Peritoneal carcinomatosis (PC) is a debilitating condition associated with high symptom burden and poor prognosis associated with advanced stage abdominal cancer such as colorectal, gastric and ovarian cancer.

While systemic chemotherapy has historically been the standard for palliation, cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a potential strategy for symptom palliation, improved quality of life and enhanced cure rate.Symptom improvement was observed from 26.5 to 100% of cases, with durable control reported in up to 90%. Debulking surgery improves outcome but higher recurrence and debilitating symptoms exists.

Chemotherapy is effective for cancer that spreads through the blood, it is less effective in cases with peritoneal cancers due to poor blood supply. Excision of the peritoneum –called Peritonectomy in addition to debulking the primary tumor improves outcome better. CRS Cyto Reductive Surgery achieves 5-year survival reached up to 31% by conventional surgery which was traditionally done through lengthy incisions and required long recovery due to higher complications rate.

Today, with advances in technology, this surgery can be done using a minimally invasive laparoscopic approach. Through small keyhole incisions and high-definition magnification, surgeons can safely perform complete removal of peritoneal cancer by excising entire peritoneum inside the abdominal cavity with greater precision. ICG also helps to detect cancer tissue by its fluorescence glowing effect in laparoscopic and robotic surgery.

This method causes less pain, less blood loss, shorter hospital stay and faster recovery, while still achieving effective cancer clearance. Undisturbed immune system and minimising blood transfusion reduces recurrence rate. Quality of life better and outcome far superior to conventional peritonectomy.

GEM Cancer Centre, GEM hospital achieved milestone in treating advanced abdominal cancers successfully using CRS-HIPEC. GEM have successfully performed laparoscopic complete parietal peritonectomy for advanced ovarian cancer involved five patients. Patients received first neoadjuvant

Chemotherapy to control systemic disease, followed by laparoscopic cytoreductive surgery with radical hysterectomy and ovarian excision and complete peritonectomy entire peritoneal lining of the abdomen. In two patients laparoscopic HIPEC intraperitoneal chemotherapy in addition to Total Peritonectomy. Specialty team of doctors headed by dr Palanivelu, Gynae oncologist Drs.Kavitha,Dr.Sai Darshini performed the surgery.

Drs Bharath Rangarajan performed HIPEC intraperitoneal chemotherapy after completing peritonectomy.Peritoneal carcinomatosis secondary to gastrointestinal cancers such as colorectal and gastric are taken care of by specialists team at GEM Cancer Centre Surgical oncologists Drs Shiv kumar and Arul Murugan, Esophago gastric cancers by R Parthasarathy and colorectal cancers by Rajapandian. Radiotherapy by dr Madhu Sairam.

Patients treated peritoneal carcinomatosis with this minimally invasive laparoscopic / robotic approach have shown faster recovery, encouraging outcomes with better quality of life on follow. This advancement technology and improved techniques in treatment towards advanced ovarian cancer offers new hope to women providing effective treatment with hope of better quality of life. Early awareness and timely consultation can significantly improve treatment. The 5-year survival exceeds 90%. Overall, ovarian cancer has a poorer prognosis compared to many other gynecologic cancers, but outcomes improve significantly with early detection, optimal surgery, and modern chemotherapy and targeted therapies.

Through small keyhole incisions and high-definition magnification, surgeons can safely remove cancer from the abdominal lining with greater precision. This method causes less pain, less blood loss, shorter hospital stay and faster recovery, while still achieving effective cancer clearance.

GEM Cancer Institute in Coimbatore, a super speciality cancer centre, is at the forefront for this advanced treatment. For the first time in India, we at GEM, have successfully performed laparoscopic complete parietal peritonectomy for advanced ovarian cancer in five patients. Patients received neoadjuvant chemotherapy prior to surgery to shrink the disease, followed by laparoscopic cytoreductive surgery with complete peritonectomy by a dedicated multidisciplinary team. In selected cases, additional treatments such as intraperitoneal chemotherapy were given. At GEM, we offer care through teamwork between medical and surgical oncologists, gastrointestinal surgeons and gynecologic oncology specialists.

Patients treated with this minimally invasive approach have shown good recovery, encouraging outcomes with better quality of life on follow up. This advancement in treatment towards advanced ovarian cancer offers new hope to women providing effective treatment with speedy recovery.