Though there have been many advances in the field of chemotherapy, they haven’t been successful in curing cancers of the abdominal cavity; and in fact, cause many side effects that are often difficult for the patient to endure. Also, cancers of the abdominal cavity lining are difficulty to treat using these methods.

It is here that HIPEC or Hyperthermic Intraoperative Peritoneal Chemotherapy is useful. The word ‘Intraperitoneal’ is used to indicate that the treatment is given directly to the abdominal cavity lining. The word ‘Hyperthermic’ is used to indicate that the chemotherapy solution is heated to a temperature which is greater than the regular body temperature.

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HIPEC is a novel technique in treating those abdominal malignancies, which were previously thought to be untreatable and were only offered palliative care.

In these patients, the cancer is seen in the form of sand like particles over the inner layer of the abdominal cavity called as peritoneal sheath. Such type of spread is usually seen in the following cancers:

  • Primary peritoneal cancer
  • Ovarian cancer
  • Appendicular cancer
  • Pseudomyxoma perotonie
  • Colorectal malignancy
  • Some pancreatic and gastric cancers



Before HIPEC procedure is performed, the surgeon uses standard surgical techniques to remove parts of the tumour visible clinical all across the peritoneal cavity. This is usually done by a cytoreductive surgery. Once this is done, the surgeon administers HIPEC treatment.

During the procedure, the surgeon circulates a heated sterile chemotherapeutic solution throughout the peritoneal cavity for up to a maximum of 2 hours. Once all the tumours are removed, the heated, sterilised chemotherapy solution (with a temperature between 41-43 degrees celsius) is delivered to the abdomen for approximately 1 1/2 hours to penetrate and destroy remaining cancer cells. Thereafter, the solution is drained from the abdomen and incision is closed. During this procedure, the chemotherapeutic drug is absorbed by the peritoneal cavity and so, there is little or no exposure to the remaining part of the body.

The procedure is aimed at killing the remnants of cancer cells that may have been left behind after the surgical removal of the tumour (that are too small to be seen or removed surgically). This also prevents the development of new tumours.


Cytoreductive surgery with HIPEC is an involved procedure that lasts an average of 8-14 hours, depending on the extent of the disease. Patients typically remain in the hospital for 10-12 days following surgery.

Total recovery period post-surgery is about 4-6 weeks but sometimes it may be up to 8-12 weeks.

The most challenging aspect of recovery is fatigue. It will likely take two or three months until you begin to feel back to normal. Until then, it is important to stay active (within your limits) and maintain good nutrition.

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