At CritiCare Asia Hospitals, we use Hyperthermic Intraperitoneal Chemotherapy (HIPEC) as an innovative treatment approach that combines surgery and chemotherapy to target cancers that have spread to the peritoneal cavity. Peritoneal carcinomatosis, the presence of cancer cells in the lining of the abdomen, often occurs as a result of advanced cancers originating from the appendix, colon, ovaries, stomach, or other abdominal organs. With CritiCare Asia Hospitals, HIPEC offers a localised and intensified chemotherapy delivery method, leading to improved outcomes for select patients.

What Is HIPEC?

HIPEC involves the administration of chemotherapy directly into the peritoneal cavity during surgery. Our primary goal is to achieve a high concentration of chemotherapy drugs in the abdomen, maximising their effectiveness against cancer cells while minimising systemic side effects.

Our team of experts usually perform HIPEC after cytoreductive surgery (CRS), which aims to remove as much visible tumour tissue as possible.During HIPEC, a heated chemotherapy solution is circulated throughout the abdomen, allowing the drugs to penetrate and destroy remaining cancer cells.

The heat, typically maintained at around 41-43 degrees Celsius, enhances the effectiveness of chemotherapy by increasing drug absorption, promoting better drug penetration into tumours, and improving the oxygen supply to the tissues. The combined effect of heat and chemotherapy helps to eliminate residual microscopic cancer cells that may have been left behind after CRS.

What Does HIPEC Treat?

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is primarily used to treat cancers that have spread to the peritoneal cavity, a common site for cancer metastasis. The peritoneal cavity is the space within the abdomen that surrounds and protects organs such as the stomach, liver, intestines, and ovaries. HIPEC is most commonly employed in the treatment of peritoneal carcinomatosis, which refers to the presence of cancer cells in the peritoneal lining.

HIPEC can be used to treat various types of cancer that have metastasized to the peritoneal cavity, including:

Appendiceal cancer

Appendiceal cancer, particularly pseudomyxoma peritonei, is one of the most common indications for HIPEC. Pseudomyxoma peritonei is a rare condition characterised by the excessive production of mucus in the abdomen, leading to the formation of gelatinous tumours.

Colorectal cancer

HIPEC can be used as a treatment option for colorectal cancer that has spread to the peritoneal cavity. It is often considered when the disease is limited to the abdominal area and can offer improved outcomes compared to systemic chemotherapy alone.

Ovarian cancer

HIPEC can be utilised in the treatment of advanced ovarian cancer that has spread within the abdomen. It is typically combined with cytoreductive surgery (CRS) to remove visible tumours and achieve optimal disease control.

Gastric cancer

For selected patients with gastric cancer that has invaded the peritoneal cavity, HIPEC may be employed as part of a multimodal treatment approach. It aims to eliminate residual cancer cells and improve overall survival rates.


Peritoneal mesothelioma, a rare cancer affecting the lining of the abdomen, can be managed with HIPEC. It offers a targeted treatment approach to combat the disease within the peritoneal cavity.

HIPEC Surgery Procedure

The HIPEC procedure involves several steps. Before surgery, patients undergo a thorough evaluation to determine their suitability for the procedure. Once deemed eligible, they undergo preoperative preparation, including bowel preparation and antibiotic administration.

During the surgery, the surgeon performs CRS, which involves removing visible tumours and affected organs if necessary. The extent of the CRS depends on the size, location, and spread of the cancer. After CRS, the abdominal cavity is extensively rinsed to remove any remaining tumour cells.

Next, the hyperthermia phase begins. The surgeon connects the abdomen to a closed circuit system that circulates the heated chemotherapy solution. The solution, containing specific chemotherapy drugs, is infused into the abdomen and circulated for a predetermined duration, usually ranging from 60 to 120 minutes. The temperature is continuously monitored to ensure optimal heat distribution.

What Are the Advantages of HIPEC Surgery?

Here are some of the advantages of getting HIPEC surgery at CritiCare Asia Hospitals:

  • Improved drug delivery: HIPEC allows for direct delivery of chemotherapy drugs to the affected area, achieving higher drug concentrations in the peritoneal cavity than can be achieved with systemic chemotherapy alone.
  • Enhanced tumour cell destruction: The combination of heat and chemotherapy increases the effectiveness of treatment, leading to better eradication of residual cancer cells.
  • Minimised systemic side effects: Since the chemotherapy drugs are primarily localised within the abdominal cavity, the systemic side effects associated with traditional chemotherapy are reduced.
  • Potential for long-term disease control: HIPEC offers the potential for prolonged disease control and improved survival rates, especially in patients with peritoneal carcinomatosis.
  • Positive impact on patient outcomes: Studies have shown that HIPEC can improve overall survival and increase the chances of complete tumour removal, leading to better quality of life for patients.

How Does HIPEC Differ from Traditional Chemotherapy?

HIPEC differs from traditional chemotherapy in several key ways:

Localised versus systemic treatment

HIPEC delivers chemotherapy directly into the peritoneal cavity, targeting the affected area, whereas traditional chemotherapy is administered systemically and affects the entire body.

Increased drug concentration in the peritoneal cavity

HIPEC allows for higher drug concentrations to be achieved within the abdominal cavity, leading to enhanced tumour penetration and destruction.

Extended exposure to chemotherapy

The prolonged exposure to heated chemotherapy during HIPEC improves the efficacy of the treatment by targeting residual cancer cells more effectively.

Potential for improved survival rates

HIPEC has shown promising results in improving survival rates, especially in patients with peritoneal carcinomatosis, when compared to traditional chemotherapy alone.

Unique considerations and limitations

HIPEC is a complex procedure that requires specialised expertise and resources. It is suitable for select patients and may not be appropriate for all individuals with abdominal cancers.