Howrah: In a significant advancement in cancer care in Eastern India, Narayana Hospital, Howrah has performed the region’s first Robotic Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for a 42-year-old woman suffering from advanced ovarian cancer.
The patient, who was diagnosed with Stage IIIC ovarian cancer, was discharged just three days after the procedure and has since returned to work and her normal daily routine.
The woman, a mother with no previous health complications, initially sought medical attention after developing abdominal swelling. Investigations revealed significant fluid accumulation in the abdomen, tumours in both ovaries and signs that the cancer had spread within the abdominal cavity. A biopsy confirmed advanced-stage ovarian cancer.
Considering the extent of the disease, a multidisciplinary tumour board recommended chemotherapy before surgery. She underwent three cycles of chemotherapy along with a targeted biological drug. The treatment produced a strong response, with her CA-125 level falling from 1,158 to 10.3. Imaging also showed a reduction in tumour size and clearance of the abdominal fluid.
With the disease burden significantly reduced and the remaining tumour mass measuring less than 8 cm, the tumour board considered her suitable for a minimally invasive robotic approach.The nearly five-hour robotic procedure achieved complete cytoreduction, meaning no visible cancer was left behind. This was followed by HIPEC, in which heated chemotherapy using Cisplatin was circulated inside the abdominal cavity for 90 minutes at around 42°C, targeting microscopic cancer cells that may remain after surgery.
Unlike conventional CRS, which generally requires a large abdominal incision and a longer recovery period, the robotic procedure is performed through small keyhole incisions. This can help reduce blood loss, lower the risk of infection and support faster recovery in carefully selected patients.
The patient subsequently completed her follow-up chemotherapy and is currently receiving planned maintenance treatment with a PARP inhibitor to help reduce the risk of recurrence.
Dr. Kaustav Basu, Clinical Lead and Senior Consultant, Gynaecologic Oncology, Narayana Hospital, Howrah, said, “Advanced ovarian cancer with abdominal spread has traditionally meant extensive open surgery. What made this case significant was that despite how advanced the disease was at diagnosis, her strong response to chemotherapy and low residual disease allowed us to safely offer the robotic route instead. Combining Robotic CRS with HIPEC in a single sitting meant we could clear the visible disease and treat what remained microscopically, without the extended recovery that a large abdominal incision would have meant for her.”
Dr. Suman Mallik, Clinical Director and Senior Consultant, Radiation Oncology, Narayana Hospital, Howrah, said, “Robotic CRS with HIPEC marks a significant advancement in ovarian cancer care, offering carefully selected patients effective cancer clearance through a less invasive approach, enabling faster recovery without compromising outcomes.”
Dr. Manas Khan, Senior Consultant, Anaesthesiology, Narayana Hospital, Howrah, said, “This procedure demonstrates that advanced ovarian cancer patients with good health and low tumour volume can safely undergo robotic CRS with HIPEC, expanding minimally invasive treatment possibilities in Eastern India.”
Mr. Ajit Kumar Bellamkonda, Facility Director, Narayana Hospital, Howrah and Chunavati, said, “Patient selection, guided by a multidisciplinary tumour board, is what makes offering advanced options like Robotic CRS with HIPEC safe. We are proud that our team in the Eastern region can now bring this level of specialised care to patients who would otherwise have had to travel for it. This reflects the strength of our clinical protocols and our commitment to advanced, minimally invasive cancer care across Eastern India.”
CRS combined with HIPEC is used in appropriately selected patients with advanced ovarian cancer and has been associated with improved survival outcomes. The conventional procedure generally involves open abdominal surgery, making recovery more demanding. The robotic approach aims to achieve the same cancer-clearing objective through minimally invasive access.
Doctors, however, emphasise that robotic CRS with HIPEC is not suitable for every patient with advanced ovarian cancer. Careful patient selection based on overall health, response to chemotherapy, tumour burden and the possibility of complete cytoreduction remains crucial.
The successful procedure at Narayana Hospital, Howrah marks an important step towards expanding access to advanced, minimally invasive cancer treatment options for patients across Eastern India.
