About Your Ommaya Reservoir Placement Surgery for Pediatric Patients

This guide will help you prepare for your Ommaya reservoir at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.

Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery. Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

For the rest of this resource, our use of the words “you” and “your” refers to you or your child.

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About Your Surgery

About your Ommaya reservoir

An Ommaya reservoir is a quarter-sized, soft, plastic, dome-shaped device that is placed under the scalp. It’s connected to a catheter (thin, flexible tube) that’s placed in one of the ventricles in your brain (see Figures 1 and 2). Your ventricles are hollow spaces that make cerebrospinal fluid (CSF), which surrounds your brain and spinal cord.

Figure 1. Ommaya reservoir

Figure 1. Ommaya reservoir

Figure 2. Placement of the Ommaya reservoir

Figure 2. Placement of the Ommaya reservoir

An Ommaya reservoir will help your healthcare provider:

  • Get samples of your CSF. Your healthcare provider can check your CSF for cancer cells or infections.
  • Give you medication, such as chemotherapy, monoclonal antibodies, or antibiotics directly into your CSF.

These procedures are referred to as an “Ommaya reservoir tap.” You may need fewer spinal taps, if you have an Ommaya reservoir.

About your Ommaya reservoir surgery

The surgery to place your Ommaya reservoir is done in the operating room. Before your surgery, you will get anesthesia (medication to make you sleep during your surgery). Once you’re asleep, a nurse will shave the hair in the area where your incisions (surgical cuts) will be. Your entire head won’t be shaved.

During your surgery, your neurosurgeon will make a C-shaped incision behind your hairline. They will insert the reservoir dome under your scalp. Your neurosurgeon will pass the catheter through your brain into the space where CSF forms. They will close your incision with sutures (stitches).

The surgery will take about 1 hour.

Possible complications from surgery

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’s in the right place, you will get a computed tomography (CT) scan the day after your surgery. If your reservoir isn’t 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 may be done after your surgery. If you need a CSF flow study, your doctor or nurse will give you more information about this.
Your neurosurgeon will explain all the possible risks and complications before your surgery.
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Before Your Surgery

The information in this section will help you prepare for your surgery.

Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It contains important information about what you need to do before your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

Preparing for Your Surgery

You and your healthcare team will work together to get ready for your surgery.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your doctor knows all the medications you’re taking.
  • I take prescription medications (medications prescribed by a doctor), including patches and creams.
  • I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
  • I take dietary supplements, such as herbs, vitamins, minerals, and natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I have had a problem with anesthesia (medication to make you sleep during surgery) in the past.
  • I am allergic to certain medication(s) or materials, including latex.
  • I am not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I use recreational drugs.

About Drinking Alcohol

The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

  • Stopping alcohol suddenly can cause seizures, delirium, and death. If we know you’re at risk for these complications, we can prescribe medication to help prevent them.
  • If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do to prevent problems before your surgery:

  • Be honest with your healthcare provider about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea, increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you can’t stop drinking.
  • Ask us any questions you have about drinking and surgery. As always, all of your medical information will be kept confidential.

About Smoking

People who smoke can have breathing problems when they have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program at 212-610-0507.

About Sleep Apnea

Sleep apnea is a common breathing disorder that causes a person to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, the airway becomes completely blocked during sleep. It can cause serious problems during and after surgery.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP) for sleep apnea, bring it with you the day of your surgery.

Within 30 Days of Your Surgery

Presurgical Testing (PST)

Before your surgery, you will have an appointment for presurgical testing (PST). Depending on your age, your testing can take place in a variety of places. The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.

Your appointment will be at one of the following places:

  • Pediatric Ambulatory Care Center (PACC)
    1275 York Avenue
    (between East 67th and East 68th Streets)
    B elevator to 9th floor
  • Presurgical Testing (PST)
    160 East 53rd Street
    (at Third Avenue)
    Elevator to 7th floor

You can eat and take your usual medications the day of your PST appointment.

During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

It’s very helpful to bring the following things to your PST appointment:

  • A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name(s) and telephone number(s) of your doctor(s).

Parking at the PACC

The PACC is located at Memorial Hospital (MSK’s main hospital). The address is:

     1275 York Avenue (between East 67th and East 68th Streets)
     New York, NY 10065
     Take the B elevator to the 9th floor

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Parking at PST

PST is located in the Rockefeller Outpatient Pavilion, also known as MSK 53rd Street. The address is:

     Rockefeller Outpatient Pavilion
     160 East 53rd Street (at Third Avenue)
     New York, NY 10022

There are several options for parking during your PST appointment. The Bristol Garage offers discounts to patients. To receive the discount, have your parking ticket validated at the concierge desk in the Rockefeller Outpatient Pavilion. There is a shuttle that goes from the Bristol Garage to the Rockefeller Outpatient Pavilion every 20 minutes.

     The Bristol Garage
     300 East 56th Street (between First and Second Avenues)
     New York, NY 10022

There are additional parking garages located at East 53rd Street between Second and Third Avenues and East 54th Street between Second and Third Avenues.

Talk With Your Social Worker About Housing, If Needed

The Ronald McDonald House provides temporary housing for out-of-town pediatric patients and their families. MSK also has arrangements with several local hotels and housing facilities that may give you a special reduced rate. Your social worker can discuss your options and make reservations.

Tell Us if You’re Sick

If you develop any illness before your surgery, call the doctor who scheduled your surgery. This includes a fever, cold, sore throat, or the flu.

10 Days Before Your Surgery

Stop Taking Vitamin E

If you take vitamin E, stop taking it 10 days before your surgery. Vitamin E can cause bleeding. For more information, read our resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

7 Days Before Your Surgery

Stop Taking Certain Medications

If you take aspirin, ask your surgeon if you should keep taking it. Aspirin and medications that contain aspirin can cause bleeding. For more information, read our resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Stop Taking Herbal Remedies and Other Dietary Supplements

Stop taking herbal remedies and other dietary supplements 7 days before your surgery. If you take a multivitamin, ask your doctor or nurse if you should keep taking it. For more information, read our resource Herbal Remedies and Cancer Treatment.

2 Days Before Your Surgery

Stop Taking Certain Medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read our resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

1 Day Before Your Surgery

Note the Time of Your Surgery

A clerk from the Admitting Office will call you after 2:00 pm the day before your surgery. If you’re scheduled for surgery on a Monday, you will be called on the Friday before.

The clerk will tell you what time you should arrive at the hospital for your surgery. They will also tell you where to go on the day of your surgery. This will be one of the following locations:

  • Pediatric Ambulatory Care Center (PACC)
    1275 York Avenue
    (between East 67th and East 68th Streets)
    B elevator to 9th floor
  • Presurgical Center (PSC) on the 6th floor
    1275 York Avenue
    (between East 67th and East 68th Streets)
    B elevator to 6th floor

If you don’t receive a call by 4:00 pm, please call 212-639-7056.

The Night Before Your Surgery


Unless you’re given other instructions, you can shower and wash your hair. Do not use any hair products such as hair spray or gel.


Go to bed early and get a full night’s sleep.

Instructions for eating and drinking before your surgery

  Do not eat or drink anything after a certain time on the night before your surgery. This exact time is based on your age and any other medical problems that you may have. Your NP will talk with you about what you can and cannot eat before surgery.

If you do not follow the instructions you are given, your surgery may be cancelled.

The Morning of Your Surgery

Take Your Medications

If your doctor or NP instructed you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications.

Starting 2 hours before your surgery, do not take any medications.

Do not eat or drink anything the morning of your surgery. This includes water, hard candy, and gum. Take any medication as instructed with a sip of water.

Things to Remember

  • Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Remove nail polish and nail wraps.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Leave valuable items (such as credit cards, jewelry, or your checkbook) at home.
  • Before you’re taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles.
  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.

What to Bring

  • Your breathing machine for sleep apnea (such as your CPAP), if you have one.
  • Your portable music player, if you choose. However, someone will need to hold it for you when you go into surgery.
  • Your cell phone and charger.
  • A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
  • This resource. Your healthcare team will use this resource to teach you how to care for yourself after your surgery.

Where to Park

For information about parking at Memorial Hospital, read the “Parking at the PACC” section.

Once You’re in the Hospital

You will be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having surgery on the same day.

Get Dressed for Surgery

When it’s time to change for surgery, you will get a hospital gown, robe, and nonskid socks to wear.

Meet With Your Nurse

You will meet with your nurse before surgery. Tell your nurse the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Meet With Your Anesthesiologist

Your anesthesiologist will:

  • Review your medical history with you.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you will receive.
  • Answer questions you have about your anesthesia.
Prepare For Your Surgery

You will either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help blood flow in your legs.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line, MediPort®, or central line, and you will fall asleep.

Once you’re asleep, your surgery will begin. You won’t feel any pain during your surgery.

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

What to Expect

When you wake up after your surgery, you will be in the Post Anesthesia Recovery Unit (PACU). 

You may have a mask over your face that will give you air and help you wake up after surgery. You will be attached to machines that will monitor your body temperature, heart rate, blood pressure, and oxygen level. You may also have dressings (bandages) over your incisions.

While you’re in the hospital, you will frequently be asked to move your arms, fingers, toes and legs. Your nurse will check your pupils with a flashlight and ask questions such as “What is your name?”

It’s normal to feel very tired after surgery. Your PACU nurse will make sure you’re comfortable and answer any of your questions.

Once you’re awake and your pain is under control, you will be taken to your hospital room. Depending on your age and condition, you may be taken to the Pediatric Intensive Care Unit (PICU), the Adult Intensive Care Unit (ICU), or the Neurology Advanced Care Unit (NACU) for close observation and monitoring.

Read our resource Call! Don't Fall! for Pediatric Patients for information about how to avoid falling and stay safe while you’re in the hospital.

After 24 hours, you will be taken to the pediatric or neurology floor for continued care. If you have a bandage over your incision, your doctor will take it off around this time. After the bandage is removed, your incision(s) will be left uncovered.

Commonly Asked Questions

Will I have any pain?

You may have a mild headache or feel discomfort from your incision for the first few days after your surgery. Your nurse will give you pain medication. Please tell your nurse if the medication isn’t helping your pain.

You may have a sore throat after your surgery. This is caused by the breathing tube that was used during your surgery. You will be given cool liquids to drink and lozenges to suck on to help with the discomfort.

How long will I be in the hospital?

Most people stay in the hospital 1 night, but this will depend on your recovery.

Parents can call the inpatient unit at any time. Ask your nurse for the phone number. Because of privacy concerns, staff will only give information to parents or spouses. Please tell friends and other relatives not to call the inpatient unit for information.

When will I be able to eat and drink?

You will be given ice chips to eat after your surgery. You will start with a liquid diet and then progress to solid food.

When will my sutures or staples be removed?

The sutures or staples in your incision will be removed 7 to 14 days after your surgery. They may need to stay in longer if you have had this surgery before. Your doctor or NP will remove them during your follow-up visit at the clinic.

How do I care for my incision?

Mild swelling around the incision is normal. As your incision heals, it may burn, itch, or feel numb. Check your incision daily for any signs of redness, swelling, or drainage.

Don’t apply any creams, ointments, hair products, or use a hair dryer on your incisions until they are completely healed. This may take about 6 weeks.

Once your incision is healed, it doesn’t need to be covered. However, you should protect it from the sun by wearing a hat or scarf and using sunblock.

When can I shower?

You can shower right after your surgery. However, for the first 5 days after your surgery, you must wear a shower cap to protect your incision from getting wet.
Five days after your surgery, you should begin to wash your hair daily. This helps to loosen up the crusting on your incision and will make it easier for your surgeon or nurse to remove your staples or sutures.
When you wash your hair, use a gentle shampoo, such as baby shampoo. You can gently massage the area near your incision to wash off any dried blood or drainage. Clean your incision with soap and water and pat it dry with a clean towel. You can let the shower water run over your incision.
Don’t let your incision soak in water. Avoid baths, hot tubs, and swimming pools for at least 2 weeks after your surgery.

When can I go back to work?

Your doctor will tell you when you can go back to work. This depends on your age, type of work, medical condition, and other factors.

When can I go back to school?

You can go back to school as soon as you feel ready. Tell your school nurse that you have an Ommaya reservoir.

When can I go back to my normal activities?

You can participate in all noncontact sports (such as swimming and running), exercise, and go to the gym 2 weeks after your surgery. You can’t participate in any contact (collision) sports (such as football, boxing and wresting) until your neurosurgeon says it’s okay. Remember to wear a helmet to decrease the risk of head injury, if needed. Ask your neurosurgeon for specific guidelines on wearing a helmet.

When can I swim?

Don’t swim for at least 2 weeks after your surgery. If your incision needs more time to heal, you may need to wait longer. Your doctor or NP will tell you when it’s okay to swim at your first follow-up appointment after your surgery.

When can I travel?

Don’t travel on an airplane until your doctor says it’s okay.

What is my first appointment after my surgery?

Your first appointment after surgery will be in 7 to 14 days after you leave the hospital. Contact your neurosurgeon’s office to schedule your appointment before you leave the hospital. Depending on how you’re healing, some or all of your stitches will be removed during this appointment.

Will I need any more tests?

You will have a computed tomography (CT) scan within 24 hours after your surgery to make sure your Ommaya reservoir is in the right place.

How do I care for my Ommaya reservoir?

Your Ommaya reservoir doesn’t need special care.

Can the Ommaya reservoir be removed?

The reservoir is usually not removed unless you have problems with it.

When should I call my doctor or NP?

Call your doctor or NP if you have:

  • A temperature of 100.4° F (38° C) or higher
  • Tenderness, redness, or swelling around your reservoir
  • Clear, bloody, or pus-like discharge from your reservoir
  • Headaches
  • Vomiting
  • Neck stiffness
  • Blurry vision
  • Confusion

These warning signs can appear quickly. If any of these signs or symptoms develop, call your doctor or NP immediately.

If you cannot wake your child, call 911 or go to the nearest emergency room immediately.

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Contact Information

If you have any questions or concerns, please talk with your doctor or nurse. You can reach them Monday through Friday from 9:00 am to 5:00 pm at 212-639-7056.

After 5:00 pm, during the weekend, and on holidays, please call 212-639-2000 and ask for the pediatric neurosurgery fellow on call.

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This section contains a list of support services available at MSK, as well as the resources that were referred to throughout this guide. These resources will help you prepare for your surgery and recover safely. Write down any questions you have and be sure to ask your doctor or nurse.

Educational Resources

MSK Resources

Call if you have any questions about anesthesia.

Blood Donor Room
Call for more information if you’re interested in donating blood or platelets.

Bobst International Center
MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.

Chaplaincy Service
At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

Counseling Center
Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed.

Integrative Medicine Service
Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

Patient and Caregiver Support Program
You may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient and Caregiver Support Program, you’re able to speak with former patients and caregivers.

Patient Billing
Call if you have any questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
Call if you have questions about the Health Care Proxy form or if you have concerns about your care.

Perioperative Nurse Liaison
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nursing Office
You may request private nurses or companions. Call for more information.

Resources for Life After Cancer (RLAC) Program
At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

Social Work
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.

Tobacco Treatment Program
If you want to quit smoking, MSK has specialists who can help. Call for more information.

For additional online information, visit LIBGUIDES on MSK’s library website at http://library.mskcc.org. You can also contact the library reference staff at 212-639-7439 for help.

External Resources

In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

Air Charity Network
Provides travel to treatment centers.

American Cancer Society (ACS)
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

275 Seventh Avenue (Between West 25th & 26th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
Provides support and education to people affected by cancer.

Caregiver Action Network
Provides education and support for people who care for loved ones with a chronic illness or disability.

Corporate Angel Network
Offers free travel to treatment across the country using empty seats on corporate jets.

Gilda’s Club
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

Healthwell Foundation
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

National Cancer Institute
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
Free cancer legal advocacy program.

National LGBT Cancer Network
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
Lists Patient Assistance Programs for brand and generic name medications.

Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Partnership for Prescription Assistance
Helps qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

Provides assistance to help people get medications that they have trouble affording.

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