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What to Expect During Stereotactic Radiosurgery: A Step-by-Step Guide

The word “surgery” is bound to make anyone feel a little uneasy, especially if you have no idea what you are getting into. But if your doctor has been talking to you about the stereotactic radiosurgery procedure, you can be reassured that there is no cutting, no incisions and no anaesthesia. Stereotactic Radiosurgery (or SRS) is a highly accurate, nonsurgical radiation therapy that delivers high doses of radiation to a targeted tumour or other abnormality. This targeted radiation is used to destroy abnormal tissue while minimising unnecessary damage to surrounding healthy tissue.

SRS is often used to treat conditions such as brain tumours, arteriovenous malformations (AVMs), trigeminal neuralgia and acoustic neuromas. Here is a step-by-step guide to a stereotactic radiosurgery procedure that covers everything you should expect, from the initial consultation to recovery.

What Is Stereotactic Radiosurgery (SRS)?

In the stereotactic radiosurgery procedure, precise radiation is used to treat conditions such as tumours and other problems in the neck, brain, liver, lungs, spine, and other parts of the body. Despite its name, it is not a “surgery” in a traditional sense, as no incisions or anaesthesia are required here. Instead, healthcare providers make use of imaging and high-dose radiation to treat the affected area by damaging the DNA of targeted cells. This causes them to lose the ability to multiply, thereby shrinking the tumours. With stereotactic radiosurgery, damage to healthy tissue surrounding the target area is minimal.

Depending on the tumour’s location, the patient’s age, and other health considerations, a doctor may recommend SRS if traditional surgery is not effective. Stereotactic radiosurgery is generally indicated for symptoms like chronic headaches, seizures, changes in vision or hearing, and neurologic symptoms such as weakness, numbness, and difficulty with coordination.

Step One: Preparing for SRS

How you prepare for stereotactic radiosurgery will mainly depend on your condition and the area to be treated. That being said, common patterns include not eating or drinking anything from midnight till the procedure.

You should wear loose & comfortable clothing, and skip jewellery, glasses, contact lenses, dentures, makeup, nail polish, and wigs/hairpieces. Talk to your attending doctor about your regular medications and whether they can be taken before the procedure. Your doctor should be made aware of any pills or injections you may be taking for diabetes, your allergies to shellfish or iodine, or implanted medical devices in your body, e.g., a pacemaker.

Step Two: Head Frame Placement

Once on the treatment table, a special mask or frame will be used to immobilise the patient’s head or neck, depending on the type of SRS being performed. This provides stability for your head, giving the radiation beams a reference point to direct themselves toward, making the process more efficient and accurate.

The frame will be attached to your head using four pins. Numbing shots will be delivered to your scalp where the pins are to be inserted. Some types of brain radiosurgery may not require placement of a head frame at all.

Step Three: Imaging

Imaging scans will then be performed to show the tumour and any other abnormalities. The scans depend on the type of condition the patient has. For example, tumours may require a CT scan or MRI, whereas doctors may prefer cerebral angiograms for AVMs, in addition to CT and MRI.

Step Four: Radiation

Brain scan results are entered into a computerised planning system, which helps the healthcare team decide the treatment plan, including the area to be treated and the radiation dose to be delivered. The planning can take a couple of hours or more.

The stereotactic radiography process can take anywhere from 30 minutes to a few hours. Advanced technology is used to deliver high doses of radiation to the targeted area.

What Happens After the Procedure

Once the stereotactic radiography procedure is complete, the healthcare team will monitor patients and ensure they are stable before discharging them. Once discharged, patients will receive thorough instructions on post-procedure care, including how to manage side effects and when to return for follow-up.

After the SRS procedure is completed, the patient may experience minimal bleeding or tenderness at the pin insertion sites. They may also have headaches, nausea, or vomiting, for which the healthcare providers will prescribe medications. You can eat or drink soon after the procedure.

What Recovery Looks Like

Recovery times vary from patient to patient, but surgery generally has short downtime for most patients. As a general rule, the patient should refrain from strenuous activity for one week. You may be advised to do light activities, such as walking. Most patients may return to normal activities gradually after two weeks, unless your doctor has asked you to avoid any in particular. Regular follow-ups allow the patient and doctor to work together to monitor the situation and address any side effects that might arise after the procedure. Most people will recover fully within a few weeks, but some may have ongoing side effects. Talk to your doctor if anything feels wrong.

Conclusion

Stereotactic radiosurgery (SRS) is one of the most remarkable advances in modern medicine: a way to treat delicate, hard-to-reach areas of the brain or spine with pinpoint accuracy, without a single incision. The idea of radiation treatment can be intimidating, but the actual treatment is much easier & effective than most patients expect. All of this meticulous planning, precise imaging and painless delivery come together to make SRS a safe and effective option for many conditions that once required open surgery.

Frequently Asked Questions

Is a stereotactic radiosurgery procedure painful?

The treatment itself is not painful. The patient may feel some mild discomfort from the head frame, but this is usually temporary and shouldn’t last long.

How long does the whole SRS process take?

Planning can take from a few days to a few weeks. The treatment session itself usually lasts from about 30 minutes to several hours.

Will I be awake during the SRS procedure?

Yes, in most cases you will be alert and awake. Doctors may anaesthetise children during imaging tests and radiosurgery.

Are there side effects to SRS?

Some people may experience headaches, fatigue, or nausea after the Stereotactic Radiosurgery (SRS) procedure. If the side effects don’t go away eventually, consult a doctor.