Peritonectomy is a form of cytoreductive surgery. Peritonectomy refers specifically to removal of the peritoneum. The goal of the surgery is to remove the cancerous part of the lining of the abdominal cavity. Organs like small intestines, large intestine, gallbladder, liver, stomach, pancreas, and spleen may also be affected.

It may also slow progression and achieve remission, although the latter is not always possible. To improve the odds of remission and reduce the chance of a recurrence after surgery, the procedure is often combined with HIPEC.

Patients with advanced ovarian cancer and selected patients with peritoneal surface malignancies need this surgery.

Total Peritonectomy is a lengthy procedure, therefore, patients are admitted to the hospital a day before the surgery. The patient undergoes preoperative testing (X-rays, blood tests and other preparatory measures) before the procedure.

During a peritonectomy, an involved procedure called cytoreductive surgery is performed, which aims to remove as much cancerous growth as possible from multiple sites in the abdomen. When the mesothelioma involves many areas of the abdominal cavity, the cytoreductive surgery may involve removing portions of various organs, including the stomach, intestines, liver, pancreas, and spleen, among others.

When performed as stand-alone procedures, peritonectomy can give patients relief from abdominal pain and loss of appetite. When used with chemotherapy, the surgery has the ability to kill cancer and extend life span. A heated chemotherapy regimen – administered into the abdominal cavity for direct contact with cancer cells – is most commonly delivered after the tumor cytoreduction is complete. This generally lasts 90 minutes, while the patient is still under general anesthesia. This combination has helped some patients to live seven years or longer after diagnosis.

After surgery, patients can expect an extensive recovery period in the hospital and at home. Many patients have a post-op hospital stay of more than a week. Once discharged from the hospital, patients should expect another two or three weeks of recovery at home. A large part of this healing depends on the recovery of the digestive system, which can experience some complications after cytoreduction.