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This site provides information about
peritonectomy, peritonektomie, treatment, peritonealcarcinoses, peritoneal carcinosis, Peritonealkarzinose, Behandlung, ovarial, peritoneal, carcinoses, carcinosis, carcinom, carcinoma, pseudomyxoma peritonei, Krebs, Tumor, Bauchfellkarzinom, Hammelburg, peritoneal, Mesothelioma, Bauchfellkrebs, Herwart Müller, Paul Sugarbaker, abdominelles, Sarcom, Sarkom, Abdominalsarkom, Beckensarkom, Bauchtumor, Bauchraum, Rezidivtumor, Becken, pelvines Rezidiv, Bauchdeckentumor, Bauchwandcarcinom, Bauchwandkarzinom, Bauchwandrezidiv, Ovarialkarzinom, Ovarialcarcinom, Eierstockkrebs, Colonkarzinom, Coloncarcinom, colorectales Karzinom, Dickdarmkrebs, Mastdarmkrebs, Pseudomyxoma peritonei, Gallertkarzinom, Gallertcarcinom

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Surgery

Surgical tools

The standard tool used to dissect tumor on peritoneal surfaces from the normal tissues is a ball-tip electrosurgical handpiece. The ball-tipped instrument is placed at the interface of the tumor and normal tissues. The focal point for further dissection is placed on strong traction. The 3-mm ball-tip electrode is used on pure cut at high voltage for dissecting. High voltage coagulation is used to transect small (< 2 mm in diameter) vessels.
Using ball-tip electrosurgery on pure cut creates a large volume of plume because of the electroevaporation of tissue. To maintain visualization of the operative field and to preserve a smoke-free atmosphere in the operating theater, a smoke filtration unit is used. The vacuum tip is maintained 2 to 3 inches from the field of dissection whenever electrosurgery is used.

Members:
Dr. Müller, Germany
Paul Sugarbaker, US
François Gilly, France
Dominique Elias, France
Santiago Gonzalez Moreno, Spain
Marcello Deraco, Italy
Syed A. Ahmad, US
Edward Levine, US
Frans Zoetmulder, Netherlands
Yutaka Yonemura, Japan
P.I. Piso, Germany
Joachim Jähne, Germany

Specific surgical technique

In order to adequately perform cytoreductive surgery, the surgeon should use a specific preparation technique, called lasermode electrosurgery. Peritonectomies and visceral resections using the traditional scissor and knife dissection will unnecessarily disseminate a large number of tumor debris within the abdomen. Also, clean peritoneal surfaces devoid of cancer cells are less likely to occur with sharp dissection or opposed to electrosurgical dissection. Lasermode electrosurgery leaves a margin of heat necrosis that is devoid of viable malignant cells. Not only does electroevaporation of tumor and normal tissue at the margins of resection minimize the likelihood of persistent disease, but also it minimizes blood loss. In the absence of lasermode electrosurgery, profuse bleeding from stripped peritoneal surfaces may occur.