Learning curve was and is a real issue in this highly technically demanding operation as well as the selection process and perioperative care.
The PSOGI organisation has been very important to the development of this procedure throughout the world. We have been extremely fortunate with our hospital support to gain dedicated nursing, data base staff and have maintained a strong research group in both basic and clinical cancer areas through donations and grants.
We have also been strongly supported by the Kingdom of Saudi Arabia with a continued fellowship training position resulting in the first and several other peritonectomy centres in the Kingdom.
At present we are very excited about the development of the latest drug (Bromelain and acetylcystene) from our cancer lab which is able to lyse tumour producing mucins but also has antitumour and chemosensitising actions.
Our clinical trials are progressing and we will start US and European Centres very soon.