Products and TechniquesPlease click one of the links listed below for more information on many of the products Bard offers for use in brachytherapy procedures, or for a step-by-step guide on procedural techniques. The Real-Time or Intra-operative Technique
IsoSleeve™ Source Delivery System SourceLink™ Connector and Seeds Two Stage Brachytherapy Needles With the Pre-Plan Technique, a volume study is performed between one and two months prior to implant. The prostate is mapped out by a physicist, radiation oncologist or a dosimetrist without anesthesia. An implant plan is developed to identify the exact spots where the seeds should be implanted through needles to kill the prostate cells but spare the urethra, bladder and rectum. A replication of the exact patient position is next to impossible to achieve because of the anesthesia, and especially if there is pubic arch interference. If exact positioning of the prostate cannot be attained, seed placement must be adjusted during the procedure. The Physicians' Roles in the Pre-Plan Technique Urologists place the needle in the patient's perineum then refer the patient to the radiation oncologist. The Radiation Oncologist is the only doctor licensed to actually deliver radiation to the patient, and is the one who delivers the seeds and spacers through the needles. The Physicist buys the seeds and creates an implant based on the seeds. The physicist also performs a dosimetry before and after the OR procedure, and often loads the seeds and spacers into the needles. Dosimetrists, when present at the hospital where the OR procedure is being conducted, can load seeds and spacers into the needles, and help perform the Plan.
With the Real-Time Technique, a volume study is performed one to two months before the implant to determine the approximate size of the prostate so that the right number of seeds can be ordered. On the day of the implant the prostate is mapped out real-time, and an implant plan is developed based on the map. The patient can be repositioned to adjust for the pubic arch interference or other abnormalities. The Physicians' Roles in the Real-Time Technique The Urologist places needles into the patient's perineum and then refers the patient to the Radiation Oncologist. The Radiation Oncologist is the only doctor licensed to deliver radiation to the patient, and delivers the seeds through needles and the Mick Applicator. The Physicist buys the seeds and creates an implant plan using PC based on seed dosimetry during the OR procedure. The Physicist also performs a post-op dosimetry. Dosimetrists, when present at the hospital where the OR procedure is being conducted, can load seeds and spacers into the needles, and help perform the Plan.
The Hybrid is a combination of techniques used during the OR procedure. The most common Hybrid technique uses SourceLink™ connectors and seeds on the periphery of the gland and the Mick® Applicator on the inside of the gland.
The IsoSleeve™ Source Delivery System incorporates a translucent inner sleeve into a proprietary design that allows physicians to verify that each needle load matches the proper load configuration prior to implant. Unlike other preloaded needle options, the IsoSleeve™ system allows for visual verification of the loading configuration. The IsoSleeve™ Source Delivery System is custom loaded for each patient, and is delivered in a convenient package that allows an easy transfer to the sterile field for immediate use. With each order, Bard Brachytherapy provides a photographic record of each needle load, giving physicians the location of each source. More about IsoSleeve™ Source Delivery System
The Mick® Applicator is designed to implant seeds in superficial or deep-seated tumors in the prostate. Specifically, it is designed for the implantation of I-125 or Pd-103 seeds.
Using a preloaded needle simply means that the needles are loaded into the needle prior to the procedure based on the pre-planned seed and spacer configurations. This is also the basis for the IsoSleeve™ delivery system.
The SourceLink™ System offers a customized approach to performing stranded implants. It addresses most common challenges associated with current stranded products and provides the flexibility of seed and spacer implant techniques.
The Two Stage brachytherapy needle maintains the advantages of conventional techniques while using a unique dual-component cannula/stylet and clear inner sleeve to promote an efficient verification of seed load and an effective implant procedure.
How to Use Two Stage Brachytherapy Needles
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