What is PIPAC Surgery?

PIPAC stands for Pressurized IntraPeritoneal Aerosol Chemotherapy. It is a minimally invasive surgical technique used in the treatment of peritoneal metastases, which are cancerous tumors that have spread to the lining of the abdominal cavity (peritoneum). PIPAC Surgery involves delivering chemotherapy directly into the abdominal cavity in the form of an aerosolized mist under increased pressure.

Here's how PIPAC Surgery Typically Works :

• Preparation : Before the procedure, the patient may undergo imaging tests such as CT scans to assess the extent and location of peritoneal metastases. They may also receive chemotherapy to shrink the tumors.
• Surgical Procedure : PIPAC Surgery is performed under general anesthesia. Small incisions are made in the abdomen to insert ports for the laparoscope (a thin, flexible tube with a camera) and for the introduction of the chemotherapy solution. Carbon dioxide gas is then used to inflate the abdominal cavity, providing space for the surgeon to work.
• Chemotherapy Administration : Once the abdominal cavity is prepared, a nebulizer device is inserted through one of the ports. This device delivers a fine mist of chemotherapy solution, which is pressurized to ensure uniform distribution throughout the abdominal cavity. The chemotherapy aerosol is circulated for a specific duration to allow the medication to come into contact with the cancerous tumors on the peritoneal surface.
• Closure : After the chemotherapy aerosol has been administered and circulated, the ports are removed, and the incisions are closed with sutures or surgical tape.

PIPAC Surgery Offers Several Potential Advantages Over Traditional Forms of Chemotherapy for Peritoneal Metastases Including :

• Localized Delivery : PIPAC delivers chemotherapy directly to the site of the cancerous tumors in the abdominal cavity, minimizing systemic side effects.
• Increased Concentration : The pressurized aerosol allows for better penetration of chemotherapy into tumor tissues.
• Repeated Administration : PIPAC can be repeated at regular intervals to maintain tumor control and potentially improve outcomes.
• Minimally Invasive : PIPAC is a minimally invasive procedure, typically resulting in shorter hospital stays and faster recovery times compared to open surgeries.

PIPAC Surgery is still a relatively new technique and may not be widely available at all medical centers. It is typically offered to patients with peritoneal metastases who may not be candidates for traditional forms of treatment such as surgery or systemic chemotherapy. As with any medical procedure, PIPAC carries potential risks and side effects, which should be discussed with a healthcare provider.