Cytoreduction of diaphragmatic metastases using the Cavitron Ultrasonic Surgical Aspirator

The Cavitron Ultrasonic Surgical Aspirator was used to reduce the volume of diaphragmatic metastases in 33 patients. Thirty patients had epithelial carcinoma of the ovary and one each had tubal adenocarcinoma, papillary peritoneal tumor, and mesothelioma. Twenty-seven patients had Stage IIIC disease, and six had Stage IV. Initially, 13 patients had diaphragmatic disease greater than 15 mm diameter (of any single nodule), and 2 had disease 6-15 mm diameter. After cytoreduction using standard means, 11 patients had disease greater than 15 mm diameter and 2 patients had disease from 6 to 15 mm in greatest diameter. After using the Cavitron, 1 patient had no gross diaphragmatic residual disease, and 30 patients had disease 1-5 mm diameter. No complication resulted from the cytoreduction of diaphragm disease using the Cavitron. The Cavitron Ultrasonic Surgical Aspirator is invaluable to obtain minimal residual disease of diaphragmatic metastases.