Electrosurgical debulking of ovarian cancer: a new technique using the argon beam coagulator

Abstract

Survival of ovarian adenocarcinoma patients depends on the size of the largest residual nodule at the end of debulking surgery. The argon beam coagulator (ABC) delivers radiofrequency current traveling in a beam of argon gas which facilitates tumor destruction and hemostasis. We used the ABC as an aid to cytoreduction in seven consecutive patients with stage III/IV ovarian cancer. Despite extensive disease, optimal debulking was achieved in all seven patients: four (57%) had no gross residual cancer; three had residual nodules of 2-3 mm. The ABC facilitated tumor destruction on the diaphragm, bowel wall and mesentery, presacral space, ureters, vagina, and iliac vessels. In addition, the ABC was used to "sterilize" surgical margins such as the vaginal cuff and rectosigmoid colon anastomoses. Five patients are currently alive, four disease free, with mean survival of 33 months since diagnosis. The ABC enables debulking of ovarian cancer in sites inaccessible to conventional resection.