The peritoneum is a membrane that covers the inner lining of the abdominal cavity and the organs lying in there. It helps to support these organs and contains the blood vessels and nerves that supply them. The space in the abdominal cavity covered by the peritoneum is known as the peritoneal cavity (Figure 1).
Figure 1: Peritoneal cavity
Complications related to Peritoneal Metastases:
Consult your doctor if you experience these symptoms.
The diagnosis of Peritoneal Cancer can be difficult. Imaging (such as CT or MRI scans), needle drainage of ascitic fluid for analysis, keyhole surgery, or a combination of these may be required to confirm the diagnosis of Peritoneal Metastases.
Patients who suffer from cancers mainly of abdominal origins such as gastric (stomach), ovarian, colorectal, appendix and pancreas cancers are at risk of developing Peritoneal Metastases. Less commonly, other cancers can also spread to the peritoneum.
Peritoneal Metastases develop as cancer spreads. Presently, besides controlling the original cancer, there is little more that can be done to prevent Peritoneal Metastases. Patients who experience the symptoms mentioned above should seek medical assistance for a thorough evaluation.
Peritoneal Metastasis is difficult to treat and is best managed by a multi-disciplinary team that includes surgeons and medical oncologists.
Figure 3: Set-up of IP Chemotherapy
PIPAC (Figure 4) is a novel method of delivering chemotherapy directly into the peritoneal cavity in an aerosol form. It utilises the physical properties of pressurized gas to distribute the drug evenly and deeply. This allows greater penetration of the drug into the cancer cells, with reduced systemic side effects of the chemotherapy agent. PIPAC is performed as a short and simple laparoscopic (keyhole) surgery. Under general anaesthesia, small instruments will be placed into the abdomen. A micro-pump will deliver the chemotherapy drug into the peritoneal cavity as an aerosol. At the end of the procedure, any residual gas within the peritoneal cavity will be removed.