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CION Cancer Clinics
How long HIPEC surgery takes, and where the hours go | CION Cancer Clinics
Most cytoreduction and HIPEC operations take between eight and twelve hours, and some take longer. Nearly all of that time is surgery: lifting the lining of the abdomen away from every surface where cancer sits and removing any organ it has grown into. The heated chemotherapy at the end is the shortest part. This page explains where the hours go, what makes it longer, and what a family waiting outside should expect. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How long does HIPEC surgery take?
- Where do the hours actually go?
- What makes it shorter, and what makes it longer?
- What should the family expect on the day?
- Four things families believe about the length of the operation
- How long is the whole thing, not only the operation?
- Common questions about the length of HIPEC surgery
The short answer
How long does HIPEC surgery take?
Most cytoreduction and HIPEC operations take between eight and twelve hours from the first cut to the last stitch, and some take longer. Add the time for anaesthesia before and for waking up after, and a family can expect to be waiting most of a day and into the evening.
Why it takes so long
Almost all of the time goes on the surgery, not on the chemotherapy. The surgeon lifts the lining of the abdomen away from every surface where cancer sits, region by region, and removes any organ the cancer has grown into. That is slow, careful work on surfaces that bleed easily. The heated chemotherapy wash at the end is the shortest part of the day.
Longer is not a sign that something has gone wrong
A long operation usually means the surgeon found disease in more regions than expected and is clearing all of it, which is exactly what you want. A short operation can mean the opposite: that there was too much disease to clear and the surgeon chose to stop. Ask the team to tell you which it was, rather than reading meaning into the clock.
Typical times are typical. Your own operation could be shorter or much longer, and the surgeon will not know until the abdomen is open.The day, stage by stage
Where do the hours actually go?
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Anaesthesia and lines
Before the first cut, you are put to sleep and the anaesthetist places the drips, a line in an artery to watch blood pressure, a catheter and often a fine tube in the back for pain relief. This preparation alone takes a good part of an hour.
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Opening and scoring
A long cut is made and the surgeon looks at every region, scoring how much disease there is. If it is far more than the scans showed, the operation may stop at this point.
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Stripping the lining and removing organs
This is the bulk of the day. Region by region, the lining is lifted away, and any organ with cancer grown into it is removed. The more regions involved, the longer this takes.
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The heated chemotherapy
Warmed chemotherapy, to around forty-two degrees Celsius, is circulated through the abdomen for between 30 and 90 minutes depending on the drug used, then drained out.
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Joining, draining and closing
Bowel that was cut is joined back together, or a stoma is made. Drains are placed and the abdomen is closed in layers.
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Waking and transfer
You go to intensive care, usually still asleep or very drowsy. The family is often told the outcome before you are awake enough to know.
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What makes it shorter, and what makes it longer?
Tends to be shorter
Tends to be longer
Disease in one or two regions only
Disease in most regions of the abdomen
No organs need to be removed
Bowel, spleen or womb removed as well
No previous abdominal surgery
Scar tissue from earlier operations to free first
Bowel can be joined directly
More than one bowel join, or a stoma to make
For those waiting
What should the family expect on the day?
Updates will be few
The theatre team is busy for the whole day, and a nurse may pass on a brief message at most. No news for many hours is normal. Ask before the operation who will speak to you, and roughly when.
Plan for the whole day
Bring food, a charger and something to do. Decide in advance who will stay and who will go home and come back. One or two people at the hospital is enough; the surgeon will speak to whoever is named.
The surgeon speaks to you after
Once the operation is over, the surgeon will tell you what was found, what was removed, and whether everything visible could be cleared. Write it down. You will be tired and it is easy to forget.
The first sight in intensive care
Expect tubes, drains, a monitor and a very drowsy patient. This is what a person looks like after a long operation, and it is not a sign that things went badly. Ask the nurse to explain each line.
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Commonly believed
Four things families believe about the length of the operation
"It has gone past ten hours, so something must have gone wrong."
Long operations are usually long because the surgeon is clearing more disease than expected, carefully. That is the job. If there is a problem, a member of the team will come and tell you. No news during the operation is normal.
"It was over quickly, so it must have been easy."
Sometimes. But a very short operation can also mean the surgeon found too much disease to clear and stopped. That is a hard thing to hear, and it is a decision made to spare the patient a brutal recovery for no benefit. Ask directly what was done.
"One surgeon works for twelve hours without a break."
This is team surgery. Two or more surgeons often work together, anaesthetists hand over, and nursing and perfusion staff change through the day. The patient is the only person in the room for the whole operation.
"The chemotherapy is the dangerous part, so that is what takes the time."
The chemotherapy wash is the shortest stage of the day. The risks of the operation come mostly from the surgery: the amount of lining stripped, the organs removed and the bowel joins. The chemotherapy adds to the risk, but not to the hours.
Did you know
During the heated chemotherapy stage the surgeon may keep a gloved hand inside the abdomen, gently moving the fluid so that it reaches every surface evenly. It is one reason the temperature is watched so closely.
Beyond the day
How long is the whole thing, not only the operation?
The operation is one day. Recovery is measured in weeks and months. Most people spend the first day or two in intensive care, then a couple of weeks or more on the ward while the bowel starts working and the drains come out. Getting back to ordinary energy takes several months.
What decides the hospital stay
How much was removed, whether a stoma was made, how quickly the bowel wakes up, and whether any complication needs treating. A person who had one region stripped goes home much sooner than a person who had bowel and spleen removed as well. Your team will give you a likely range, and it is a range, not a promise.
What this page cannot tell you
It cannot tell you how long your own operation will take, because that depends on what the surgeon finds once the abdomen is open. Ask what they expect from your scans, what would make it longer, and at what point they would stop rather than continue.
If you are the one waiting and the hours are passing, call the ward or theatre reception rather than assuming. They will tell you what they can.Questions we are asked
Common questions about the length of HIPEC surgery
Is it safe to be under anaesthesia for that long?
Long anaesthesia is routine for this operation and the anaesthetist plans for it: warming, fluid balance, blood pressure and pain relief are all managed through the day. The risks of the day come more from the size of the surgery than from the length of the sleep. Your fitness tests beforehand are there to check you can cope with both.
Will the surgeon come and speak to us in the middle?
Rarely. The surgeon cannot leave the table, so any message during the day comes through a nurse or coordinator. If the surgeon does come out mid-way, it is usually because a decision is needed, such as stopping the operation. Otherwise, expect to be spoken to once it is over.
Why did my mother's operation stop after two hours?
Most often because the surgeon found more disease than the scans showed, usually along the small bowel, and judged it could not be cleared. Continuing would have meant all of the risk and recovery for little benefit. Ask the team what was seen and what the plan is now.
Does the heated chemotherapy part take long?
No. It is the shortest stage. Warmed chemotherapy is circulated through the abdomen for between 30 and 90 minutes depending on the drug, then drained. The hours before it, when the lining is stripped and organs removed, are where the day goes.
How long will she be in intensive care?
Usually the first day or two, sometimes longer if breathing, blood pressure or kidney function need close support. Intensive care after this operation is planned, not a sign of trouble. The move to a normal ward happens when the team is happy that the heart, lungs and kidneys are steady.
Can I go back to work after a month?
Desk work is sometimes possible within a couple of months; physical work usually takes longer. Tiredness lasts well beyond the wound healing. Talk to your surgeon about your particular job, and plan for a gradual return rather than a fixed date.
Do I need to arrange blood for the operation?
Blood is often needed during a long operation with large raw surfaces, and the hospital will cross-match units beforehand. Some centres ask families to arrange donors to replace what is used. Ask your centre what its policy is well before the day, so it is not a scramble.
Does a longer operation cost more?
Often, yes, because theatre time, intensive care days and any extra organ removals all add to the bill. Ask for a written estimate that states what it assumes, and what changes it if the operation is bigger. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled; call the helpline to check your cover.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- Cancer Research UK — Pseudomyxoma peritonei
- NICE — Cytoreduction surgery followed by hyperthermic intraoperative peritoneal chemotherapy for peritoneal carcinomatosis (IPG331)
- National Cancer Institute — HIPEC (NCI Dictionary of Cancer Terms)
- Macmillan Cancer Support — Surgery for cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
ICU and Hospital Stay After HIPECWhat the days after the operation look likePeritonectomy: Stripping the Lining of the AbdomenThe part of the operation that takes the hoursWhy the Chemotherapy Is HeatedWhat happens during the shortest stageThe Day of the OperationFasting, arrival and waiting, for any cancer operationCaretaker and Family Guide to SurgeryFor the person waiting outside
Talk to us
Preparing for the operation day?
Call the helpline or send us the surgeon's plan. An oncologist will walk you through what to expect on the day and what to ask your centre beforehand. One helpline serves every CION centre.