VIAMED INSTITUTE OF
ADVANCED SURGICAL ONCOLOGY

Electrostatic precipitation Pressurized IntraPeritoneal Aerosol Chemotherapy (ePIPAC)

An option for patients with chemo-resistant disease and beyond, even an option for PIPAC-resistant disease

An ePIPAC, a minimally invasive technique for patients with peritoneal carcinomatosis, is performed for the first time in Spain.

Madrid, July 10, 2023. The team from the Viamed Institute of Advanced Surgical Oncology (IVOQA), led by Dr. Delia Cortés Guiral, performed an ePIPAC for the first time in Spain on a patient with peritoneal carcinomatosis at the Viamed Santa Elena Hospital in Madrid. IVOQA is the only center in Spain that offers this state-of-the-art treatment for patients with malignant peritoneal disease.

The ePIPAC consists of delivering, by minimally invasive surgery (laparoscopy) intraperitoneal chemotherapy in a pressurized aerosol with electrostatic precipitation.

This minimally invasive surgery, which only requires two or three small 1 cm incisions, consists of a laparoscopy for delivering pressurized aerosolized chemotherapy (PIPAC) into the abdomen. In addition to this is the latest ePIPAC technology, which consists of adding electrostatic precipitation to increase the penetration of chemotherapy into tumor nodules and improve its distribution within the abdomen.

This procedure is indicated for cancer patients with peritoneal metastases of any origin who, due to the location or amount of disease within the abdomen, are not candidates, from the outset, for a surgery with curative intent (cytoreductive surgery and HIPEC)

Likewise, patients with peritoneal metastases from ovarian, fallopian or endometrial, colon, rectal, stomach, pancreatic, cholangiocarcinoma, appendix, small intestine, primary peritoneal cancer, primary peritoneal cancer, mesothelioma, pseudomyxoma, breast cancer, melanoma may be candidates for this new technique.

As explained by Dr. Cortés, among the main benefits of this direct administration in the form of a pressurized aerosol and with electrostatic discharge, it must be highlighted, the deeper penetration of the chemotherapy in the tumor nodules since it is four times deeper than with PIPAC, and the improved distribution of chemotherapy throughout the abdomen, reaching more homogeneously the whole abdomen instead of remaining the largest amount of chemotherapy in front of the nebulizer.

“This is really interesting because thanks to an electrode we can charge, negatively ionize the gas and a plate let the patient’s tissues, in this case the peritoneum, to remain positively charged. The result of all this is that the aerosol chemotherapy negatively charged is attracted to the tumor nodules (positively charged) and to every corner of the abdomen, going a step beyond the benefits of the conventional PIPAC technique”, points out the specialist.

In addition, ePIPAC makes it possible to shorten surgical time and the patient is usually discharged 24 hours after the intervention.

“It is a safe technique, with a very low number of complications and similar to those of the conventional PIPAC technique, the most frequent and not very serious being abdominal discomfort that subsides in the hours following the procedure, since the chemotherapy remains acting in the peritoneum and in tumor nodules, so systemic effects are marginal”

IVOQA is the most active PIPAC center in Spain and they are leaders in personalized medicine for patients with advanced cancer. "Carrying out this intervention for the first time means for us to continue advancing in our commitment to make the most advanced techniques for the treatment of cancer patients accessible in Spain," says Dr. Delia Cortés Guiral

To which she adds that “ePIPAC is available in Switzerland, Germany and France and now in Spain as a treatment option for patients with advanced cancer thanks to IVOQA”.

IVOQA located in the Viamed Santa Elena Hospital, Madrid, Spain, is characterized by having an experienced multidisciplinary team dedicated to the treatment of cancer patients and state-of-the-art technology facilities that have allowed this pioneering intervention to be carried out, where, Dr. Carlos Guijarro, member of the surgical team and Drs. Carlos Perrino and Cristina Corrales, anesthetists specialized in this type of procedure, has also participated.

Do not hesitate to request an appointment with our specialists

ePIPAC at IVOQA in the news

Dr. Javier Heras

BREAST UNIT

  • Graduate in Medicine and Surgery from Universidad Autonoma de Madrid 1992.
  • Specialist via MIR in Family Medicine at Hospital Universitario Ramón y Cajal 1994-1996.
  • Specialist via MIR in OBSTETRICS AND GYNECOLOGY at Hospital Universitario Santa Cristina in Madrid 1997-2001.
  • Specialized in the last 27 years in Gynecological Oncology and Breast Pathology, both malignant and benign, with experience in Oncoplastic Surgery.
  • Specialization Course in Oncoplastic Breast Surgery 2015.
  • Coordinator of the Breast Unit and the Breast Tumors and Gynecology Oncology Committee in Hospital Universitario Infanta Sofía.
  • Main Author of the Breast Unit Accreditation Project (Hospital Universitario Infanta Sofía) 2019-2020.

Dr. Beatriz García-Conde

DIGESTIVE SYSTEM MEDICINE

  • Graduate in Medicine and Surgery.
  • MIR specialisation in Digestive System Medicine, Puerta de Hierro University Hospital in Majadahonda. Currently working at the 12 de Octubre University Hospital.
  • Specialist in capsule endoscopy and in diagnostic and therapeutic endoscopy: chromoendoscopy, colon cancer screening, digestive dilatations, PEG placement, endoluminal vacuum therapy (fistulas/leaks), polypectomy/mucosectomy.
  • She also a general digestive consultant with a Master’s Degree in Neurogastroenterology.

Dr. Micaela Riat Castro Zocchi

DIGESTIVE SYSTEM MEDICINE

  • Graduate in Medicine and Surgery.
  • MIR specialisation in Digestive System Medicine, Princesa Hospital (Madrid).
  • Clinical consultation. Diagnostic and therapeutic endoscopy: Chromoendoscopy, Colon Cancer Screening, Placement of digestive prosthesis (oesophagus, colon), Digestive dilatations, PEG Placement, Endoluminal Vacuum Therapy (fistulas/leaks), Polypectomy/mucosectomy. Experience in Bariatric Endoscopy: Intragastric balloon.

Dr. Diana Fresneda Cuesta

DIGESTIVE SYSTEM MEDICINE

  • Graduate in Medicine and Surgery.
  • MIR specialisation in Digestive System Medicine, Jiménez Díaz Foundation. (Madrid)
  • Clinical consultation. Specialist in Endoscopic Capsule and in Diagnostic and Therapeutic Endoscopy: Chromoendoscopy, Colon Cancer Screening, Ligation of Oesophagus Varices, Placement of digestive prosthesis (oesophagus, colon), Digestive dilatations, PEG Placement, Endoluminal Vacuum Therapy (fistulas/leaks), Polypectomy/mucosectomy. Experience in bariatric endoscopy: intragastric balloon, POSE method and Endo-sleeve with POSE system, etc.

Dr. Teresa Valdés Lacasa

DIGESTIVE SYSTEM MEDICINE

  • Graduate in Medicine and Surgery
  • MIR specialisation in Digestive System Medicine, 12 de Octubre University Hospital (Madrid). Advanced Endoscopy Fellowship (ERCP and digestive prostheses) at Ninewells Hospital (United Kingdom). 2020-2021.
  • Clinical consultation and abdominal ultrasound.
  • Specialist in pancreatico-biliary conditions and therapeutic endoscopy: ERCP, placement of digestive prostheses (oesophagus, duodenum, colon, biliary), digestive dilatations, placement of PEGs, endoluminal vacuum therapy (fistulas/leaks), polypectomy/mucosectomy.

Dr. Andrés J. del Pozo García, MD. PhD.

DUAL SPECIALISATION IN DIGESTIVE SYSTEM MEDICINE / FAMILY AND COMMUNITY MEDICINE

  • Graduate in Medicine and Surgery.
  • Dual specialised training (MIR) at the Princesa University Hospital (Madrid).
  • Specialist in Digestive System Medicine and Specialised in Family and Community Medicine
  • PhD in Medicine from the Autonomous University of Madrid. Cum Laude. 2020.
  • Member of S.E.P.D, S.E.E.D., A.E.G, E.S.G.E, AESPANC, Board Member of GETTEMO; Consultant of Apollo Endosurgery in 2021.

Dr. José María Abadal Villayandre

SPECIALIST IN VASCULAR INTERVENTIONAL RADIOLOGY

  • Graduate in Medicine and Surgery from Navarra University.
  • MIR specialisation in Radiology, Radiodiagnosis at Gregorio Marañón University Hospital.
  • PhD in Radiodiagnosis from the Complutense University of Madrid. Cum Laude Doctoral Thesis.
  • Specialist in Vascular Interventional Radiology, accreditation from the Spanish Society of Interventional Radiology.
  • European Board Interventional Radiology (EBIR) Health Sciences) at Alfonso X el Sabio University. 2010-2014.
  • Medical Director of the “Centro de Radiología y Diagnóstico por Imagen”.
  • Scientific and research activity with numerous publications and research studies.
  • Director and professor of Interventional Vascular Radiology at the I-XI Endo-school. Teaching activity.
  • Member of SERAM (Spanish Society of Medical Radiology), CIRSE (Cardiovascular Interventional Radiology Society Europe), and Secretary of SERVEI (Spanish Society of Interventional Vascular Radiology).

Belén Pérez Peiro. Psychologist

SPECIALIST IN PSYCHO-ONCOLOGY

  • Graduate in Psychology
  • Clinical psychologist, Gregorio Marañón University General Hospital, Psycho-oncology, Gynaecological Psychology, Neuropsychology, Detoxification and Out-patient Hospital, inflammatory bowel disease and teenagers.
  • Clinical activity at the Niño Jesús Children’s University Hospital, Psychiatric and Eating Disorder Units.
  • Expert qualification in Psychosomatic Medicine and Health Psychology.
  • Expert qualification in Psychopathology and Psychiatry from the Spanish Society of Psychosomatic Medicine and Medical Psychology.
  • Specialist qualification in Psychotherapy and projective techniques, both of which are recognised by the Madrid Official Association of Psychologists.

Dr. Ana María Moreno

SPECIALIST IN INTERNAL MEDICINE AND NUTRITIONAL PREHABILITATION

  • Graduate in Medicine and Surgery. 1986– 1992.
  • Extraordinary Graduation Award. 1992.
  • MIR specialisation in Internal Medicine. Number 283.
  • Master’s Degree in Palliative Care from Valladolid University. 2011.
  • University Master’s Degree in Advanced Chronic Nursing and palliative care from Antonio de Nebrija University. 2017.
  • PhD Courses 1993.
  • Extensive professional career in many renowned hospitals.
  • Head of Internal Medicine Services at Viamed Santa Elena (Madrid). September 2021 – Present.
  • Teaching and research work.
  • Numerous publications and papers. Participation in courses and seminars.