During your clinic appointment with the neurosurgeon or radiation oncologist:
- Please let us know if you have had any of the required tests performed in the past year. If so, please bring copies of the test results with you.
- Doctor will record your medical history, perform a physical examination and obtain your consent to perform the Gamma Knife procedure.
- Please let your nurse or medical assistant (MA) know if you are diabetic or on blood thinner medication (Anticoagulant, aspirin or aspirin-containing products etc.). While we don’t necessarily have to stop these medications, we may need to make additional arrangements for your care.
- You will have an opportunity to ask questions about the procedure and expected results. We recommend that you write down your questions before your appointment to ensure you don’t forget them.
One Week before your procedure:
- Stop all aspirin or aspirin-containing products. You may continue to take other medication only after you have consulted the doctors.
The night before your procedure:
- Nothing to eat or drink after midnight the night before your procedure. Take your medications the morning of the procedure with a small amount of water. If you must take your medicine with food, please have something light (toast, muffin, bread). NO EGGS, MILK, OR SUGARY FOODS OF ANY KIND.
Preparation for your procedure:
- Please wear comfortable clothing to your procedure. Sweatpants and a t-shirt are fine (nothing with metal pieces/buttons or hoods). The temperature in our facility is quite cold, so please dress accordingly. Bring socks to keep your feet warm.
- Don’t wear mascara or makeup as this may introduce problems with the imaging services.
- You may wear your contact lenses as you may not be able to wear spectacles during the treatment.
- Bring the medications you are currently taking with you on the day of the procedure.
- You are welcome to bring food/snacks. Food will be allowed after the treatment phase has been completed. A meal or sandwich will be provided.
- You may want to bring a book or magazine to help pass the time between the planning and treatment phases. You may bring your own music in the form of a CD or USB that we can play for you while you are undergoing your treatment.
- Please have a designated person available in case of an emergency and to drive you home.
- You will need to admit as inpatient for your treatment the day before the surgery day. Your family may wait for you in the waiting area until you return from MRI, at which time the nurse will bring them back to stay with you during the planning phase of the treatment.
WHAT TO EXPECT DURING PROCEDURE
What is Gamma Knife® surgery
Gamma Knife surgery is a well-established method to treat targets in the brain. Leksell Gamma Knife Perfexion is not a knife in the normal sense of the world. The doctor makes no incisions in the head. Instead, very precisely focused beams of radiation are directed to the treatment area in the brain. The shape and dose of the radiation are directed to the treatment area in the brain. The shape and dose of the radiation is optimized to hit only the target, without damaging surrounding healthy tissue. Every year around 70,000 people worldwide, undergo Gamma Knife surgery. The treatment procedure is simple, more or less painless and straightforward.
|1. Securing Accuracy
A lightweight frame is attached to your head. The head frame ensures that the radiation beams can be exactly located and directed with precision to the target. A mild local anaesthetic is applied to the skin of your forehead.
|2. Target Localization
Magnetic resonance imaging (MRI), computed tomograpgy (CT) or angiography is required to determine the exact size, shape and position of the target in the brain.
|3. Treatment Planning
Once your images have been taken, you can rest while your doctor develops a treatment plan. The treatment plan is done in a specially designed software and computer and calculates how the treatment should be performed.
You are awake during the procedure. When the treatment begins, the couch will move into the dome section of the unit. The treatment is silent and totally painless.
|5. After Treatment
When the treatment is complete, the head frame will be removed. Some patients might experience a mild ache or minor swelling where the frame was attached, but most report no problems.
|6. What Happens Next?
In a day or so you should be able to return to your normal routines. The effects of the treatment will occur over time. Your doctor will stay in contact with you to assess the progress, which may include follow-up MRI, CT or angiography images.
Always consult your doctor if you have any questions.
You will have an initial consult with a Gleneagles Kuala Lumpur Neurosurgeon and a Radiation Oncologist to determine if Gamma Knife radiosurgery is for you. If so, the procedure will be scheduled.
Hospitalization Day 1: Admission
Patient enters assigned ward after finishing admission process at the ground floor of the main building in the afternoon on the day before surgery. Patient washes their hair with sterilization shampoo and goes to bed after having dinner.
Hospitalization Day 2: Procedure
- Patient is sent to Gamma Knife Centre at about 8am.
- The stereotactic frame is placed on your head while in a sitting position. It is applied in the pre-operative area. The frame acts as a guide to find the exact location of the brain lesion. Your head will not be shaved. Children are given general anesthesia before the frame is attached and remain asleep during the Gamma Knife procedure. A neuro-anesthesiologist gives the anesthesia and stays with your child throughout the procedure.
- Before the procedure, patient will undergo imaging studies, such as magnetic resonance images (MRI) or computed tomography (CT) scans or cerebral angiogram. During the studies, we ask that the family member or friend return to the outpatient surgical waiting area. He or she can return after the imaging studies are done, prior to treatment. These studies help doctors locate the brain lesion as it relates to the stereotactic frame.
- While patient take a rest on the treatment couch, treatment planning will take one to several hours depending on the size and shape of the target area. Your doctors will locate the brain lesion in three dimensions using computer software and data from your imaging studies. The position of your head in the helmet, radiation dose and length of treatment will be decided.
- After the doctors plan your treatment, you will be brought to the Gamma Knife area and placed on the treatment bed, lying on your back. Your blood pressure and pulse will be monitored throughout the treatment. The stereotactic frame will be fitted into a steel helmet and fixed in position. You are awake during this procedure, and can communicate with your nurse and physician the entire time. This procedure takes about fifteen (30) minutes or more depending on the shape and number of lesions.
- After your Gamma Knife treatment, the stereotactic frame is removed and you will be transferred to your ward for recovery. You may have a headache, and not having eaten all day may add to your discomfort. Medication for the headache will be provided as needed. You will be monitored, including your blood pressure and pulse. In most cases, patients are discharged the same day, next day discharge is available on request. You may resume normal activities, eat and drink as you feel able.
The entire procedure from frame application until treatment completion usually takes half of the day.
Follow Up – After Discharge
Patient needs to visit your physician 1 month later, and if necessary, takes MRI scans once in every 3-6 months. If you have any questions, please contact the Gamma Knife Resource Centre at +603 4141 3091/3528/3530.