During Cytoreductive Surgery and HIPEC for PSM
Feeling scared or overwhelmed the day of your cytoreductive surgery and HIPEC procedure is perfectly normal. Our experienced team is here to help you feel comfortable physically and emotionally. We will educate, guide and support you and your family through the entire process:
- Check-in and registration
- Getting ready for your procedure
- Presurgical preparation
- Your surgery and HIPEC procedure
- Your visitors
Check-In and Registration
The day of your surgery:
- Arriving: Plan to arrive at Memorial Regional Hospital about three hours before your scheduled time of surgery (unless your appointment is at 7:30 am, then arrive at 5:15 am).
- Parking: Use our complimentary valet parking, then enter through the outpatient entrance.
- Registering: A staff member at the registration desk will place a band on your wrist that lists your name, date of birth and medical record number. Please make sure that all the information is correct.
- Meeting with your preoperative nurse: After you are registered, you will be escorted to the second floor, where a preoperative nurse will greet you. He or she will verify your identity, ask you what surgery you are having and who your surgeon is.
Getting Ready for Your Procedure
We will give you a hospital gown to wear and a bag for your clothes and other belongings. Your nurse will complete a preoperative assessment and make sure that all loose or removable items are put in your bag, such as:
- Dentures
- Eyeglasses or contact lenses
- Jewelry
- Hair clips and pins
- Removable prostheses
Just before surgery, you will use the restroom to empty your bladder. We will place an intravenous (IV) catheter in your arm. It will provide fluids and any preoperative medications directly into your bloodstream.
You and your family will have another chance to speak to members of the surgery and anesthesia team prior to your procedure. We want to answer all of your questions to ensure you feel prepared.
Presurgical Preparation
Once you have completed registration and taken all of the steps to get ready, you will be taken to the operating room (OR) on a stretcher. A nurse will help move you onto the operating table and give you a warm blanket to keep you comfortable.
Your surgery team will take care of the last of your surgery preparation, including:
- Monitoring equipment: We will connect you to devices that will report your blood pressure, heart rate and oxygen levels.
- Anesthesia IV, breathing tube and catheter: The anesthesiologist will administer the medications to put you to sleep. Once you are asleep, we’ll insert a tube into your nose to help you breathe and a catheter to drain your urine.
- TAP block: Just before the procedure begins, the anesthesiologist will perform a transversus abdominis plane (TAP) block. This is a local anesthetic injection guided by ultrasound into the nerves of the abdominal wall. It significantly decreases postoperative pain around the incision and may decrease the need for narcotics.
Your Cytoreductive Surgery and HIPEC (Hot Chemo) Procedure
The complete treatment may take four to 10 hours, depending on the amount of cancer the surgeon finds. It can be divided into three main parts:
- Exploration: First, your surgeon will explore the area to locate any tumors and determine what should be removed.
- Cytoreductive surgery: The surgeon will then remove whatever cancer they can see.
- HIPEC: To kill any remaining cancer cells that cannot be seen, the surgeon will use HIPEC, also called hot chemo. They will add chemotherapy to a heated sterile liquid, then infuse that into your abdomen via tubes. The solution will be circulated for about 90 minutes, then drained from your body.
Once the treatment is complete, the surgeon will close your incision with one of the following:
- Dissolvable sutures and surgical glue: These stitches disappear on their own.
- Staples: We remove the staples 7-10 days after your surgery.
- A VAC dressing: This is a vacuum-sealed covering that may help prevent infections. You usually wear it for five to seven days — until we remove it for you.
After your incision is closed, we will take you to recovery.
Family Members and Friends
Waiting during this 4-10 hour surgery can be stressful for family members and loved ones. Rest assured, our PSM team will take good care of them as well. Throughout your procedure, a nurse will provide updates on your surgery, and answer any questions they may have.
The surgeon will speak with your family immediately after your procedure to let them know:
- How it went?
- When they may see you?
- What to expect during your recovery?
