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Staging laparoscopy and Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) for peritoneal metastasis: safe access to the abdomen.
Glatz, Torben; Horvath, Philipp; Lang, Sven A; Archid, Rami; Nadiradze, Giorgi.
Afiliación
  • Glatz T; Department of General and Visceral Surgery, University of Freiburg, Freiburg, Germany.
  • Horvath P; Department of General and Transplant Surgery and National Center for Pleura and Peritoneum, University of Tübingen, Tübingen, Germany.
  • Lang SA; Department of General and Visceral Surgery, University of Freiburg, Freiburg, Germany.
  • Archid R; Department of General and Transplant Surgery and National Center for Pleura and Peritoneum, University of Tübingen, Tübingen, Germany.
  • Nadiradze G; Department of General and Transplant Surgery and National Center for Pleura and Peritoneum, University of Tübingen, Tübingen, Germany.
Pleura Peritoneum ; 4(1): 20190004, 2019 Mar 01.
Article en En | MEDLINE | ID: mdl-31198854
BACKGROUND: Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) is an innovative drug delivery technique. Most common indication is palliative therapy of peritoneal metastasis of gastrointestinal and gynecological origin in the salvage situation. Access to the abdomen is the critical step of the procedure, since most patients had previous surgery. Potential pitfalls include non-access because of adhesions, bowel access lesions and postoperative subcutaneous toxic emphysema. METHODS: We propose a technique, the "finger-access technique" that might prevent largely these pitfalls. A minilaparotomy of 3 cm is performed in the midline, a finger introduced into the abdomen and a 5-mm double-balloon trocar (no Hasson trocar) is placed under finger protection at some distance of the first incision. The fascia of the minilaparotomy, not the skin, is then closed. The abdomen is insufflated with CO2 and tightness is controlled with saline solution in the minilaparotomy. A second 10-12 mm trocar is then introduced under videoscopic control. The first trocar is then visualized through the second one to exclude a bowel lesion during first access. RESULTS AND CONCLUSIONS: In our hands, this access technique has shown to be safe and effective.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pleura Peritoneum Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pleura Peritoneum Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania