The term "stereotactic" comes from two words: "stereo," meaning more than one, and "tactic" meaning target. Stereotactic techniques enable physicians to locate a precise target for treatment by obtaining images of the brain from several different angles and dimensions. These images can be fed into a computer and reconstructed in 2 or 3-dimensions to help plan a surgical approach to the target that will minimize the risk of injury to healthy tissue.
- The stereotactic serial biopsy is used to obtain a series of small tissue samples from an abnormal area of the brain.
- Using stereotactic techniques the neurosurgeon can determine the exact size and location of the area to be biopsied. The area to be biopsied often contains different types of cells or cells at different stages of development. Therefore, the doctor will take a series of biopsies from the center and the boundaries of the abnormal area. Usually, all biopsies can be obtained through a single small opening in the skull called a burr hole. A burr hole is a surgical opening in the skull that is usually about the size of a nickel.
Preparing for your procedure
On the morning of the biopsy you need to report to the Harper Hospital Admitting office. After you check in, admitting personnel will direct you to the Surgical Reception Center. A nurse from our operating room holding area will meet you in the Surgical Reception Center. The nurse will help prepare you for your procedure. First, you will be escorted to a dressing room where you will be asked to change into a hospital gown. Then you will be escorted to the preoperative holding area (POH) where you will be placed on a stretcher. Nurses in the POH area will explain the remainder of the process while you are there. An intravenous line (IV) will be started. This will require a needle to be inserted into a vein. The primary purpose of the IV is to provide a convenient means to administer medications you will receive during your stereotactic biopsy procedures.
Scanning procedures
You can expect to receive both an MRI and a CAT scan before the biopsy procedure. MRI and CAT scans assist us in obtaining images necessary to perform the biopsy. If you are claustrophobic please let us know ahead of time so we can administer the appropriate sedation before your MRI.
The MRI is a painless scanning method used to obtain images of the body's internal structures. This imaging technique provides information regarding structural problems directly affecting your brain. Before you have your MRI, marking capsules will be affixed to your scalp and forehead. Usually, 5 to 7 markers are used. Each marker is about the size of a dime. An adhesive backing helps the markers stick to your skin. These markers show-up on the MRI images and are used during surgery to help determine the precise location of the abnormal areas to be biopsied, so DO NOT REMOVE THE MARKERS. If a marker comes off accidentally let the nurse know but DO NOT REPLACE ANY MARKERS THAT FALL OFF. Your doctor will remove all the markers when the biopsy procedure is completed.
Following the MRI a CAT scan will be obtained. Before doing the CAT scan a special stereotactic ring will be fitted to your head. You will be given medication to help you relax as well as anesthetics to reduce your pain. Once the stereotactic ring has been fitted the CAT scan will be done. While you are being scanned, we will be directing the process and watching you through a window in the adjacent CAT control and observation room. The stereotactic ring will not be removed until the biopsy procedure is completed.
Treatment plans and procedures
After the CAT scan is done, you will be returned to the POH area to wait for the surgery to begin. During this time the doctor will be reviewing images from the MRI and CAT scan and, with the assistance of a computer, complete the planning for your surgery.
When your doctor is satisfied that all information has been gathered and interpreted correctly, you will go to the operating room where the biopsy will be done. You will be asleep during the biopsy procedure. Typically, it takes 11/2 to 2 hours to complete the biopsy.
While the surgical biopsy procedure is being performed, your family and friends are welcome to wait for you in the Surgical Lounge located on the first floor.
Removing the stereotactic ring
Generally, the ring is removed immediately after surgery while you are still in the operating room. However, there may be times when the surgeon needs a post-op CAT scan with the ring in place. In these cases the ring will be removed after the scan is satisfactorily completed.
