neoprobe
TM
GDS Operation Manual
AW-000639 Page 20 of 38
Minimally invasive radioguided parathyroidectomy
A preoperative
99m
Tc -Sestamibi scan may be used on patients with primary hyperparathyroidism to localize target
parathyroid adenoma and enable limited exploration as an alternative to complete bilateral surgical exploration.
Hand-held gamma probes may be useful in assisting surgeons in intraoperative localization of target adenomas.
Gamma probes can be used to detect and localize increased uptake of
99m
Tc -99m-Sestabibi by hyperparathyroid
gland.
Evaluation of ischemic bowel
Strangulation of gut may cause ischemic bowel. Surgeon must revascularize it and determine its viability as part of
surgical protocol. Gamma probes can be used to detect intra-arterial distribution of
99m
Tc labeled red blood cells as a
means of determining if gut is reperfused. Other tracers, such as
99m
Tc labeled DTPA for perfusion or
9999m
Tc
labeled
pyrophosphate for muscle infarction, may require investigational drug status for this application.
Perfusion of anastomosis-assessment of compromised blood flow
When a surgeon creates an anastomosis, it must be determined that each side of anastomosis has adequate perfusion;
otherwise, anastomosis may fail, and leakage may occur. A high degree of morbidity is associated with this failure.
Gamma probes provide opportunity to assess perfusion before and after creating anastomosis. Intravenous
administration of stannous pyrophosphate followed by
99m
Tc automatically labels red blood cells in vivo. Blood flow
to anastomotic ends and across anastomotic juncture can be verified with radiolabeled labeled blood cells detected by
gamma probe.
Intraoperative localization of osteoid osteomas
Osteoid osteoma is a small, but painful, benign bone lesion. Surgical excision is curative. Modern radiographic
techniques externally image lesion with
99m
Tc labeled pyrophosphate. However, because of their size (rarely greater
than 1 centimeter) and location within cortical bone, it may be difficult for surgeon to localize lesion intraoperatively.
A gamma probe may be useful in localizing a lesion site intraoperatively. Additionally, checking high concentration
of radioactive isotope in removed bone fragments provides evidence that nidus is being excised.
7. Cleaning & Disinfection
Follow precautions established in your facility when handling any medical device that has been in contact with body
fluids, tissues, or blood (intraoperative). All medical devices used intraoperatively must be cleaned, decontaminated
or sterilized before reuse.
WARNING: Do not clean console or accessories when energized. Disconnect power cord from console
and from power outlet before cleaning. Do not sterilize console or immerse it in fluids. Attempting to do so will
cause permanent damage. Damp wipe only.
CAUTION: Following general warnings apply to sterilization of system components:
Do not sterilize console
Use only approved sterilization procedures described with each probe or accessory.
Do not touch patient or operator with product when electrosurgical device is in use or energized.
CAUTION: Prior to sterilization, probe and collimator should be inspected to ensure:
Cleanliness
Power cable is free of cracks or cuts
Connectors are completely dry
Artwork No: AW-000639 Revision: A Artwork Status: Released Lifecycle Name: Artwork
PCO No: N/A ECN No: ECN-000214 Release Date: 10/09/2012 Effective Date: 10/09/2012
To Next Page