Surgical Oncology

TV-ms cooperated with the Spanish giant Combat Medical with patented hyperthermic technologies that are helping to transform cancer patients globally.

TV-ms cooperating and present Combat Medical  in the Egyptian medical markets.

Why use Hyperthermia to treat NMIBC?

Clinical hyperthermia is defined as the therapeutic use of temperature between 41°C to 44°Ca. The introduction of thermal energy affects the cancer cells more because of their inability to manage the heat as well as healthy cells. MitomycinC (MMC) is stable at temperatures up to 50°Cf, but has shown to be 1.4 times more active at 43°Cc. Hyperthermia inhibits the formation of new blood vessels (angiogenesis) by the tumor mass. At 43°C the cytotoxicity increases by 10 times, without any increase in the toxicity to the patients. At elevated temperatures the lipid-protein cellular membrane bilayer will become more permeable, due to the unfolding (denaturing) of the cellular membrane and cytosolic proteins. These resulted in higher intracellular concentration of the chemotherapy agent. Direct effects on the DNA include; strand breaking, impaired transcription, reducing replication and cell division. Thermotherapy has profound effects on the immune system resulting in increased activation of more natural killer cells (NKC) that target heat stressed cancer cells as they signal heat shock proteins on the cancer cell surface. The consequence is that the cancer cells actively participate in their own demise through the natural process of apoptosis.

Chemo-hyperthermia multifactorial modes of action create a strong combination effect, ensuring cancer tumors and cells are specifically targeted. Therefore hyperthermia substantially increases the effectiveness of chemotherapy compared to instillation at room temperature. The Combat BRS is the first system to allow the delivery of thermotherapy within the tight parameters necessary to optimize the delivery of chemo-hyperthermia without compromising patient safety, comfort or increasing resources required.

Based on the available body of evidence including real world experience data, the recommended protocol to achieve best results with HIVEC for Intermediate Risk patients is a 6 weekly induction treatment plus an additional 1 year maintenance for High Risk patients. The COMBAT BRS is recommended to be used at a temperature setting of 43°C for 1 hour using a 40mg dose of Mitomycin C.

TV-ms cooperated with the italian giant Medica Group which had been operating since 1985 . this cooperation in the oncologic locoregional normo/hyperthermic treatments .

TV-ms cooperating and present Medica Group in the Eastern african medical markets .

FLEXIPER : stand-alone instrument to perform Chemo-hyperthermic procedures in local or regional compartments of the human body , which can carry out several Chemohyperthermia procedures 

- Hyperthermic Intraperitoneal Perioperative Chemotherapy (HIPEC)

- Removal of ascites with Intraperitoneal “lavage”

- Isolated Limb Perfusion 

- Hypossic perfusion with extracorporeal circulation

 FLEXIPER : HIPEC used to treat the Peritoneal Carcinomatosis .Regional hyperthermic chemotherapy is intended for the perioperative treatment of peritoneal carcinomatosis caused mainly by colon and ovarian cancer.

 For a long time Peritoneal Carcinomatosis has been considered an incurable pathology . The advancements in both surgical techniques and intensive care has led to new approaches to treat this pathology one of the most successful being the cytoreductive surgery in combination with perioperative chemohyperthermia. 

The procedure consists in the removal of the whole parietal peritoneum and of several abdominal organs. Then the abdomen is treated with Perioperative Intraperitoneal Chemo-hyperthermia, whose goal is to remove tumour cells and microscopic cancers seed from the abdomen.

Chemohyperthermia consists in a “washing” of the abdominal cavity , executed through the insertion of several drains into the abdominal surface. Some are for infusing liquid inside the abdominal cavity and others for removing it.

The drains are linked to an external circuit mounted on a pump similar to those for extracorporeal circulation . The pump is fitted with a fluid heat exchanger to bring the circulating liquid ( usually saline or dialysis liquid) at 41-42 °C. When the desired temperature is reached , a chemotherapeutic agent is injected in the line so as to enter the circulation. The treatment lasts one or two hours. The heat damages the cancer cells on its own and also plays in synergy with the chemo-therapic agents improving the penetration of it inside the cancer layers and potentiating the drug efficacy.

When perfusion is finished, the liquid into the abdomen is completely removed by the pump. Then, the surgery team goes on with the surgical reopening of the abdominal cavity for a further verification, in order to eliminate all blood clots and residual fragments of extra-abdominal tumours.

FLEXIPER  had a user- friendly interface