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The Ommaya Reservoir

The Ommaya Reservoir PATIENT INFORMATION FACT CARD Introduction The Ommaya reservoir is a soft plastic dome.
The Ommaya Reservoir PATIENT INFORMATION FACT CARD Introduction The Ommaya reservoir is a soft plastic dome.

PATIENT INFORMATION FACT CARD

Introduction

The Ommaya reservoir is a soft plastic dome. It is connected to a catheter that is placed into a cavity of the brain. (See Figure 1.) Your doctor has recommended that you have one to make it easier to treat you. It will reduce the need for lumbar punctures (spinal taps). A lumbar puncture is when a needle is inserted into the small of your back. It is done to draw some of the fluid that circulates through the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF).

Your neurosurgeon will insert the reservoir dome under your scalp. He or she will pass the catheter through the brain into the spaces where the CSF forms. (See Figure 2.)

An Ommaya reservoir is inserted to:

Reservoir Dome

Catheter Figure 1
Catheter
Figure 1

1. Obtain samples of CSF. These are used to find cancer cells in the spinal fluid, infection of the lining around the brain, or both.

2. Give drugs, such as chemotherapy and antibiotics, into the CSF.

Ommaya Reservoir Placement

Do NOT eat or drink anything after midnight the night before surgery. Take any medicines with only a sip of water. Before you go to the operating room, a nurse will insert an intra- venous (IV) line in a vein. You will receive medicine through it. It will make you drowsy and help you relax.

You will be given general anesthesia. This is medicine that will put you to sleep. In the operating room, a nurse will shave your scalp where the reservoir will be placed. The surgeon will make a half circle incision behind the hair- line. (See Figure 2.) The reservoir will be placed between your scalp and skull. It takes about one hour. Afterwards, you will be in the Post- Anesthesia Care Unit (PACU). You will stay there until you are alert or until your doctor says it is safe for you to return to your room.

You will have a bandage over the spot where the Ommaya reservoir was inserted. You will be able to eat and drink as soon as you go back to your room. You can get out of bed as soon as the effects of the anesthesia have cleared. Your

get out of bed as soon as the effects of the anesthesia have cleared. Your Figure

Figure 2

doctor will take the bandage off the next day. The metal clips or stitches on your scalp will be taken out in about 10 days. It takes about that long for the incision to heal completely. The day after surgery you will have a CT scan. This is done to check the placement of the catheter in the ventricle.

Risks of the Procedure

Most surgical procedures have some risks. This section of the booklet describes the risks of having an Ommaya reser- voir placed. Your doctor, nurse, or both will discuss these risks with you in more detail and answer your questions.

Bleeding

There is a small chance that you could bleed into your brain. You will have a blood test the day before the surgery to make sure your platelet count is okay. Platelets make clots to prevent bleeding. Stop taking anything that has aspirin in it 10 days before surgery. Stop taking drugs such as ibuprofen 48 hours before the operation. Your nurse will give you a card that lists most of the medicines and brand names that have either of these drugs. Be sure to tell your doctor or nurse if you have any questions.

Neurologic Injury

The catheter goes through a part of the brain that has no critical function. This part of the brain does not involve language, movement, or major sensory functions such as taste or touch. Still, there is a small risk that you could have some loss of function.

Infection

There is a small risk that you could get an infection in the brain. Tell your doctor if you have any sign of infection before your surgery. These include:

• Fever over 101° F (38.3° C)

• Cough

• Local skin wounds

• Rash

Your surgeon will take great care in cleaning the skin on your scalp before the surgery. You will take an antibiotic for 24 hours after the surgery. It helps reduce the chance of an infection.

Catheter Placement

Your catheter must be in the right place before you can get chemo through it. You will have a CT the day after sur- gery. If the catheter is not in the right position, you may need more surgery to fix it.

Care of Your Incision

• Check your incision daily. Look for any signs of redness, swelling, or drainage. While you are in the hospital, your doctor and nurse will check it. When you are at home, use a mirror or ask a family member or friend to check the incision with you.

• Keep your incision clean and dry for five days. After five days you may shower, wet your incision and wash your hair. Be sure to use a gentle shampoo such as baby shampoo. The clips or sutures will still be on your scalp.

• It takes about six weeks for the incision to heal completely.

• You may wear soft clean scarves, hats, or caps. Do not wear wigs or tight-fitting hats until your incision is com- pletely healed.

• Avoid the use of hair tints for at least six weeks.

• If you have any questions or concerns, please discuss them with your doctor or nurse.

Ommaya Reservoir Tap

Your doctor may tap your Ommaya reservoir to:

• Withdraw fluid.

• Give you medicine directly into your spinal fluid.

This section of the booklet describes the tap procedure.

General Information

Tell your doctor and nurse if you are allergic to iodine. We use Betadine ® to clean the top of your scalp before a tap. It has iodine.

Your doctor or a nurse practitioner will do the tap procedure. It is done in an exam room or at your bedside.

Preparation

You do not need to do anything to get ready for a tap. You may eat your meals as usual.

Time

The tap takes about 15 – 20 minutes.

Procedure

1. You will lie on your back. A small amount of hair over the Ommaya reservoir will be shaved. Your skin will be cleaned with Betadine solution. If you are allergic to it, alcohol will be used.

2. A small needle will be inserted into your Ommaya reservoir. It will not hurt. A small amount of spinal fluid will then be withdrawn.

3. If you are getting medicine during the tap, the doctor or nurse will inject it slowly. This will be done after the fluid is withdrawn. This does not usually hurt.

After the Procedure

You have no restrictions after the tap. You may wash your hair.

Call Your Doctor If:

• There is redness, swelling, or drainage over your incision.

• You have a temperature of 101° F (38.3° C) or higher.

• You have a headache that does not go away or is different from what you have had in the past. DO NOT take any medicine for your headache without speaking to your doctor first. If your doctor is not available, ask to speak to the doctor on call.

Doctor

Telephone

Nurse

Telephone

After 5 p.m. or on weekends, call the Page Operator (212) 639-7900 and ask for the doctor on call for your service.

639-7900 and ask for the doctor on call for your service. ©1998 Memorial Sloan-Kettering Cancer Center

©1998 Memorial Sloan-Kettering Cancer Center 1275 York Avenue, New York, New York 10065 Revised 1998; reviewed 2002, 2004; revised 2006, 2008, 2010 Illustrations by Medical Illustration & Graphics

2004; revised 2006, 2008, 2010 Illustrations by Medical Illustration & Graphics The Ommaya Reservoir [ 3