Video summary: Peritonectomy and HIPEC

March 28, 2008 § 11 Comments

Peritonectomy

This is a video I’ve made of a peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei. The video is published on www.oncolex.no in Norwegian. I’ve written a short summary of the video in English.

Peritonectomy

  • Preoperative MRI show:
    • Tumor tissue and mucus in the abdominal cavity right up to the diaphragm.
    • Tumor and mucus has pushed the small intestine to the back of the abdomen, and the colon to the anterior abdominal wall.
  • Opening the abdomen reveals thick mucus in cystic cavities.
  • The tumor has infiltrated the greater omentum and the transverse colon with adherences to the anterior abdominal wall.
  • Dissection of the tumor/omentum along the ascending colon.
  • Exposing the small intestine. Removing mucus.
  • Tumor in the coecum/appendix area.
  • Cutting the ileum 20 cm above the coecum with a stapler.
  • Sealing and cutting the rectum with a stapler.
  • Cutting adherences along the diaphragm and around the liver.
  • Removing the operation specimen, consisting of the greater omentum, colon, rectum and 20 cm of the terminal ileum.
  • Stripping the peritoneum from the diaphragm using electrocautery.

HIPEC

  • Coliseum technique:
    • Clamping forceps around the wound edges.
    • Fixing forceps to Bookwalter’s ring using plastic strips.
    • Abdominal wall forms a basin (“coliseum”).
  • Placing catethers for solution flow and temperature probes in the abdomen.
  • Controlling flow before covering the wound.
  • The solution is circulated throughout the patient’s abdomen via a heat exchanger. It keeps the solution at 40-41 Celsius and flow at 800-1000 millilitres per minute.
  • Adding chemotherapy to the solution. This is done at the start, after 30 minutes and after 60 minutes.
  • Stiring the solution to spread over all surfaces.
  • The chemotherapy solution is circulated with continous stiring for 90 minutes.

Watch the HIPEC video

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§ 11 Responses to Video summary: Peritonectomy and HIPEC

  • Stephen Stewart says:

    I am giving a presentation on chemoperfusion to a predominantly perfusion audience and am requesting permission to use segments of your video for this presentation. Please let me know if this is possible. Appropriate recognition would, of course, be given. Thank you.

  • Øystein says:

    Stephen,
    Thanks for the request. Check your e-mail.

    • Jenny Preka says:

      Hello, I am a 5th year medical student from Greece that will make a presentation to our surgery department about peritonectomy and HIPEC. Your site helped me a lot realizing how this is performed. Would you have a problem to send it to me in order to present it with my lecture? It would be nery interesting for all our surgeons here because this is not performed in our university hospital. I would really appreciate it so much, thank you in advance, anyway. My best regards, Jenny Preka.

  • Prekas Lampros says:

    I am medical student and i am requesting permission to use segments of your video for a presentation. Please let me know if this is possible. Appropriate recognition would, of course, be given. Thank you.

  • BENNY PAUL.M says:

    I am giving a presentation on HIPEC to a predominantly perfusion audience and am requesting permission to use segments of your video for this presentation. Please let me know if this is possible. Appropriate recognition would, of course, be given. Thank you.

  • s lolohea says:

    hi

    i am doing a few peritonectomy in nz and your coliseum set up looks very good. would appreciate if u could send me a set up diagram /video etc if possible. regards.

  • Chris Whitney says:

    I’m a PHO at a hospital in Brisbane Aust (PAH). Would like to use a section of your video for presentation. I would be very grateful for permission and will give appropriate recognition. Kindest regards.

  • Nabil Wasif says:

    Would appreciate a copy of your excellent video in mpeg format for presentation purposes. I am a surgeon in the US.

  • Ann-Katrin Krokström says:

    Hello. I am a patient with Polymyxoma Peritonei. I did a peritonectomy in october 2013 in Uppsala innSweden. Really interesting to see your video. Thanks for sharing it.

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