Ideally, the intraperitoneal chemotherapy (IP) delivery device is placed at the time of the original diagnostic procedure, when an optimal surgical resection can be completed. The patient, who is appropriately counseled before surgery about her risk of cancer and the treatment options available, should have an IP device placed at the time of surgical resection of the presumed ovarian or primary peritoneal cancer. The pathologic diagnosis and stage is not completely understood in that setting, but good clinical judgment can identify an appropriate candidate for IP chemotherapy. It is safer to place the device and remove it unused at the bedside later, than to forego placement and have to re-operate to place the device at a second procedure. The second procedure to place an IP catheter is an important barrier to initiating IP chemotherapy, and also delays proper treatment.
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