What Is PIPAC?
PIPAC (Pressurised Intraperitoneal Aerosol Chemotherapy) is a minimally invasive technique for administering chemotherapy to the peritoneal cavity using a pressurised aerosol delivered laparoscopically. Developed by Professor Marc Reymond in Germany, PIPAC achieves drug concentrations in peritoneal tissue 10–50 times higher than systemic intravenous administration, with minimal systemic toxicity.
Dr. Juan José Torrent: Pioneer of PIPAC in Spain
Dr. Juan José Torrent introduced PIPAC in Spain and has been one of its most active proponents in Europe and internationally. He received training at the originating centre in Germany and has since trained surgeons from across Spain, Portugal, Latin America and other countries. Dr. Torrent participates in international PIPAC working groups, clinical trials and expert consensus panels.
How the PIPAC Procedure Works
PIPAC is performed laparoscopically under general anaesthesia as a day-case or short-stay procedure. Two trocars are inserted. The abdominal cavity is explored and biopsies are taken (for disease assessment and response evaluation). A micro-pump nebuliser is connected to the chemotherapy solution and inserted through a trocar. The chemotherapy aerosol is administered at regulated pressure for 30 minutes. The aerosol is safely neutralised by the anaesthesia team before exsufflation. The procedure takes approximately 60–90 minutes in total.
Who Can Benefit from PIPAC?
Patients with peritoneal carcinomatosis from various primary tumours (colorectal, ovarian, gastric, pancreatic, appendiceal, mesothelioma) who: are not eligible for CRS+HIPEC due to disease extent or performance status, have progressed on systemic chemotherapy, need a bridge strategy before a potential CRS+HIPEC, or wish to assess response to locoregional chemotherapy.
Results
PIPAC has demonstrated pathological response rates of 60–80% in ovarian carcinomatosis. Symptom improvement (reduced ascites, pain control) in palliative settings. Acceptable toxicity profile enabling repeated treatment cycles every 6 weeks. Ongoing trials are establishing its role in treatment algorithms.
Want to know if PIPAC is appropriate for your peritoneal disease? Request a consultation with Dr. Torrent at Quenet Torrent Institute — one of the leading PIPAC centres in Europe.