Laparoscopic placement of PAP catheters for intraperitoneal chemotherapy in ovarian carcinoma

Objective. To our report our experience with the laparoscopic placement of peritoneal access ports and to compare it to our experience with placement at laparotomy. Methods. Patients with advanced ovarian carcinoma were enrolled in a study to receive intraperitoneal paclitaxel in combination with intravenous cisplatin and cyclophosphamide as first-or second-line chemotherapy. Patients had a PAP catheter placed at primary laparotomy or by a separate laparoscopic procedure under general anesthesia. Results. In 13 patients a PAP catheter was placed during primary laparotomy, without complications. Thirteen patients had laparoscopic catheter placing, using routine Veress needle insufflation. After a bowel perforation at insertion of the umbilical trocar had occurred in one patient, due to extensive adhesions, we decided to use only an open laparoscopic procedure. No other procedure or catheter-related complications occurred. Conclusion. Laparoscopic-assisted placement of PAP catheters is feasible, but should preferably be performed by an open laparoscopic procedure in this patient population at risk for intraabdominal adhesions. (C) 1998 Academic Press.