Primary debulking surgery of the upper abdomen and the diaphragm, with a plasma device surgery system, for advanced ovarian cancer.
OBJECTIVE
Electrically neutral argon plasma (PlasmaJet™) technology is a surgical option that helps to get an aggressive cytoreduction in selected patients with ovarian cancer because it can be directly applied by the surgeon to treat the tissue surface [1,2]. Upper abdominal surgical procedures are an important part of the surgery in these patients [3], there is a 22% complications rate when they are performed [4]. We present a surgical approach to ovarian cancer debulking using PlasmaJet™.


METHODS
Case history and operative technique: 51 women supported for ovarian cancer Stage IIIC-IV were operated with systematic use of the PlasmaJet device at the Regional Institute Bergonié Cancer Center of Bordeaux, France between June 2012 and June 2014. 41.2% (n=21) patients underwent a Primary Debulking Surgery (PDS) and 58.8% (n=30) underwent an Interval Debulking Surgery. 78.4% (n=40) of the 51 patients studied had a complete cytoreduction. We present the case of a woman diagnosed with a mucinous ovarian carcinoma FIGO stage IVA, who underwent a PDS. Complete cytoreduction to no macroscopic disease was achieved, this included diaphragmatic and abdominal peritoneal stripping.


RESULTS
No post-operative complications were found in this case. 15.7% (n=8) of patients undergoing diaphragmatic stripping with the PlasmaJet required a pleural drain. It is a safe structured procedure, which could be performed to achieve optimal surgical results for patients with ovarian cancer.


CONCLUSIONS
PlasmaJet™ helps the surgeon to perform a peritoneal stripping of the upper abdominal areas and appears to enable the surgeon to remove more disease without increased morbidity, pushing the cytoreduction/morbidity tradeoff.
Institut Bergonié, Centre regional de lutte contre le cancer, 229, cour, Bordeaux, France.
Gloria
G
Cordeiro Vidal
Institut Bergonié, Centre regional de lutte contre le cancer, 229, cour, Bordeaux, France.
Guillaume
G
Babin
Institut Bergonié, Centre regional de lutte contre le cancer, 229, cour, Bordeaux, France.
Denis
D
Querleu
Institut Bergonié, Centre regional de lutte contre le cancer, 229, cour, Bordeaux, France.
Frédéric
F
Guyon
D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000601:surgery*; D057908:Argon Plasma Coagulation / Q000295:instrumentation; D065426:Cytoreduction Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D003964:Diaphragm / Q000601:surgery*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000601:surgery*
Cytoreduction; Debulking; Diaphragmatic surgery; Ovarian cancer; Plasma