Step 1: Cytoreductive Surgery (CRS)

Before HIPEC treatment in Chennai begins, the surgeon performs Cytoreductive Surgery (CRS) to remove every visible tumour deposit from the peritoneal surfaces. This may include removing portions of the bowel, abdominal wall lining, or the omentum. The goal is to leave behind no visible cancer, a state known as complete cytoreduction. This surgery typically takes 4 to 10 hours depending on the extent of disease.

Step 2: The Heated Chemotherapy Wash

Once all visible tumours are removed, the HIPEC phase begins immediately without closing the abdomen. A heated chemotherapy solution, usually cisplatin, oxaliplatin, or mitomycin C, is circulated through the abdominal cavity at 41 to 43 degrees Celsius using a perfusion machine. This continuous wash runs for 90 minutes to 2 hours, reaching every surface and fold that surgery alone cannot address. This is what makes intraperitoneal chemotherapy in Chennai a more targeted approach than standard intravenous treatment.

Step 3: Closure and Recovery Begins

After the wash is complete, the chemotherapy solution is drained and the abdomen is closed. The patient moves to the ICU for monitoring. Most patients undergoing HIPEC treatment in Chennai spend 2 to 4 days in the ICU, followed by a total hospital stay of 10 to 14 days. Recovery at home typically takes 6 to 8 weeks.

• The Aerosolized Chemotherapy Approach: PIPAC treatment in Chennai works on a straightforward principle: a drug delivered as a fine mist under pressure spreads more evenly and penetrates more deeply than a liquid. The chemotherapy is loaded into a high pressure injector, which atomises it into tiny particles inside the abdominal cavity. This mist distributes evenly across all peritoneal surfaces and stays in contact with the tissue long enough for meaningful absorption. Because it is done laparoscopically through just two small keyhole incisions, it places far less physical burden on the body compared to open surgery.
• What Happens During a PIPAC Session: You arrive at the hospital on the day of the procedure. PIPAC is performed under general anaesthesia, so you will be fully asleep and comfortable throughout. The surgeon makes two small incisions and inserts a camera and the PIPAC device. Carbon dioxide gas gently inflates the abdomen to create working space. The surgeon first examines the peritoneal surfaces directly through the camera, and biopsies can be taken at this point. This built in visual assessment is one of the key advantages of PIPAC treatment in Chennai as it allows the team to monitor how the cancer is responding at every session. The chemotherapy aerosol is then delivered under controlled pressure and left to work for 30 minutes before being safely removed through a filter system. The entire procedure takes 60 to 90 minutes. Most patients are discharged within one to two days and resume normal activity within a week. A full course of intraperitoneal chemotherapy in Chennai with PIPAC typically involves three or more sessions, each spaced 4 to 6 weeks apart, with response evaluated after every session.

• Directly targets peritoneal disease.
• Higher drug concentrations, lower systemic toxicity. 
• Heat amplifies the effect. 
• A single session treatment after surgery. 
• Proven outcomes in selected patients. 
• Potential for long term disease control.

• Minimally invasive with fast recovery. 
• Tolerated well even by patients who are debilitated. 
• Repeated delivery with visual monitoring. 
• Effective even after conventional chemotherapy has failed. 
• Can be a bridge to HIPEC. 
• Improves quality of life. 

• Ovarian Cancer
• Colorectal Cancer
• Stomach (Gastric) Cancer
• Appendiceal Cancer
• Peritoneal Mesothelioma
• Endometrial and Other Gynaecological Cancers

This is often the first question patients ask and it is the right question. Not everyone with peritoneal cancer is a candidate for every procedure. The decision depends on many factors, and it should always be made by an experienced specialist after a thorough review of your case.

Who Benefits from HIPEC

You may be a candidate for HIPEC treatment in Chennai if:

• You have peritoneal metastases from ovarian, colorectal, gastric, appendiceal, or other abdominal cancers
• Your Peritoneal Cancer Index (PCI) score is within a range where complete cytoreduction is achievable
• You are fit enough to tolerate major abdominal surgery
• Your liver and lungs are free from significant cancer spread
• Your abdomen is not too scarred from prior surgeries to allow adequate cytoreduction

Even if another doctor has told you that surgery is not possible, a second opinion from a specialist in CRS and HIPEC is worth pursuing. What one surgeon considers unresectable, a more experienced specialist may find achievable.

Who Benefits from PIPAC

PIPAC treatment in Chennai may be the right option if:

• Your peritoneal cancer is too widespread for complete surgical removal
• You are not currently strong enough to undergo major open surgery
• Your cancer has stopped responding to intravenous chemotherapy
• You are on systemic chemotherapy and need an additional local treatment
• You have recurrent peritoneal disease after previous HIPEC or surgery
• You want a lower burden treatment that helps control disease while preserving quality of life

PIPAC is also used as a bridge therapy in intraperitoneal chemotherapy in Chennai, helping reduce tumour burden until the patient becomes a suitable candidate for CRS and HIPEC.

• Before the Surgery: In the days leading up to your procedure, you will undergo a thorough pre operative assessment. This typically includes blood tests, imaging scans, an ECG, and in some cases a consultation with an anaesthetist and a nutritionist. If you are having HIPEC, your surgeon may ask you to follow specific bowel preparation instructions before the operation. You will be asked to fast from the night before. Most patients are admitted to the hospital the day before their procedure so the team can complete all final checks and ensure you are well prepared.
• During the Procedure: For HIPEC: You will be taken to the operation theatre and given general anaesthesia. The surgical team will perform the cytoreductive surgery first, removing all visible tumour deposits. Once this is complete, the HIPEC phase begins. You will remain under anaesthesia throughout the entire process. The combined procedure typically takes 6 to 12 hours depending on the extent of disease. For PIPAC: You will be given general anaesthesia. Two small incisions will be made in your abdomen. The surgeon will examine the peritoneal surfaces through a camera, take biopsies if needed, and then deliver the chemotherapy aerosol under controlled pressure. After 30 minutes, the aerosol is removed and the incisions are closed. The entire procedure takes approximately 60 to 90 minutes.
• After the Surgery: After HIPEC, you will be moved to the intensive care unit, where the team will monitor your vital signs, pain levels, and fluid balance closely. After a few days in the ICU, you will move to a regular ward room where recovery continues. After PIPAC, most patients wake up in the recovery room and are transferred to a regular room within a few hours. You will likely be discharged within one to two days. The team will give you detailed discharge instructions, including what to eat, what activities to avoid, and when to return for follow up.

Recovery After HIPEC

Recovery after CRS and HIPEC is a gradual process. The surgery is major, and your body needs time to heal on multiple levels.

• In the hospital: Most patients spend 2 to 4 days in the ICU followed by 7 to 10 days in the ward, a total hospital stay of approximately 10 to 14 days. During this time, the team will manage your pain, ensure your gut starts working again, and monitor for any early complications.
• At home: The first 2 to 3 weeks at home are typically the most tiring. Most patients feel significant fatigue and will need help with basic daily tasks. Eating small, frequent meals is often easier than large ones as the gut adjusts. Walking even short distances is encouraged from early on to support recovery.
• By 4 to 6 weeks, most patients are moving more freely and feeling progressively stronger. By 6 to 8 weeks, many are able to return to light activities and feel something closer to their pre surgery baseline.
• Full recovery including regaining strength, appetite, and stamina can take 3 to 6 months.

Recovery After PIPAC

• PIPAC recovery is considerably lighter. Most patients are discharged within one to two days and feel well enough to resume gentle daily activities within a week.
• Some patients experience mild abdominal discomfort or nausea in the days following the procedure; this is normal and usually manageable with medication. Fatigue may persist for a few days.
• Because PIPAC is repeated in cycles, recovery is designed to be short enough that patients can reasonably return to their life between sessions. The goal is that PIPAC should improve or at least preserve your quality of life, not diminish it.

• One of the most practical concerns for patients and families is the HIPEC & PIPAC treatment cost in Chennai. It is a fair question, and you deserve a straightforward answer.
• The cost of HIPEC treatment in Chennai varies depending on several factors: the extent of cytoreductive surgery required, the duration of the operation, the chemotherapy agents used, the length of hospital stay, and the level of post operative care needed. No two HIPEC procedures are identical, which is why costs can differ meaningfully from patient to patient.
• PIPAC treatment costs in Chennai are generally lower per session than HIPEC, but since PIPAC is typically delivered over multiple sessions, the total cost over a course of treatment should be discussed in full during your consultation.
• In our practice, we believe that patients and families deserve complete transparency about costs before making a treatment decision. During your consultation with Dr. Senthil, the team will provide you with a clear, itemised estimate based on your specific case including surgery, anaesthesia, hospital stay, chemotherapy drugs, and follow up. There should be no surprises.

When the diagnosis is serious and the treatment is complex, the experience and judgment of the surgeon matters more than almost anything else. Dr. Senthil is one of the few surgical oncologists in Chennai who has dedicated his practice to the treatment of peritoneal surface malignancies cancers that have spread to the lining of the abdomen. His surgical training and clinical focus have been specifically oriented around CRS, HIPEC, and PIPAC, which means that these are not occasional procedures performed alongside a general oncology practice, they are central to what he does.

• Surgical Experience in Complex Cases: Cytoreductive surgery requires the ability to operate across multiple organ systems in a single procedure, sometimes for many hours. Dr. Senthil has performed these procedures across the full range of peritoneal cancers ovarian, colorectal, gastric, appendiceal, mesothelioma, and gynaecological and in patients who were told elsewhere that surgery was not possible.
• A Second Opinion is Welcome: If you have received a recommendation or a refusal from another centre, Dr. Senthil's practice welcomes second opinion consultations. Many patients who were told that nothing more could be done have found, after a detailed review of their case here, that an option did exist.
• Honest Assessment, Not False Hope: Not every patient is a candidate for HIPEC or PIPAC, and Dr. Senthil will tell you that clearly and compassionately if that is the case. But if an option exists, it will be explained to you in full what it involves, what it may achieve, and what the recovery looks like.
• Support for the Whole Family: We understand that the person sitting in the consultation room is often a family member, not the patient. We support families through this process with time, information, and patience because the decisions you are making affect everyone.
• Intraperitoneal Chemotherapy in Chennai: Dr. Senthil's practice is one of a small number of centres in Chennai offering both HIPEC and PIPAC as part of an integrated peritoneal cancer programme not as isolated procedures, but as part of a complete treatment plan tailored to each patient.