New technology at NNUH helps patients with ovarian cancer

New technology that monitors blood pressure during surgery is having a major positive impact on our patients with advanced ovarian cancer.

The device looks at the patient’s blood pressure, providing detailed information about their heart function. It also guides the theatre team and helps them give more targeted fluid therapy during surgery.

Due to ovarian cancer having few or no symptoms, around 75% of people are diagnosed when it is at an advanced stage. Standard treatment for advanced ovarian cancer – meaning it has spread beyond where the tumour first started – is cytoreductive surgery (CRS), which is a complicated procedure involving surgery lasting between eight and 14 hours and blood loss can be extensive, far more so than in other surgeries.

The introduction of this haemodynamic monitor has seen patient stays in critical care reduced from three days to one day and overall hospital stays from 10 days to six. This means those who need chemotherapy can have it sooner, which further improves their survival chances.

This brings us in line with most other Trusts, who are already using blood pressure monitoring equipment. Our Consultant Anaesthetist Rocio Ochoa-Ferraro tested the “Mostcare Up” device from medical equipment suppliers Vygon.

She said: “I was not going to buy a £50,000 machine if it was not going to improve care of my patients, but it did. Care was massively improved, and this monitor is key to developing our therapy for ovarian cancer patients.”

The technology monitors arterial blood pressure beat-by-beat and from these values calculates in-depth haemodynamic levels meaning clinicians can accurately assess a patient’s condition, optimise fluid therapy and deliver appropriate treatment, without delay.

With primary ovarian cancer, patients often initially present to hospital with a clot in their lungs or legs and further investigations identify a cancer site in the abdomen, which needs to be surgically treated.

During this type of cytoreductive surgery it is not unusual for patients to need 15-20 litres of fluids which would be extreme in most other surgeries. For example, in colorectal surgery the surgical team might use two to four litres.

Our ground-breaking HIPEC* team, who provide a heated chemotherapy treatment during surgery, also use this new cardiac montioring technology, which has allowed them to use more intravenous fluids and less potent, specialist medication to control blood pressure.

“Before using the monitor our fluid therapy involved giving medication during the procedure to manage blood pressure, with the monitor we can give better fluid levels which reduces the need for more medication,” said Rocio.

Based on figures from more than 100 patients, a significantly higher amount of fluid was received during the operation. This includes cases in which over 23litres had to be infused, based on the values observed from the “Mostcare Up” machine.

As a result, we have also identified a 100% reduction in respiratory or renal complications following the procedure.”

One patient to benefit from use of this equipment is 47-year-old Genene Sheppard, who remains cancer-free since her surgery in December 2021.

Following her laparoscopy, Genene remained in hospital under the care of consultant surgeon Nikos Burbos who delayed her surgery until she was well enough. Her fluid levels needed to be built up, but she also needed surgery quickly. The decision was made to conduct the surgery using the new monitor.

Genene said: “The anaesthetist said she had never seen levels as low as mine before – but she liked a challenge. She told me that my recovery would be slower than most because I was coming from such a low point.

“She was just lovely. She put me at ease and explained everything to me. That’s how you want it; you don’t want things sugar-coated. She filled me with confidence and said that if my levels dropped during surgery they could stop, look at what was going on and use the monitor to help give me what I needed and then carry on.”

Genene added: “I was scanned in June 2022 and there are no signs of disease. So as long as that is the situation, I remain on maintenance medication.

“There is light at the end of the tunnel. For women just starting out on this treatment it might seem like there isn’t but there are always new procedures and new equipment that are coming along. We must always try to remain optimistic.”


Notes to editors

We are the first centre in the UK to offer patients with advanced ovarian cancer Heated Intraperitoneal Chemotherapy (HIPEC). This pumps a hot chemotherapy solution through the patient’s abdomen to kill off any cells which surgeons have not been able to visually detect and remove surgically.

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