Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a highly specialized procedure used to treat certain types of cancers that have spread to the lining of the abdomen or peritoneum. This procedure involves removing visible tumors from the peritoneum and then delivering a heated chemotherapy solution directly into the abdominal cavity, where it can penetrate the microscopic cancer cells that may be present. 

Before the HIPEC procedure

Before the HIPEC procedure, patients will undergo several pre-operative assessments to ensure they are suitable candidates. These assessments may include blood tests, imaging studies, and physical examinations. Patients will also receive detailed instructions on how to prepare for the procedure, including dietary restrictions and medication adjustments. 

During the HIPEC Procedure

The HIPEC procedure begins with cytoreductive surgery (CRS), a surgical procedure that aims to remove all visible tumors from the peritoneum. This involves making a large incision in the abdomen and carefully removing any visible tumors. The surgeon will then spend several hours meticulously examining the entire peritoneal cavity to ensure that all visible tumors have been removed. 

After CRS, the HIPEC solution is delivered directly into the abdominal cavity via catheters that are placed through small incisions in the abdomen. The chemotherapy solution used in HIPEC is heated to between 41-43°C and circulated throughout the peritoneal cavity for approximately 90 minutes. The heat of the solution enhances the effectiveness of the chemotherapy and helps to penetrate any microscopic cancer cells that may be present. After the chemotherapy has been circulated for the desired amount of time, it is drained from the abdomen and the incisions are closed.

After the HIPEC Procedure

Post-operatively, patients will require close monitoring in a specialized unit with trained nurses and medical professionals. Patients may experience pain, fatigue, and weakness for several weeks or even months after the procedure. Patients will need to be closely monitored for signs of infection or other complications, and may require additional treatment such as antibiotics or pain medications. A multidisciplinary team, including surgeons, oncologists, and nursing staff, will work together to manage post-operative care and recovery.

Recovery from HIPEC is typically longer and more difficult than recovery from traditional surgery. Patients will require extensive support from healthcare professionals and family members during the recovery period. Patients will need to follow strict guidelines for wound care and medication management. Rehabilitation, including physical therapy, may also be necessary to help patients regain strength and mobility.

Not all patients with peritoneal surface malignancies are candidates for HIPEC. The procedure is typically reserved for patients with certain types of cancers, such as appendiceal cancer, ovarian cancer, or mesothelioma, that have spread to the lining of the abdomen. Additionally, patients who are not in good overall health may not be candidates for this procedure.

SUMMARY 

In conclusion, HIPEC is a highly specialized procedure that can be an effective treatment option for certain types of cancer that have spread to the lining of the abdomen. Patients considering this procedure should be fully informed of the pre-operative requirements, the procedure itself, and the post-operative recovery process. The procedure should only be performed by experienced surgeons who are trained in both CRS and HIPEC techniques. Patients should discuss the risks and benefits with their healthcare provider and carefully weigh their options before making a decision.

By Recmed Medical - General Surgeons and Medical Oncology Team ( Click this link to see our doctor for this treatment)