Name of the Procedure:

Placement of Interstitial Device(s) for Radiation Therapy Guidance (e.g., Fiducial Markers, Dosimeter), Open, Intra-Abdominal, Intrapelvic, and/or Retroperitoneum, Including Image Guidance

Summary

This procedure involves inserting small devices, such as fiducial markers or dosimeters, into specific areas within the abdomen, pelvis, or retroperitoneum through an open surgical approach. These devices help guide and optimize radiation therapy by marking tumor locations or measuring radiation dose.

Purpose

The primary purpose of this procedure is to enhance the precision and effectiveness of radiation therapy for cancer treatment. By accurately marking tumor sites or measuring radiation doses, this procedure helps in targeting cancerous tissues while minimizing exposure to surrounding healthy tissues.

Indications

• Diagnosis of cancer requiring precise radiation therapy, particularly in the abdominal, pelvic, or retroperitoneal regions.
• Patients who need enhanced targeting for radiation therapy to maximize treatment effectiveness.
• Situations where traditional imaging techniques do not provide sufficient detail for effective therapy guidance.

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-operative imaging studies or assessments are often required for precise targeting.

Procedure Description

1. Preparation: The patient is brought to the operating room and prepped for surgery. Anesthesia is administered.
2. Incision: An incision is made at the targeted area in the abdomen, pelvis, or retroperitoneum.
3. Placement: Using imaging guidance (e.g., X-ray, CT), small devices like fiducial markers or dosimeters are placed accurately at the desired locations.
4. Closure: The surgical site is closed using sutures or staples, and dressings are applied.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and number of devices being placed.

Setting

This procedure is generally performed in a hospital's operating room or a specialized surgical center.

Personnel

• Surgeons or interventional radiologists
• Anesthesiologists
• Surgical nurses
• Radiology technicians for imaging guidance

Risks and Complications

• Common risks: Infection, bleeding at the incision site, and pain.
• Rare risks: Injury to surrounding organs, adverse reactions to anesthesia, and device migration or malfunction.

Benefits

• Improved precision of radiation therapy
• Potential for better treatment outcomes
• Reduced radiation exposure to healthy tissues

Recovery

• Post-procedure monitoring in a recovery room
• Pain management with medications
• Instructions on wound care and activity restrictions
• Follow-up appointments for monitoring and imaging

Alternatives

• Non-invasive imaging techniques alone (less accurate)
• Other types of markers with different insertion methods
• Potential cons: Less precision in radiation treatment

Patient Experience

• Mild discomfort or pain during recovery managed with pain relief medications
• Feeling of soreness at the incision site
• Gradual return to normal activities as directed by the healthcare provider