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PIPAC
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PIPAC (pressurized intraperitoneal aerosol chemotherapy) is a targeted, minimally invasive approach for patients with peritoneal surface malignancies. These complex cancers affect the lining inside the abdomen and can be difficult to control with standard treatments alone.
UT Southwestern Medical Center provides advanced care for patients with peritoneal surface malignancies, bringing together specialized expertise and treatment options designed for the complex disease.
What Is PIPAC?
Pressurized intraperitoneal aerosol chemotherapy, or PIPAC, is a minimally invasive cancer treatment that delivers chemotherapy directly into the abdomen. The goal is to treat cancer on the peritoneum – the thin lining inside the abdomen.
PIPAC is performed during a short laparoscopic procedure that uses small incisions, a tiny camera, and special tools. It’s usually considered a palliative treatment, meaning it’s used to help manage cancer and symptoms but not cure it.
What Conditions Does PIPAC Treat?
PIPAC treats certain cancers that involve the peritoneum. These cancers usually start in another organ, then spread inside the abdomen.
PIPAC can be used to treat:
- Colorectal cancer
- Gastric (stomach) cancer
- Ovarian cancer
- Appendix cancer
- Peritoneal mesothelioma
Why Choose UT Southwestern for PIPAC?
UT Southwestern offers expert care for peritoneal surface malignancies (PSM), which can be complex and often require specialized treatments. For patients facing difficult-to-treat disease, PIPAC offers access to an advanced therapy that’s not widely available.
Our patients benefit from a coordinated, team-based approach that brings together specialists across disciplines. Key features include:
- A multidisciplinary PSM program at the only National Cancer Institute (NCI)-designated Comprehensive Cancer Center in North Texas
- Expertise in both surgical and minimally invasive treatments, including PIPAC
- A care team with specialized training in PIPAC techniques and safety protocols
- Advanced equipment and dedicated operating room processes for aerosol chemotherapy delivery
- Close coordination among surgical oncology, anesthesia, and perioperative teams to support care before, during, and after treatment
What Are the Benefits of PIPAC?
PIPAC offers a targeted approach for cancers that are difficult to treat. It may help patients continue treatment when standard options are no longer effective.
Potential benefits of PIPAC include:
- Direct chemotherapy delivery: PIPAC sends chemotherapy directly into the abdominal cavity. The medicine becomes a fine mist and is delivered under pressure. This helps it spread across the peritoneum and be absorbed into cancer tissue.
- Fewer whole-body side effects: Less chemotherapy travels through the bloodstream. This may reduce some side effects compared with standard chemotherapy.
- Less invasive treatment: PIPAC uses small incisions instead of open surgery, which can mean less discomfort and a quicker recovery.
- Shorter hospital stay: Many patients go home the same day or within 24 hours.
- Symptom relief: PIPAC may help control symptoms for some patients, improving their comfort and quality of life.
- Possible bridge to other treatments: PIPAC may shrink tumors for some patients, which could make surgery or another procedure possible later.
What Should Patients Expect Before PIPAC?
Our surgical oncology team evaluates patients before PIPAC, considering:
- Cancer type
- Disease location
- Symptoms
- Prior treatments
Our team also considers whether laparoscopy can be done safely.
PIPAC may not be right for every patient. Other treatments may be better if cancer blocks the bowel or if cancer has spread outside the abdomen. Our care team may discuss several options to match treatment to the patient’s disease and overall health.
What Should Patients Expect During PIPAC?
PIPAC is performed under general anesthesia, which means the patient is asleep during the procedure and monitored by an anesthesiologist.
The surgeon makes small cuts in the abdomen and inserts a tiny camera and special device through the incisions. The device turns liquid chemotherapy into a pressurized mist, and the mist spreads through the abdominal cavity.
The chemotherapy mist usually stays in the abdomen for about 30 minutes. Then the care team removes the gas and chemotherapy mist through a closed system. The procedure typically takes about one to two hours.
What Should Patients Expect After PIPAC?
After PIPAC, patients are monitored in a recovery area. Many patients go home the same day or within 24 hours. Recovery is usually shorter than after major abdominal surgery.
PIPAC is typically repeated every six to eight weeks. The exact schedule depends on the patient’s cancer and care plan.
Most side effects are mild and temporary. They can include:
- Abdominal pain or cramping
- Nausea or vomiting
- Bloating
- Temporary appetite changes
- Constipation or diarrhea
Serious side effects are rare. They can include infection, bleeding, bowel injury, or scar tissue.
What Support Services for PIPAC Does UT Southwestern Offer?
Patients receiving PIPAC may need help managing many parts of care. UT Southwestern offers support to help patients and families understand next steps, schedule visits, and move through treatment.
A nurse navigator serves as a point of contact for patients and families, helping coordinate appointments, gather information, and connect patients with the right services.
Additional support we provide may include:
- Social work
- Nutrition guidance
- Education
- Help finding resources
What Clinical Trials Are Available for PIPAC?
As an NCI-designated Comprehensive Cancer Center, we offer access to a broad range of clinical trials. These can give eligible patients access to options not available at many centers.
Current trials for patients with peritoneal surface malignancies include:
- NCT06269978: A Phase 1 Study to Evaluate Safety and Efficacy of Intraperitoneal FOLFOX in Patients with Unresectable Colorectal Cancer Peritoneal Metastasis
- NCT07001748 (STOPGAP II Trial): A Randomized Phase II/III Trial for Testing the Addition of Paclitaxel Administered into the Abdominal Cavity Combined with Chemotherapy for Patients with Gastric Cancer Spread to the Abdominal Cavity
Patients should talk to their care team to see if a clinical trial is appropriate.
Related Conditions and Treatments
We have a wide range of clinical trials open to patients with all types and stages of cancer. Search for opportunities to participate in a cancer study.
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