What Does a Gamma Knife Procedure Entail?

When you’re getting ready to undergo a Gamma Knife procedure, knowing exactly what to expect will better prepare you for the day of treatment. Gamma Knife radiosurgery, unlike traditional surgery, doesn’t come with strict rules such as abstaining from eating and drinking 12 hours before surgery, nor does it require that you get ready for a lengthy hospital stay. Nonetheless, being prepared with knowledge of the procedure and the different steps, both before and after, can make the process much smoother for you.

How Does Gamma Knife Radiosurgery Work?

A marvel of science and medicine, Gamma Knife radiosurgery is a completely non-invasive treatment. Despite the name, Gamma Knife radiosurgery relies solely on the use of imaging and tiny, focused beams of radiation. Around 200 of these beams enter the body at relatively low levels so that they don’t damage healthy tissue as they pass through on their way to the target. Once they do reach the target, they converge and create what is called a “therapeutic dose,” essentially meaning that there is enough radiation focused on the treatment site to destroy the offending cells.

Gamma Knife Procedure From Start to Finish

Gamma Knife radiosurgery is a fairly complex procedure in that it requires a great deal of accuracy and planning. From the time you arrive to when you leave the hospital, there are numerous steps that must be carried out for a successful Gamma Knife procedure. While each case will vary a small amount, the general succession of this non-invasive treatment is outlined below.

Arrival at the Hospital

Your surgeon’s staff will let you know when you should arrive for your procedure. Plan on arriving at least 15 minutes before your scheduled  Gamma Knife procedure, just to make sure you have ample time to settle in and fill out any paperwork that might be required at the time of your appointment.

Head Frame or Facemask Placement

After you’re led to the treatment suite, you will be fitted with a head frame that will help keep your head and neck steady during the duration of the treatment. The use of local anesthetic will help ensure you don’t feel any discomfort before or during your procedure. If your hospital has the newest Gamma Knife technology, such as the Leksell Gamma Knife® Icon™, a facemask can be used to keep your head in place, instead of a head frame. Talk to your doctor to see if you’re a candidate for frameless treatment.

Development of Treatment Plan

When you’re in place for the proper diagnostics, your neurosurgeon and team of radiation specialists will use either MRI or CT imaging to view the area(s) that require treatment. If you are having a procedure for an arteriovenous malformation, an angiography will likely be used. Once they’ve analyzed all of the images from your study, a customized plan will be formulated based on the results. You’ll be welcome to rest in a private, quiet room while waiting for the team to put together your treatment plan. At this time, your surgeon will probably be able to tell you how long your Gamma Knife radiosurgery procedure will take. The majority of cases take anywhere from 10 minutes to 70 minutes.

Gamma Knife Radiosurgery Treatment

Once the treatment plan has been developed you’ll be placed in a precise position and the head frame will be secured. You will be fully conscious and be able to speak to your surgeon in order to give input on your overall comfort level. Then, you will be moved into the machine (it is not fully enclosed like an MRI — and depending on the model, your head will likely be the only part of your body within the large enclosure). At this point, the staff will ensure you’re comfortable and perfectly positioned before proceeding to the control booth.

Throughout the entire Gamma Knife procedure, you will be able to speak to and hear the doctors and technicians operating the Gamma Knife machine. At no point are you left alone. If you are concerned about claustrophobia, be sure to tell your doctor before your procedure. He or she will recommend some ways to remedy this, such as a mild sedative.

The entire procedure shouldn’t take more than 70 minutes — this, of course, is depending on the location, size and severity of the area being treated. Once your treatment is completed, the machine will automatically withdraw the table you’re lying on and your head frame (if using) will be removed.

Immediately Following Your Procedure

You can expect to go home the same day as your procedure. It’s not uncommon to experience headaches for a few days after you’ve had your Gamma Knife procedure. You may also experience some minor pain or discomfort at the four sites where the head frame pins were in contact with your skin. This is to be expected and will usually subside within a day or two.

You can expect to resume your normal activities within 24 to 48 hours after your procedure. There are no restrictions on your activities, except for those that were already in place before undergoing Gamma Knife radiosurgery.

The Weeks and Months After Your Gamma Knife Procedure

As the area that was treated responds to the procedure, you may begin to notice relief from symptoms, such as the pain associated with trigeminal neuralgia. For large tumors or other lesions that may have been causing discomfort, as the area shrinks, you can expect to feel a reduction in pressure or the alleviation of other symptoms. In other cases where there wasn’t any discernable pain or discomfort, you probably won’t feel any different at all.

You will likely need to follow up regularly for imaging to ensure that the affected area is showing signs of progress. Your doctor will advise you on the frequency of follow-up visits.

Gamma Knife radiosurgery is a safe and effective upfront treatment for patients of all ages. It is also a reasonable alternative for those who cannot undergo traditional surgery for one reason or another. If you’re considering Gamma Knife radiosurgery, be sure to talk to your doctor about the pros and cons for your particular case, as well as to see if you are a candidate.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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