Abstract
In order to reach cytoreduction in advanced ovarian cancer, peritonectomy and diaphragmatic stripping are procedures required to remove the disease in the upper abdomen. Diaphragm involvement is estimated in up to 40% of cases. Nevertheless, in some of these patients, the tumour volume may constitute a limitation of the technique due to the association with abdominal wall involvement, bulky tumour at the Morrison’s pouch or liver infiltration. Extensive upper abdominal procedures should represent a basic resource for the gynaecologic oncologist in order to reach an optimal cytoreduction. A radical peritonectomy with en bloc resection for treating advanced ovarian cancer with extensive widespread diaphragmatic peritoneal carcinomatosis is showed in this surgical film.
Highlights
Primary debulking surgery was considered after laparoscopic assessment
From beyond the upper limb, parietal peritoneum was dissected from the subdiaphragmatic, paracolic areas and Morrison’s pouch
The tumour present at the right abdominal wall and liver parenchyma was resected en bloc with the parietal peritoneum (Video 1)
Summary
In patients with advanced ovarian cancer, peritoneal carcinomatosis is commonly reported. Peritonectomy and diaphragmatic stripping are the elective procedures chosen to remove the disease in the upper abdomen at the diaphragm [1]. In some cases the tumour volume may represent a limitation of the technique due to abdominal wall involvement, bulky tumour at the Morrison’s pouch or liver infiltration [2]. A radical peritonectomy with en bloc resection for treating advanced ovarian cancer with peritoneal carcinomatosis involving abdominal wall, liver and bulky tumour at Morrison’s pouch is shown in a surgical film (Video 1)
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