Comprehensive management of epithelial ovarian cancer with peritoneal metastases

Figure 2 Peritonectomy procedures. A: A fixed retractor is used to provide exposure of the entire abdomen so that peritonectomy procedures on the anterior abdominal wall, beneath the hemidiaphragms, and within the pelvis can proceed in an efficient manner; B: Left upper quadrant peritonectomy; C: Cholecystectomy, lesser omentectomy and peritonectomy of the omental bursa; D: Rectosigmoid colon resection and complete pelvic peritonectomy; E: Reconstruction after rectosigmoid colon resection and complete pelvic peritonectomy. The vagina is closed prior to the hyperthermic intraperitoneal chemotherapy. The low stapled colorectal anastomosis is performed after the chemotherapy lavage is complete (all from Sugarbaker [19]).