HIPEC

I found this information on the Internet for a portion of the operation that I might have. This is the part that brought me to Dr. Y because he is one of three or four surgeons who are trained to do it. In addition I am told he is the best.
HIPEC means Hyperthermic Intra Peritoneal Chemotherapy.

Note: Peritoneal refers to the membrane that wraps abdominal organs.

Before connecting the HIPEC, the surgeon must remove all visible cancer. It must be understood here that surgeons do not cut into a tumor, they take a margin all around the tumour of healthy cells. This, (having an acceptable margin), can lead to difficulties and that is why Dr. Y does not give me any guaranties. Once all visible cancer is removed (in my case probably colon, duodenum, part of the stomach, part of the mesentery and perhaps more) the doctor installs tubes and the abdomen closed temporarily to perform HIPEC ( read the description of HIPEC below). HIPEC is therefore expected to kill all traces of cancer that can not be seen with the naked eye and even perhaps some that can be seen but are not possible to cut(no margin).
Then he opens the abdomen, removes the tubes and proceeds to clean the cavity and finally close it permanently. Note that if the rectum is affected by cancer and there is not enough room to connect the small intestin then there will be ileostomy (an opening in the abdominal wall for elimination of feces in a bag).

How HIPEC Works
Below is an animation of the HIPEC procedure.



During the HIPEC procedure, the surgeon will continuously circulate a heated sterile solution containing a chemotherapeutic agent throughout the peritoneal cavity, for a maximum of two hours. The HIPEC procedure is designed to attempt to kill any remaining cancer cells.
Giving the chemotherapy in the abdomen at the time of surgery allows for greater concentrations of the drug where it is needed. Adding heat has a threefold advantage:
Heat at 42 degrees Celsius kills cancer cells while not affecting normal cells.
Heat makes the killing effect of the chemotherapy more powerful.
Heat softens the tumor nodules so the penetration of the chemotherapy into the tumor is enhanced.
The procedure also improves drug absorption and effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.