Hyperthermic Intraperitoneal Chemotherapy, or HIPEC, is a treatment option for patients with advanced cancers that have spread to the abdominal cavity, or peritoneum.
Doctors begin with what is called “cytoreductive surgery” to remove all visible tumors in the abdominal area.
The extent of the surgery depends on the findings during surgery.
Surgery can involve the removal of tumors in the upper and lower abdominal area
on the omentum, on the liver, stomach, small intestine, colon, rectum, pancreas, spleen, appendix, uterus, ovaries, and the peritoneal surfaces.
Surgery to remove tumors is thorough and aggressive, with the goal of preserving organs whenever possible.
The doctor carefully examines the abdominal region, quadrant by quadrant, searching for and removing tumors.
With great care, the doctor uses highly specialized surgical techniques to strip the tumors from the peritoneal surfaces and organs, and seal small blood vessels.
All of the visible tumors are removed.
Next, the doctor administers the HIPEC, or heated chemotherapy treatment with the goal of killing any remaining cancer cells that cannot be seen.
Tubes and temperature probes are placed into the abdominal cavity.
The doctor briefly closes the skin of the abdomen with sutures.
The abdominal cavity is flooded with a solution that includes chemotherapy drugs. This solution is heated.
The tubes and probes are connected to a machine. This controls the temperature and flow of the solution.
The heated chemotherapy solution is continuously circulated throughout the abdominal cavity so that the cavity is uniformly exposed to heat and chemotherapy.
The combination of heat and chemotherapy causes the solution to kill microscopic cancer cells.
Gentle shaking is applied to the abdomen to help the solution distribute to all surfaces within the abdomen.
Following the HIPEC treatment, the fluid is drained from the abdominal cavity.
The abdomen is reopened, and the tubes and probes are removed.
At this time any necessary reconstructive surgery is performed. For example, the doctor may need to reconnect a resected colon.
Finally, the doctor closes the abdominal incision. The surgery and HIPEC treatment together may take 6-12 hours to complete.