1. Laparoscopic access
Two small incisions (5-12mm) are made to introduce the camera and nebulizer device into the abdominal cavity.
Reviewed by Dr. Juan José Torrent — Updated: April 30, 2026
Innovative Procedure
PIPAC: Pressurized Intraperitoneal Aerosol Chemotherapy
Minimally invasive technique that delivers chemotherapy as a pressurized aerosol directly into the abdominal cavity for the treatment of peritoneal carcinomatosis.
CONTACT SPECIALISTWhat is PIPAC?
PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) is an innovative technique that delivers chemotherapy as a pressurized aerosol directly into the abdominal cavity. It is performed via laparoscopy, making it a minimally invasive procedure.
Unlike HIPEC, PIPAC can be performed repeatedly and is especially indicated for patients with extensive peritoneal carcinomatosis who are not candidates for complete cytoreductive surgery, or as neoadjuvant treatment to reduce tumor burden.
How is the PIPAC procedure performed?
PIPAC is performed in the operating room under general anesthesia using laparoscopic technique:
2. Exploration and biopsy
Visual evaluation of the abdominal cavity, documentation of tumor extent, and biopsies for histological analysis.
3. Drug nebulization
Chemotherapy is nebulized at high pressure (12 mmHg) creating an aerosol that distributes evenly across the entire peritoneal surface.
4. Exposure time
The aerosol remains in contact with the peritoneum for 30 minutes, after which it is safely evacuated and the incisions are closed.
Advantages of PIPAC
PIPAC offers multiple advantages over other peritoneal carcinomatosis treatments:
Minimally invasive
Performed laparoscopically through only two small incisions, allowing rapid patient recovery.
Repeatable
Can be performed multiple times (every 6-8 weeks), allowing sustained treatment of peritoneal disease.
Greater penetration
The aerosol pressure allows chemotherapy to penetrate deeper into tumor tissue than liquid chemotherapy.
Good tolerance
Systemic toxicity is very low, allowing patients to maintain quality of life during treatment.
PIPAC indications
PIPAC is especially indicated in the following situations:
Unresectable carcinomatosis
Patients with extensive peritoneal carcinomatosis who are not candidates for complete cytoreductive surgery with HIPEC.
Neoadjuvant treatment
To reduce tumor burden before definitive cytoreductive surgery, converting inoperable cases to operable ones.
Peritoneal recurrence
In patients with carcinomatosis recurrence after previous treatment with HIPEC or other therapies.
Palliative control
To control malignant ascites and improve quality of life in patients with advanced disease.
Our experience in PIPAC
At Quenet-Torrent Institute we were pioneers in introducing PIPAC in Spain and have one of the largest series of patients treated with this technique. Our team has developed specific treatment protocols and actively participates in international clinical trials.
The PIPAC technique complements our therapeutic offering for peritoneal carcinomatosis, providing treatment alternatives to patients who previously had no surgical options.
Pathologies treated with PIPAC
The PIPAC procedure is used in the treatment of various pathologies with peritoneal involvement.
Peritoneal carcinomatosis
Treatment of peritoneal tumor spread from various origins.
More informationGynecological tumors
Especially useful in advanced or recurrent ovarian cancer.
More informationEsophagogastric tumors
In unresectable gastric carcinomatosis.
More information
Real cases
Patient testimonies and surgery explanations
Real testimonies from patients treated by our team in high-complexity surgical oncology.
Debra's case
66-year-old English woman with advanced ovarian cancer and peritoneal metastases. Treated with cytoreduction + HIPEC, she is now disease-free.
Read the full caseRosario (Charo)'s case
73-year-old patient with advanced cancer treated with chemotherapy and high-complexity surgical oncology. Excellent survival and quality of life.
Read the full caseLaura's case
Rare abdominal tumor treated with complex cytoreductive surgery plus HIPEC and systemic chemotherapy. Disease-free after almost 2 years.
Read the full caseSantiago's case
Diagnosed with widespread peritoneal carcinomatosis and considered inoperable. After complete cytoreduction with HIPEC, today his is a story of hope and survival.
Read the full case
Verified reviews
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★★★★★
What our patients say
L
4 weeks ago
★★★★★
Wonderful surgical team, among the best out there. Dr. Torrent (expert in peritoneal carcinomatosis) is an exceptional surgeon and an even better person. His coordinator is super kind, fast and efficient. The human treatment is great and the results are too. This is of vital importance for cancer patients.
K
5 months ago
★★★★★
In the public healthcare system they gave my father a maximum of one year to live. They only offered him chemo and no hope, said it was impossible, that nothing could be done. He had several tumors inside the peritoneal sac with metastases. A year and a half later he is clean, completely cured. His latest PET scan came back clean. We are very happy. Thanks to Dr. Torrent and his team. THANK YOU.
M
A year ago
★★★★★
Excellent professionals, especially Dr. Torrent, attentive at all times to the patient (my wife), operated for peritoneal pseudomyxoma. They helped us with all our needs since we came from outside Barcelona. Thank you Elisabeth. We are very grateful to Quenet Torrent Institute, thank you for everything.
P
2 years ago
★★★★★
I am a 63-year-old patient. They detected adrenal gland cancer and told me there was nothing to be done. I sought a second opinion and they told me about the Quenet Torrent team, specialists in complex operations. Dr. Torrent, from the first moment, told me they could operate. They operated and removed a large tumor mass. I spent a week in the ICU and a month on the ward. Every day he came morning and evening, no matter Saturday or Sunday. Never throw in the towel. I am happy to have found these professionals who gave me my life back. Thank you.
I
3 years ago
★★★★★
Many thanks for your attention. Dr. Torrent always attentive, involved and decisive. The reception staff very pleasant and always offering the best option. 100% RECOMMENDED. THANK YOU.
M
5 years ago
★★★★★
Dr. Torrent helped me make the best decision at a difficult moment. I think he is a great professional and a person capable of accompanying you and putting himself in another's shoes. Thank you for everything.
F
6 years ago
★★★★★
I have peritoneal carcinomatosis. Sending my diagnosis to every center, practically all agreed on palliative chemo with little survival time since I had very aggressive cell types. Until we reached Dr. Quenet, Dr. Torrent and their team. I can only confirm what their CV announces: they are far ahead of the rest. They saved my life — at surgery the harmful cells everyone diagnosed (and used to refuse to operate) were not there. This intervention has become the best investment of my life.
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