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Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC)

What is PIPAC used for?

PIPAC is a novel technology that can be used in the treatment of patients with cancer that has spread to the peritoneum. The peritoneum is a special lining that covers all organs within the abdomen – like filmy plastic wraps that we use to cover food items.

While Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS & HIPEC) is used for curative treatment in such patients, in those with extensive amounts of cancer cells affecting the lining, a big surgery is not possible. This is when PIPAC may be used to control the cancer. Chemotherapy is given a spray form (gaseous state) during PIPAC to increase distribution and absorption by cancer cells on the lining.

During PIPAC

A key hole approach is used to insert a camera into the abdomen. Subsequently, chemotherapy in an aerosolized form (converted from liquid to gas via an instrument called the capnopen) is given into the tummy and left for absorption for 30minutes. The whole procedure takes 1-2hours.

What to expect after PIPAC?

Post-PIPAC, patients are discharged within 2-4 days. Common side effects include mild abdominal pain (15%) and pancreatitis (< 5%) – both may be treated with painkillers with no serious sequele. PIPAC may be repeated every 6-8weeks multiple times to achieve maximum effect, and can be used in patients who are also receiving chemotherapy via their veins.