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Robotic Cytoreductive Surgery With Heated Intraperitoneal Chemotherapy.

Clayton O Rooks¹, Tara Hughes¹, Skylar Rodgers¹

¹Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA.

The American Surgeon

|March 3, 2023

Summary

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Robotic cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC) offers a minimally invasive option for select low-grade mucinous appendiceal neoplasms (LAMNs). This approach achieved complete cytoreduction, demonstrating feasibility for advanced peritoneal disease.

Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Gastrointestinal Oncology

Background:

Cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC) is a standard treatment for peritoneal carcinomatosis but is traditionally performed via open surgery.
Minimally invasive approaches to CRS-HIPEC are emerging, yet achieving complete cytoreduction (CCR) using these techniques is less frequently reported.

Observation:

A 49-year-old male with metastatic low-grade mucinous appendiceal neoplasm (LAMN) to the peritoneum was treated with robotic CRS-HIPEC.
Diagnostic laparoscopy revealed a low Peritoneal Cancer Index (PCI) score of 5, indicating limited peritoneal disease.
Robotic cytoreduction was successfully performed, achieving a completeness of cytoreduction (CCR) score of 0, followed by HIPEC with mitomycin C.

Findings:

Keywords:

appendiceal cancer cytoreductive surgery with heated intraperitoneal chemotherapy intra-abdominal mucinous neoplasms minimally invasive surgery

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Robotic-assisted CRS-HIPEC is feasible for select cases of LAMN with peritoneal metastasis.
Complete cytoreduction (CCR 0) was achieved robotically in this patient with LAMN.
The procedure involved robotic cytoreduction followed by HIPEC using mitomycin C.

Implications:

This case supports the use of robotic-assisted CRS-HIPEC as a viable minimally invasive option for carefully selected LAMN patients.
Advocates for the continued exploration and application of minimally invasive techniques in managing peritoneal surface malignancies.
Highlights the potential for robotic surgery to improve outcomes and reduce invasiveness in CRS-HIPEC procedures.