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About Your Ommaya Reservoir Placement Surgery

This information will help you prepare to have an Ommaya reservoir placed. 

An Ommaya reservoir is a quarter-sized, soft, plastic, dome-shaped device that is placed under the scalp. The reservoir is connected to a catheter (thin, flexible tube) that is placed into your brain (see Figure 1).

An Ommaya reservoir will help your doctor:

  1. Get samples of cerebrospinal fluid (CSF), which can be used to look for cancer cells in your spinal fluid and infections in the lining around your brain
  2. Give you medication, such as chemotherapy, monoclonal antibodies, or antibiotics directly into your CSF

The surgery to place your Ommaya reservoir can cause some complications. These complications are listed below.

  • There is a small risk that you could bleed into your brain.
  • There is a small risk that you could have some loss of function. Your neurosurgeon will talk with you about this risk.
  • There is a small risk that you could get an infection in your brain. To reduce the risk of infection, you will be given antibiotics after your surgery.
  • Your Ommaya reservoir may need to be adjusted. To make sure it is in the right place, you will get a computed tomography (CT) scan the day after your surgery. If your reservoir is not in the right place, you may need to have another surgery to fix it.
  • Your Ommaya reservoir may not work. To make sure your Ommaya reservoir is working, a CSF flow study will be done after your surgery.

Having Your Ommaya Reservoir Placed

You will need to have surgery to place your Ommaya reservoir. We will first shave the hair on your head in the area where the reservoir will be placed. A small, half circle-shaped incision (surgical cut) will be made behind your hairline. Your neurosurgeon will insert the reservoir dome under your scalp. He or she will pass the catheter through your brain into the space where CSF forms (see Figure 2). The surgery will take about 1 hour.

Preparing for Your Surgery

10 days before your surgery

Stop taking aspirin, medications that contain aspirin, and vitamin E. Review the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) given to you by your nurse.

You may have a blood test to check your red blood cell count.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil®, Motrin®) and naproxen (e.g., Aleve®).

1 day before your surgery

A nurse or session assistant will call you 1 business day before your procedure. He or she will tell you what time you should arrive at the hospital for your surgery. If you are having your surgery on a Monday, you will be called on the Friday before your appointment. If you do not receive a call by 4:00 pm, please call (212) 639-5948.

Use this area to write in the information about your surgery:

Date ______________ Time ______________

  • Pediatric Day Hospital (PDH)
    1275 York Avenue (Between East 67th and East 68th Streets)
    B elevator to 9th floor
  • Presurgical Center (PSC)
    1275 York Avenue (Between East 67th and East 68th Streets)
    B elevator to 6th floor

The Night Before Your Surgery

  • Unless your doctor gave you other instructions, do not eat or drink anything after midnight the night before your surgery. This includes water, gum, and hard candy.
  • Go to bed early.

The Morning of Your Surgery

  • Unless your doctor gave you other instructions, do not eat or drink anything the morning of your surgery. This includes water, gum, and hard candy.

Medications

Your doctor or nurse may have instructed you to take certain medications the morning of your surgery. If so, list them below. Take only these medications with a sip of water the morning of your procedure.

Things to remember

  • Do not put on any lotion, cream, deodorant, make-up, powder, or perfume.
  • Do not wear any metal objects. Remove body piercings and all jewelry. The equipment used during your surgery can cause burns if it touches metal.
  • Leave valuables, such as credit cards, jewelry, or your checkbook, at home.
  • Before you are taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles, such as a rosary.

What to bring

  • A case for your glasses
  • Your Health Care Proxy form, if you have completed one
  • This guide

Before you enter the operating room

Before your surgery, an intravenous (IV) line will be inserted into a vein in your arm. If you have a MediPort or central line, this will be used. You will receive medication through your IV, MediPort, or central line that may make you feel drowsy and help you relax.

After Your Surgery

What can I expect right after my surgery?

When you wake up after your surgery, you will be in the Post Anesthesia Recovery Unit (PACU). You will be attached to machines that will monitor your vital signs (body temperature, heart rate, blood pressure, and oxygen level). It is normal to feel very tired after surgery. Your PACU nurse will make sure you are comfortable and answer any of your questions. Once your anesthesia has worn off, you will be taken to your hospital room.

You will have a bandage over the area where your Ommaya reservoir was inserted. You will be able to eat and drink as soon as you go back to your room. Your doctor will take your bandage off the next day.

Will I need any more tests?

To make sure your Ommaya reservoir is in the right place, you will have a CT scan the day after your surgery.

How do I take care of my incision?

  • Check your incision daily for any signs of redness, swelling, or drainage. It will take at least 6 weeks for it to heal completely.
  • Keep your incision clean and dry for 5 days after your surgery. Do not shower for 5 days after your surgery.

When can I shower?

  • You can shower 5 days after your surgery. When you wash your hair, use a gentle shampoo, such as baby shampoo.
  • Do not let your incision soak in water. Avoid baths, hot tubs, and swimming pools for at least 2 weeks after your surgery.
  • Do not use a hair dryer, creams, ointments, or hair products on your incision.

When will my stitches be removed?

The stitches on your scalp will be removed 7 to 14 days after your surgery.

What happens during an Ommaya reservoir tap?

Your doctor or nurse practitioner will perform your tap in an exam room or at your bedside. An Ommaya tap is sometimes done under anesthesia at the same time as magnetic resonance imaging (MRI). It usually takes about 20 minutes and will not hurt. You do not need to do anything to prepare for your tap.

  1. You will lie on your back. Your doctor or nurse practitioner will clean your skin with Betadine®. Tell your doctor or nurse practitioner if you're allergic to iodine and a different solution will be used.
  2. If some of your CSF is being removed, your doctor or nurse practitioner will insert a small needle into your Ommaya reservoir and remove a small amount of CSF.
  3. If you're getting medication during your tap, your doctor or nurse practitioner will inject the medication into your reservoir.
  4. If your treatment requires pharmacokinetic (PK) samples, the needle may be left in your Ommaya reservoir for a few hours.

Call Your Doctor or Nurse if You Have:

  • A temperature of 100.4° F (38.0° C) or higher
  • A cough
  • A rash
  • Redness, swelling, or drainage in the area of your incision
  • A headache that does not go away or is different from those you have had in the past. Do not take any medication for your headache without speaking to your doctor first.