What is HIPEC?
HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy It is a technique where heated chemotherapy is delivered directly inside the abdomen during surgery- Done immediately after Cytoreductive Surgery (CRS)
- Targets cancer cells that cannot be seen by the surgeon
Who performs HIPEC for ovarian cancer in Ahmedabad?
Dr Swati Shah, MS, DNB (Robotic UroGynec Oncosurgeon), performs cytoreductive surgery with HIPEC for ovarian cancer at Apollo Hospital, Bhat, Gandhinagar, and consults at Gota, Ahmedabad.
What is HIPEC?
HIPEC is heated chemotherapy circulated inside the abdomen at about 42 degrees Celsius at the end of cytoreductive surgery, to treat microscopic disease left on the peritoneal surfaces.
When is HIPEC used in ovarian cancer?
Most often at interval cytoreductive surgery, after chemotherapy has been given first, when all visible disease has been removed and the peritoneum was the main site of spread.
What does CRS with HIPEC cost in India?
Cytoreductive surgery with HIPEC for ovarian cancer at Apollo Hospital, Bhat, Gandhinagar ranges from ₹5,50,000 to ₹7,00,000 depending on the extent of the resection.
How long does HIPEC add to the operation?
The HIPEC circulation itself takes about 90 minutes and is done after the cytoreduction is complete, so it adds roughly one and a half to two hours to the operation.
Which patients are not suitable for HIPEC?
Patients in whom visible disease cannot be fully removed, those with spread outside the abdomen, and those whose kidney, heart or lung reserve will not tolerate a long operation.
Why HIPEC Works in
Ovarian Cancer
Ovarian cancer is primarily a surface disease
chemotherapy delivered directly inside the abdomen can act on cancer cells across peritoneal surfaces
- Cancer spreads along peritoneal surfaces inside the abdomen
- Does not initially invade deep into organs
- Direct abdominal chemotherapy helps target cancer cells present across these surfaces
Key Concept
HIPEC delivers chemotherapy exactly where the disease lies — on the surfaces inside the abdomen.
Treatment is not decided only before surgery How Treatment is Planned
Final decisions are made during surgery using:
- Resection without rupture
- Frozen section (LIVE biopsy)
This allows:
Right surgery to be performed in a single operation
Why Biopsy Should Be Avoided Before Surgery
In most ovarian masses, preoperative biopsy is NOT recommended
1. Risk of Tumour Rupture
- Needle biopsy can puncture the cyst/tumour
- Leads to spillage โ cancer spread
2. Does Not Change Treatment Plan
- If biopsy shows cancer โ surgery is still required
- If biopsy shows no cancer โ not reliable (only small sample taken)
3. False Reassurance Risk
- A negative biopsy does NOT rule out cancer
CRS + HIPEC Treatment Strategy
Cytoreductive surgery (CRS) combined with HIPEC provides a comprehensive treatment approach for advanced ovarian cancer.
How HIPEC Treatment Is Performed
Ensures uniform exposure across all abdominal surfaces
Benefits of HIPEC
Direct Action on Cancer Cells
- Targets microscopic cancer deposits on peritoneal surfaces
- Treats disease that cannot be seen during surgery
High Local Effect, Less Systemic Toxicity
- Minimal absorption into bloodstream
-
Reduced side effects on:
- Bone marrow
- Kidneys
- Other organs
- Use of stronger chemotherapy (e.g., Cisplatin)
- Higher effective dose
Heat Enhances Effectiveness
-
Heat increases:
- Drug penetration
- Cancer cell sensitivity
Step-by-Step Surgical Approach
Preoperative Evaluation
- Tumour markers
- Imaging (CT / MRI / PET)
- Fitness assessment
Resection Without Rupture
First and most critical step:
- Tumour removed intact
- Prevents spillage
- Avoids cancer spread and upstaging
Frozen Section (LIVE Biopsy)
Diagnosis during surgery. Report available in 15โ30 minutes.
Guides:
- Type of tumour
- Extent of surgery
- Fertility preservation decisions
When is HIPEC Used?
HIPEC is used in selected ovarian cancer patients as part of a structured multidisciplinary treatment approach.
Clinical Situations Where HIPEC is Used
- Advanced ovarian cancer (commonly Stage III)
- During interval cytoreductive surgery
- Selected recurrent ovarian cancer cases
HIPEC Does NOT Replace Chemotherapy
Systemic (IV) chemotherapy is still required as part of complete ovarian cancer treatment.
Outcomes Depend on Complete Care
Best treatment outcomes require careful planning and complete multidisciplinary care.
- Proper patient selection
- Complete cytoreduction (CRS)
- Careful preoperative planning
- Structured postoperative care
Complexity of HIPEC Procedure
HIPEC is a highly specialized treatment performed together with major cytoreductive surgery (CRS) and requires advanced infrastructure and expertise.
Why HIPEC is Complex
A multidisciplinary high-precision procedure
- Combined with major CRS surgery
- Requires a specialized perfusion machine
- Needs an experienced surgical team
- Intensive care support is essential
Why Choose an Experienced Centre for HIPEC?
HIPEC outcomes depend heavily on surgical expertise, intensive care support, anaesthesia management, and specialized infrastructure.
Surgical Expertise
- Experienced surgeons in advanced ovarian cancer
- Complete tumour removal
- Meticulous surgical technique & consistent outcomes
Anaesthesia Expertise
- Specialized body temperature management
- Careful fluid balance monitoring
- Hemodynamic stability management
Critical during the HIPEC phase
Intensive Care Support
- Preoperative optimization
- Postoperative recovery management
Advanced Infrastructure
- Dedicated HIPEC setup
- Well-equipped operation theatre
- Trained OT staff & technicians
- Procedures performed routinely
Evidence-Based Practice
- Standardized protocols (SOPs) followed
- Experience supported by published outcomes and clinical practice
Surgical Expertise & Real Experience
Surgical videos
Educational videos
Surgical images
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This inspiring video shares the remarkable success story of a cancer patient who underwent Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) under the expert care of Dr. Swati Shah, an esteemed Oncosurgeon in Ahmedabad. The patient’s family member narrates their challenging medical journey, explaining how they traveled from their hometown to seek advanced treatment upon learning about Dr. Shah’s profound clinical expertise. Following a comprehensive medical examination, the patient was diagnosed with advanced cancer. To effectively combat this severe condition, Dr. Shah successfully performed a complex, highly specialized procedure combining CRS and HIPEC.
Features an inspiring testimonial from a brave patient who successfully battled stage 3 ovarian cancer. Hailing from Modasa, Gujarat, the patient and her family share their challenging medical journey from the initial diagnosis to her ongoing recovery. After consulting multiple medical professionals, they found Dr. Swati Shah, a specialized Robotic Uro-Gynecological Onco-Surgeon based in Ahmedabad, who provided them with much-needed guidance, reassurance, and confidence to proceed. The patientโs primary treatment involved Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
- Case Summaries
Advanced Cytoreductive Surgery and HIPEC for Stage IV High-Grade Ovarian Carcinoma
- The Challenge
- Advanced Stage IV Ovarian Carcinoma
A 54-year-old female presented with severe lower abdominal pain and a complex pelvic mass. Comprehensive evaluations revealed FIGO Stage IV high-grade serous ovarian carcinoma with extensive tumor deposits across the colon and peritoneum. This aggressive spread demanded immediate, complex surgical intervention for optimal survival.
The Solution
โฆฟ Comprehensive Cytoreduction and HIPEC
Dr. Swati Shah performed an extensive Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC). The highly intricate procedure included a subtotal colectomy, extensive peritonectomies, and bilateral lymph node dissections. Advanced surgical precision ensured maximal tumor clearance while meticulously safeguarding vital urinary and pelvic structures.
ยป Surgical Highlights & Precision
โข Procedure: Cytoreductive surgery and HIPEC comprehensively eradicated extensive malignant intra-abdominal deposits.
โข Extensive Dissection: Bilateral pelvic and retroperitoneal lymph nodes were meticulously cleared using advanced surgical techniques.
โข Patient Safety: Vital structures were strictly safeguarded, effectively managing blood loss during this massive multi-organ resection.
โข Cancer Clearance: Complete macroscopic tumor cytoreduction was successfully achieved across the entire abdominopelvic cavity.
ยป The Outcome
โฆฟ Uneventful Recovery and Stable Health
Following this extensive cytoreductive surgery, the patient experienced a remarkably uneventful postoperative recovery phase. She was successfully extubated, regained healthy independent mobility, and maintained excellent hemodynamic stability throughout her hospital stay. Final evaluations confirmed the successful removal of the malignancy, allowing for a confident and highly stable discharge on postoperative day eight.
ยป Dr. Swati Shahโs Insight
Managing Stage IV ovarian carcinoma requires aggressive and meticulous cytoreduction followed immediately by targeted HIPEC. By integrating advanced surgical techniques, we achieved complete macroscopic tumor clearance, providing this patient with an exceptionally strong foundation for long-term survival and renewed quality of life.
Advanced Left Breast Conserving Surgery And Cytoreductive Surgery With HIPEC For Synchronous Carcinomas
- The Challenge
- Synchronous Breast And Ovarian Malignancies
A 41-year-old female presented with a highly aggressive, simultaneous diagnosis of left invasive breast carcinoma and a high-grade serous ovarian carcinoma. The extreme complexity of this synchronous presentation demanded an urgent, extensive multidisciplinary surgical approach to aggressively control and eliminate both primary malignancies simultaneously.
The Solution
โฆฟ Left BCS, Cytoreductive Surgery, And HIPEC
Dr. Swati Shah performed a highly precise left breast conserving surgery with axillary sampling, followed immediately by extensive cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). This advanced and meticulous surgical technique ensured the comprehensive resection of both the breast tumor and the complex tubo-ovarian mass.
ยป Surgical Highlights & Precision
โข Procedure: Left breast conservation paired with complete macroscopic cytoreduction and hyperthermic intraperitoneal chemotherapy delivery.
โข Extensive Lymphadenectomy: Fifty-three lymph nodes across the axillary, pelvic, and paraaortic regions were meticulously cleared.
โข Patient Safety: The patient remained hemodynamically stable throughout the complex multiorgan resection with well-controlled pain.
โข Cancer Clearance: Histopathology confirmed completely tumor-free breast surgical margins and fifty-three negative, tumor-free lymph nodes.
ยป The Outcome
โฆฟ Complete Tumor Resection And Stable Recovery
The patient achieved an outstanding immediate postoperative recovery, becoming independently ambulatory with completely stable hemodynamics shortly after surgery. Comprehensive final pathology confirmed clear, tumor-free margins in the breast and entirely zero metastatic spread across fifty-three evaluated lymph nodes. She was successfully discharged in a highly stable condition with clean surgical wounds.
ยป Dr. Swati Shahโs Insight
Managing synchronous breast and ovarian carcinomas required highly synchronized surgical precision and a radically aggressive approach. By combining breast conservation with comprehensive cytoreduction and HIPEC, we achieved a completely margin-free clearance, granting her an exceptional chance for long-term survival.
HIPEC for Ovarian Cancer in Ahmedabad, Gujarat
Advanced CRS + HIPEC treatment is available in Ahmedabad at specialized centres experienced in complex ovarian cancer care.
Specialized Expertise Available
Comprehensive multidisciplinary ovarian cancer treatment
- Advanced ovarian cancer surgery
- Heated intraperitoneal chemotherapy (HIPEC)
- Multidisciplinary cancer care
Patients Visit From
Seeking specialized CRS + HIPEC treatment
Common Indications
Conditions commonly treated using CRS + HIPEC
- Stage III ovarian cancer
- Recurrent ovarian cancer
Consult for Advanced Ovarian Cancer Treatment
Advanced Ovarian Cancer
Recurrent Ovarian Cancer Disease
Frequently Asked Questions
It improves outcomes when combined with proper surgery, especially in advanced disease.
Yes, when performed in experienced centres with proper monitoring.
Heat increases penetration and effectiveness of chemotherapy.
Yes, at specialized centres with trained teams and infrastructure.
