How to Perform Safe and Technically Optimized Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): Experience After a Consecutive Series of 1200 Procedures

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new approach to deliver intraperitoneal chemotherapy as a pressurized aerosol in patients with advanced peritoneal metastases (PM). Although this treatment has rapidly been adopted into clinical practice, most surgeons are not familiar with the basics and principles of this technology. The purpose of this article is to review patient selection criteria, as well as highlighting important operative and technical details regarding PIPAC technology with a focus on how to do it. To this end, safety and feasibility data from a series of 1200 consecutive PIPAC procedures performed by two pioneers of PIPAC treatment are presented.