OHSU Knight Cancer Institute

HIPEC Surgery

Dr. Divya Sood, reassures a patient in an exam room. She is in the center of the image, pointing to a scan as she explains the HIPEC procedure. The patient is sitting on the left, facing her.
Dr. Divya Sood is a cancer surgeon and researcher with advanced expertise in HIPEC surgery.

HIPEC surgery is a leading-edge therapy for patients whose cancer has spread inside the abdomen. Key points to know about this therapy:

  • It can help patients with many types of cancer that are hard to treat.
  • It can extend life span and ease symptoms.
  • It requires expert care from a team of skilled providers.
  • You’ll spend five to seven days in the hospital and several months in recovery.
  • Recovery times are getting shorter, thanks to innovations developed at the Knight.

This animation explains how HIPEC works. It depicts surgery and internal organs. Mira este video en Español. (Medical Animation Copyright © 2023 Nucleus Medical Media. All rights reserved.)

What is HIPEC surgery?

This therapy is an innovative treatment for cancer that has spread inside your abdomen. This type of cancer can be hard to treat. HIPEC surgery has two steps:

  • Cytoreductive surgery to remove tumors.
  • Hyperthermic intraperitoneal chemotherapy (HIPEC) to flood your abdomen with a powerful dose of cancer-fighting drugs.

How does it work?

Your abdominal cavity is lined with a tough membrane called the peritoneum. It’s like a balloon that contains several organs, such as your stomach, liver and intestines.

The peritoneum protects your organs and forms a barrier against infection. Unfortunately, this barrier also makes it harder to treat your cancer with traditional chemotherapy. The balloon keeps the chemo drugs from reaching all the cancer.

HIPEC surgery turns this problem into a solution. Instead of trying to fill the balloon from the outside, doctors fill it from the inside. That way the chemo drugs go straight to the cancer. Even better, the peritoneum stops them from entering your bloodstream, which cuts down on side effects.


First, doctors perform cytoreductive surgery. They remove tumors from your abdomen with special tools. When possible, they use minimally invasive techniques such as robotic surgery.

This is an aggressive surgery. Doctors may remove whole organs or parts of several organs, though they spare as many organs as possible.


After the surgery, doctors use HIPEC to kill any microscopic traces of cancer that remain. They use tubes to flood your abdomen with heated chemotherapy drugs.

This method enables doctors to deliver 20 times more chemo with fewer side effects. The heat makes the drugs even better at killing cancer cells.

The solution circulates for about 90 minutes. Then surgeons drain the solution, remove the tubes and stitch you back up.

HIPEC surgery is a complex procedure that usually requires eight to 10 hours in the operating room.

What types of cancer is HIPEC used for?

The most common conditions include:

How long will I stay in the hospital?

HIPEC is complex surgery. Nationwide, many patients spend 10 to 12 days in the hospital and several months in recovery.

However, recovery times are getting shorter, thanks to innovations pioneered at the Knight. This includes:

  • Physical therapy and a high-protein diet before the operation.
  • More local anesthetics, fewer narcotics.
  • Nutrition support.
  • Physical therapy after the operation.

We provide extensive support before and after surgery.

Most of our patients spend five to seven days in the hospital.

Find out more about how we support patients and their families.


Studies show this therapy provides many patients with significant benefits:

  • Longer life span
  • Fewer symptoms
  • Fewer side effects, such as fatigue or hair loss


This therapy has important limitations and risks:

  • Some patients may not be well enough for surgery.
  • Any surgery carries a risk of complications. The risk is lower at hospitals where the procedure is done more often.
  • Patients spend days in the hospital and months recovering.
  • Patients benefit from ongoing medical support afterward.

Why choose the Knight?

For patients

Call 503-494-5501 to:

  • Request an appointment
  • Seek a second opinion
  • Ask questions


Knight Cancer Institute, South Waterfront

Center for Health & Healing, Building 2
3485 S. Bond Ave.
Portland, OR 97239

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