Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal mucocele tumors: Five case reports and review of literature

Figure 6 Intraoperative findings. A: Multiple mucinous nodules around the abdomen along with thick omental caking; B: Small lesions less than 2 mm in the mesentery along with another in the Douglas; C: Large lesion in the hepatic pedicle invading the retro portal space and the hiatus of Winslow; D: Complete omentectomy; E: Excision of the hepatic pedicle nodule and hepatic capsule; F: Complete peritonectomy starting sub diaphragmatic right and left walls bilaterally reaching the Douglas; G: Coliseum technique with suspension of abdominal walls; H: Hyperthermic intraperitoneal chemotherapy done with mitomycin 10 mg/m² in 3 L of 1.5% Dextrose peritoneal solution at 41 degree for 90 minutes.