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Surgical oncology

SURGICAL ONCOLOGY

Flexiper™

FLEXIPER Unit for oncologic locoregional normo/hyperthermic treatments
FLEXIPER is a stand-alone instrument to perform Chemohyperthermic procedures in local or regional compartments of the human body
Flexiper can carry out several Chemohyperthermia procedures :

  • Hyperthermic Intraperitoneal Perioperative Chemotherapy (HIPEC)
  • Removal of ascitys with Intraperitoneal “lavage”
  • Isolated Limb Perfusion 
  • Hypossic perfusion with extracorporeal circulation

Among these the most common procedure is the HIPEC to treat the Peritoneal Carcinomatosis
Regional hyperthermic chemotherapy is intended for the perioperative treatment of peritoneal carcinomatosis caused mainly by colon and ovarian cancer.

For long time Peritoneal Carcinomatosis has been considered an incurable pathology.

The advancements in both surgical techniques and intensive cares has lead to new approaches to treat this pathology one of the most successful being the cytoreductive surgery in combination with perioperative chemohyperthermia.

The procedure consists in the removal of the whole parietal peritoneum and of several abdominal organs. Then the abdomen is treated with Perioperative Intraperitoneal Chemohypertermia, whose goal is to remove tumor cells and microscopic cancers seed from the abdomen.

Chemohyperthermia consists in a “washing” of the abdominal cavity , executed through the insertion of several drains into the abdominal surface. Some are for infusing liquid inside the abdominal cavity and other for removing it.

The drains are linked to an external circuit mounted on a pump similar to those for extra-corporeal circulation . The pump is fitted with a fluid heat exchanger so to bring the circulating liquid ( usually saline or dialysis liquid) at 41-42 °C. When the desired temperature is reached , a chemotherapeutic agent is injected in the line so to enter the circulation. The treatment lasts one or two hours. The heat damages the cancer cells on its own and also plays in synergy with the chemotherapic agents improving the penetration of it inside the cancer layers and potentiating the drug efficacy.

When perfusion is finished, the liquid into the abdomen is completely removed by the pump. Then, the surgery team goes on with the surgical reopening of the abdominal cavity for a further verification, in order to eliminate all blood clots and residual fragments stage of extra-abdominal tumors.

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