Design: Case Report

Setting: Surgery done using 3D laparoscopy and HIPEC apparatus ( BELMONT Medical technologies, USA ). Entire procedure done by qualified and experienced team

Patients or Participants: 58 year old female, post hysterectomy status and post 12 cycles chemotherapy for Papillary serous Adeno-carcinoma ovary with recurrence

Interventions: Diagnostic Laparoscopy with excision of nodules larger than 2.5cm followed immediately by HIPEC

Measurements and Main Results: 58 year old female who underwent Total Abdominal Hysterectomy for fibroid uterus in 2010, presented in 2018 with right adnexal complex cyst for which she underwent oopherectomy and biopsy was s/o Papillary Serous Adenocarcinoma ovary. She underwent completion surgery later. She received 12 cycles chemotherapy ( Paclitaxel and Carboplatin ) Repeat PET CT s/o Peritoneal Carcinomatosis. She underwent Diagnostic Laparoscopy with excision of nodule larger than 2.5cm and laparoscopic HIPEC on 10/04/2023.

Under vision 4 drains positioned (2 inflow and 2 outflow) and connected to closed extracorporeal sterile circuit which is further connected to heating circuit. Around 4-6L perfusate circulated with help of peristaltic pump. Flow rate of 1000ml/min maintained. Temperatures kept between 42-43 degrees C. Total duration was 90min and Cisplatin injected at a dose of 75mg/m2. Trendelenberg and Latero-Lateral inclinations of patient was done every 10min to make sure that entire endo- abdominal surface was perfused. Post op patient was kept in ICU for monitoring for 12 hours. Post surgery period was uneventful and she was discharged on Post operative day 5. On follow up patient was comfortable

Conclusion: Among patients with advanced and recurrent ovarian cancer, addition of HIPEC to cytoreductive surgery results in a longer recurrence free survival and overall survival with a better quality of life and a lesser side effects