Laparoscopic continuous hyperthermic peritoneal perfusion.

Peritoneal carcinomatosis occurs as an advanced stage of certain malignancies and is often considered incurable. 1 No good standard treatment options exist, so new and innovative treatments must be sought and investigated to combat this stage of disease. These treatments may be used as an adjuvant after surgical resection or to palliate symptoms such as ascites in patients with bulky disease. Regional intraperitoneal chemotherapy provides prolonged high concentration of a cytotoxic agent directly to intraperitoneal tumor cells while limiting systemic exposure of the patient to the drug. It has been shown to improve results compared with systemic chemotherapy alone in patients with ovarian cancer. 2 Continuous hyperthermic peritoneal perfusion (CHPP) is a method by which heated cytotoxic chemotherapy is recirculated at high flow rates through the peritoneal cavity. 3 This technique is designed to improve distribution of the chemotherapy in the peritoneal cavity and take advantage of known synergy between chemotherapy and hyperthermia. Although this has been previously performed after open laparotomy and complete lysis of adhesions, we describe here a minimally invasive approach that may be more appropriate for many clinical settings.