HIPEC / CRS-HIPEC (Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy)
Oncology
Starting from
$15,000
Up to $45,000 depending on centre
Typical duration
21–45 days
Including pre-operative work-up
Content reviewed for medical accuracy by: Dr. Rodina Ainasoa · Medical Content Writer & Health Communications
Overview
A two-step surgical oncology treatment for peritoneal surface malignancies — cytoreductive surgery (CRS) to remove all visible tumour from the abdominal cavity, followed immediately by heated chemotherapy circulated directly within the abdomen (HIPEC) to destroy remaining microscopic disease. Used for peritoneal carcinomatosis arising from colorectal, appendiceal, ovarian, and gastric cancers, and pseudomyxoma peritonei.
Your case is matched to a centre on the basis of clinical outcome data, not marketing. We coordinate every step — from pre-operative work-up to post-treatment follow-up — with a dedicated care coordinator.
What's included
HIPEC / CRS-HIPEC (Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy)
Coordinated from
or message us on WhatsApp
No commitment required. Your data is never shared with third parties.
Who Is a Candidate for CRS-HIPEC?
CRS-HIPEC is reserved for patients with peritoneal surface malignancy where complete or near-complete removal of visible tumour is realistically achievable. Candidacy is assessed using the Peritoneal Carcinomatosis Index (PCI) alongside imaging and diagnostic laparoscopy.
- Peritoneal carcinomatosis arising from colorectal cancer, appendiceal cancer (including pseudomyxoma peritonei), ovarian cancer, or select gastric cancers, per Cleveland Clinic and NCBI/StatPearls
- A Peritoneal Carcinomatosis Index and disease distribution assessed on CT/PET imaging and staging laparoscopy as amenable to complete or near-complete cytoreduction
- No significant disease outside the abdominal cavity (extra-abdominal metastasis), which would generally make CRS-HIPEC inappropriate
- Overall fitness — including comorbidities and functional status — sufficient to tolerate a long operation and extended recovery, reviewed by a multidisciplinary surgical oncology tumour board
The Procedure: Step by Step
CRS-HIPEC is performed in two connected stages during a single operation. The steps below describe the standard open approach; a robotic-assisted approach may be suitable for carefully selected, low tumour-burden cases (see the standard vs. robotic-assisted comparison below).
Staging and pre-operative work-up
CT/PET imaging and, in most cases, a staging laparoscopy confirm the extent of peritoneal disease and calculate the Peritoneal Carcinomatosis Index, per NCBI/StatPearls.
Cytoreductive surgery (CRS)
The surgical team removes all visible tumour from the peritoneal surfaces and, where affected, involved organs — this stage alone can take several hours depending on disease extent.
Hyperthermic intraperitoneal chemotherapy (HIPEC)
Heated chemotherapy solution is circulated directly through the abdominal cavity for a set period immediately after cytoreduction, to treat microscopic residual disease that surgery cannot remove, per Cleveland Clinic.
Closure and ICU recovery
The abdomen is closed and you are transferred to intensive care for close monitoring, given the extent of the surgery and the fluid and metabolic shifts involved.
Recovery Timeline
Open CRS-HIPEC commonly takes many hours in the operating room — reported ranges run from around 6 hours up to 12-15 hours depending on how much peritoneal surface must be treated.
A period in intensive care follows surgery for close monitoring of fluid balance, kidney function, and early complications, per Cleveland Clinic.
Inpatient recovery is typically 10-14 days or longer, depending on the extent of surgery and any complications, per NCBI/StatPearls.
Full recovery at home continues for several more weeks; your care team will guide activity levels, nutrition, and follow-up imaging.
Source: Cleveland Clinic; Mayo Clinic; NCBI/StatPearls (Bookshelf NBK570563). Individual recovery varies and is guided by your surgical oncology team.
Known Risks & Limitations
- Anastomotic leak — a breakdown of a bowel reconnection made during surgery — is a recognised risk, and the likelihood increases with the number of bowel resections performed, per published perioperative outcomes analyses.
- Infection, including deep surgical site infection, and the possible need for reoperation are risks that also rise with more extensive bowel resection.
- Chemotherapy-related renal (kidney) toxicity can occur from the agents circulated during the HIPEC phase and is monitored closely during and after surgery.
- As an extensive abdominal operation, bleeding and general surgical morbidity are comparable to other major surgical oncology procedures, per NCBI/StatPearls; one contemporary analysis reported no operative or 30-day mortality with a 60-day mortality of 2.7%.
- As with any procedure involving general anaesthesia, there are anaesthesia-related risks your medical team will review with you individually.
Source: NCBI/StatPearls (Cytoreduction and HIPEC, Bookshelf NBK570563); Cleveland Clinic; published perioperative outcomes analyses (PMC). No procedure is without risk; your surgical oncology team will review your individual risk factors.
The CureSureMedico Care Pathway
Remote case review
Share your imaging, pathology, and staging laparoscopy findings. Our coordination team forwards your case to a surgical oncology tumour board to confirm candidacy and calculate your Peritoneal Carcinomatosis Index.
Approach confirmation
The tumour board confirms whether open CRS-HIPEC or, for carefully selected low-burden disease, a robotic-assisted approach is appropriate for your case.
Consolidated estimate
A cost estimate covering surgery, HIPEC chemotherapy agents, ICU and inpatient stay, and initial follow-up is issued before you travel.
Surgery and extended recovery
Your care team monitors your ICU and inpatient recovery, coordinating nutritional support and any stoma care needs before you are cleared to travel home.
Continuity of care post-return
A treatment summary — including surgical findings, chemotherapy agents used, and a follow-up surveillance imaging schedule — is shared with your home oncologist.
Treatment approaches
Standard and robotic-assisted HIPEC / CRS-HIPEC (Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy)
Standard Approach
Open CRS-HIPEC
21–45 days
Robotic-Assisted Option
Robotic-Assisted CRS-HIPEC
14–28 days
Comparing the two approaches
| Standard | Robotic-Assisted | |
|---|---|---|
| Procedure | Open CRS-HIPEC | Robotic-Assisted CRS-HIPEC |
| Technology | Conventional surgical instruments | Robotic-assisted surgical system with surgeon oversight |
| Availability | Hospital-dependent | Selected hospitals with robotic capability |
| Specialist | Procedure specialist | Specialist with relevant robotic experience |
| Clinical suitability | Case-dependent | Case-dependent |
| Tariff | $15,000–$45,000 | $28,000–$50,000 |
| Duration | 21–45 days | 14–28 days |
Eligibility for robotic-assisted treatment
- Low peritoneal tumour burden (a low Peritoneal Carcinomatosis Index) confirmed on imaging and staging laparoscopy — this comparison applies only to carefully selected, low-burden cases, most established for appendiceal neoplasms and studied for limited-metastasis gastric cancer in trials such as the Mayo Clinic's ROBO-CHIP Phase II study
- No extensive multi-quadrant peritoneal disease that would require the wide surgical access only open surgery can provide for complete cytoreduction
- Multidisciplinary surgical oncology tumour board review confirming that complete or near-complete cytoreduction is achievable through a minimally invasive approach
- Availability of a robotic surgical platform and a surgical oncology team with specific experience in robotic CRS-HIPEC at your selected hospital — offered at very few centres worldwide
Risks and limitations of robotic-assisted surgery
- Robotic assistance does not eliminate the risks of CRS-HIPEC, including anastomotic leak, bleeding, infection, and chemotherapy-related renal toxicity
- The surgical oncologist remains responsible for achieving complete cytoreduction; robotic guidance is an aid, not a substitute for the surgeon's judgement, and conversion to open surgery is possible if disease is more extensive than expected
- Robotic CRS-HIPEC is still an emerging approach studied mainly in phase II trials and retrospective series for low-burden disease — open surgery remains the standard of care for most patients, particularly those with higher-burden or multi-quadrant peritoneal disease
- Availability is limited to a small number of specialist surgical oncology centres, and the technology fee adds to the overall cost compared with open CRS-HIPEC
Tariff structure
Why can robotic-assisted procedures cost more?
Robotic-assisted procedures rely on additional technology and equipment beyond the standard operating platform and clinical team. This additional technology component is generally not included in standard case pricing.
Is robotic-assisted surgery always recommended?
No. Robotic-assisted surgery is not appropriate for every procedure or patient. Availability and suitability are determined by the treating specialist, based on your imaging, clinical condition, and the treating hospital's capabilities.
Global cost comparison — HIPEC / CRS-HIPEC (Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy)
Average coordinated costs across our partner centres. Final pricing depends on clinical complexity and chosen hospital.
| Country | Avg. cost | vs. cheapest |
|---|---|---|
🇮🇳 India New Delhi · Chennai · Bengaluru · Hyderabad · Mumbai · Kochi | $18,000 | —chevron_right |
🇹🇷 Turkey Istanbul | $32,000 | +78%chevron_right |
Costs are indicative estimates and vary by procedure specifics, hospital, and clinical complexity. Request a personalised estimate for your specific case.
Frequently asked questions
Candidacy depends on the extent and location of peritoneal disease, measured using the Peritoneal Carcinomatosis Index (PCI), and whether complete or near-complete cytoreduction is achievable. Patients with peritoneal spread from colorectal cancer, appendiceal cancer (including pseudomyxoma peritonei), ovarian cancer, or select gastric cancers may be candidates, provided there is no extensive disease outside the abdominal cavity and the patient's overall fitness can tolerate a long operation. A multidisciplinary tumour board reviews imaging and staging laparoscopy findings before confirming candidacy.
No fees. No commitment.
Our guidance is completely free
We are compensated by our partner hospitals — never by patients. You get independent clinical matching, cost transparency, and end-to-end coordination at no cost to you.