Feasibility of laparoscopic peritonectomy followed by intra-peritoneal chemohyperthermia: an experimental study.
OBJECTIVE
Hyperthermic intraperitoneal chemotherapy (HIPEC) is being evaluated for patients with minimal residual or no residual disease after primary surgery and chemotherapy for stage III ovarian carcinoma. The use of operative laparoscopy to perform peritonectomy and HIPEC is reported.


METHODS
Five adult pigs were used. The placement of trocars in the four quadrants was planned in order to complete a total peritonectomy and then to place the HIPEC drains. The umbilical trocar was then replaced manually by the surgeon through a Lapdisc to manipulate the bowel loops. The abdominal cavity was filled with heated saline (43 degrees C), and the pumps were activated for 30 min.


RESULTS
The procedure was successfully completed with an adequate intraabdominal temperature and distribution.


CONCLUSIONS
These preliminary data suggest the technical feasibility of the laparoscopic approach for HIPEC, in an animal model without carcinomatosis. Our ongoing research is designed to gather pharmacokinetic data in an experimental controlled randomized fashion to compare a laparoscopic to a laparotomy approach on the same model.
Ferron
Gwénaël
G
Department of Surgical Oncology, Institut Claudius Regaud Cancer Center, 20-24 Rue du Pont Street Pierre, 31052 Toulouse Cedex, France. ferron@icr.fnclcc.fr
Gesson-Paute
Amélie
A
Classe
Jean-Marc
JM
Querleu
Denis
D
D000818:Animals; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral; D010535:Laparoscopy / Q000379:methods*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D010537:Peritoneum / Q000601:surgery*; D010865:Pilot Projects; D012965:Sodium Chloride / Q000008:administration & dosage; D013552:Swine
D012965:Sodium Chloride