherapy throughout the abdominal cavity.
  6. Reconstruction: The choice between the closed-abdominal and open-abdominal technique might depend on surgeon preference, patient-specific factors, or the specifics of the disease. Both methods aim to ensure that the chemotherapy has maximum contact with the abdominal surface.
  7. HIPEC: The heated chemotherapy is believed to penetrate tissues more effectively, while the heat itself can have direct cytotoxic effects on the tumor cells.
  8. HIPEC drainage: Efficient removal of the chemotherapy minimizes potential systemic absorption and related side effects.

For anyone considering or learning about this procedure, this step-by-step outline provides a clear overview of what to expect. However, patient experiences can vary, and individualized care is paramount.