HIPEC Patient Journey: From First Consultation to Discharge

The short answer: HIPEC (heated chemotherapy inside the belly, sometimes called garam chemo, पेट के अंदर गर्म कीमोथेरेपी) is given during a long open operation that removes all visible cancer, mostly for selected women with advanced ovarian cancer (see our guide to ovarian cancer diagnosis and treatment). Tests and preparation usually take a few weeks before surgery, often about 4–8 weeks, and longer if chemotherapy is given first (usually 3 cycles). The operation usually takes 8–14 hours. Most women stay in hospital about 10–14 days, including 3–5 days in the ICU (intensive care). Gentle daily activity usually returns in about 4–6 weeks, and full recovery takes about 3–4 months. Every patient is different, so use this as a general guide; your own plan comes from your surgical team. Below is the step-by-step roadmap.

On this page

• Step 1: First consultation
• Step 2: Work-up and tumour board
• Step 3: Pre-op preparation
• Step 4: Surgery day
• Step 5: ICU and ward
• Step 6: Discharge and recovery
• Step 7: Adjuvant therapy + surveillance

Step 1: First consultation (1 day)

Bring all reports — CT/MRI scans, biopsy results, tumour markers, prior treatment summaries. Dr. Nishtha reviews disease distribution (PCI estimate), surgical resectability, and patient fitness. Discussion about candidacy, expected duration of surgery, hospital stay, costs, and outcomes. Decision to proceed is shared — not unilateral.

Step 2: Work-up and tumour board (1–2 weeks)

Investigations: CT chest/abdomen/pelvis (if not done), echocardiography, pulmonary function tests, comprehensive blood work, anaesthesia consultation. Case discussed at multidisciplinary tumour board with medical oncology, radiation oncology, pathology, radiology. Final decision documented.

Step 3: Pre-op preparation (2–4 weeks)

Optimisation phase: nutritional review, physiotherapy assessment, iron repletion if anaemic, smoking cessation if applicable. Insurance pre-authorisation initiated. Date for surgery scheduled. Pre-op physical conditioning (“prehabilitation”) meaningfully improves recovery — most patients should walk 30 minutes daily for 2–4 weeks before surgery.

Step 4: Surgery day (usually 8–14 hours)

Admission previous evening. Bowel preparation. Anaesthesia review confirms readiness. The operation usually takes 8–14 hours: first the cancer-removal surgery (cytoreduction), then heated chemotherapy circulated inside the belly (HIPEC perfusion) for 60–90 minutes, then any repair (reconstruction). Family is updated by phone at intervals.

Step 5: ICU and ward (about 10–14 days)

• First days: ICU (intensive care) monitoring, usually for 3–5 days: pain control, fluid balance, breathing support if needed
• After the ICU: move to the ward; sitting, then walking with support
• Diet restarts gradually as the bowel starts working again
• Drains and tubes are removed step by step; preparing for discharge
• Around day 10–14: discharge home, depending on recovery

Step 6: Discharge and recovery (about 3–4 months)

Gentle daily activity usually returns in about 4–6 weeks, and full recovery takes about 3–4 months. First follow-up at 1–2 weeks post-discharge. Wound check, drain check, function review. Light walking allowed immediately; heavy lifting avoided for 6 weeks. Pathology discussed at 2–3 weeks once final report available. Adjuvant therapy decision made.

Step 7: Adjuvant therapy + surveillance

Adjuvant chemotherapy typically starts at 4–6 weeks post-surgery if planned. Surveillance: 3-monthly examinations + CA-125 for 2 years, then 6-monthly to year 5, then annually.

See complete HIPEC guide, HIPEC eligibility and treatment, cost details.

FAQs

Reviewed by Dr. Nishtha Tripathi Patel, MBBS, DGO, DNB, Fellowship Gynaecological Oncology, ESGO-certified. To book: WhatsApp +91 76988 00333.