Transcript

Let's review techniques for placement of the Leksell head frame for gamma knife radiosurgery. This patient has consented for her video to be used for our viewers. The patient has been placed in a relatively semi-sitting position. The head frame has been shown to the patient and the procedure details are also explained. The assistant can use the bridge of the nose for stabilizing the head frame. Local anesthetic is used at each pin site. About 1cc of injection is used initially, and then additional injection is provided after the initial numbness achieved. The burning at the site of the injection during the first few seconds can be quite problematic for the patient. You can see injection initially allowing the burning to disappear and then additional injection is provided. Same techniques are used for the posterior pin sites. The surgeon communicates with the patient at every stage of the operation. injection is provided. Here's the final pin site. We usually provide the patient for a few minutes before the pins are inserted. The pin sites maybe gently massaged for the anesthetic to take effect. Four appropriate pins are used for fixation of the head frame. The two pins that are facing each other across court are tightened first. Any feeling of sharp pain stops the surgeon and additional anesthetic is provided. The pins are subsequently tightened. You can see that the two pins facing other are tightened first. Patients are warned that the pressure feeling will eventually dissipate after a few minutes. Two finger tight. The frame is checked, appears well fixated. Next, the patient is taken to the MRI scanner for a stereotactic MRI. Thank you.

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