Surgery of Patient with Radioactive Material

When a patient who has been administered radioactive material requires surgery, there is an important distinction between radioactive material administered for diagnostic studies and patients who have been administered radioactive material for therapeutic purposes.

A. Surgery for a Patient Who Received Diagnostic Amounts of Radionuclides

  1. There are no special precautions beyond standard (universal) precautions for the handling of a patient with residual radioactivity from a diagnostic study.       
  2. Individuals involved in the surgical procedure should protect themselves from exposure to body fluids by wearing disposable gloves and an outer garment such as a surgical gown, laboratory coat or an isolation gown.
  3. Bodily fluids should all be handled in a routine manner – i.e. blood-soaked pads should be disposed in red bags, urine may be flushed down the toilet.

B. Surgery for a Patient Who Received Therapeutic Amounts of Radionuclides

The following procedures should be followed:

  1. Call Radiation Safety (212-305-0303), the Authorized User and the Referring Physician
  2. If emergency surgery is performed within the first 24 hours following the administration of Iodine-131 sodium iodide, fluids (e.g., blood, urine, saliva) will be carefully removed and contained in a closed system. If the surgery is performed after the first three days from therapeutic administration of I-131, a vast majority of radiation will have already biologically exited the body.
  3. Protective eye wear will be worn by the surgeon and any personnel involved in the surgical procedure for protection of the eyes from possible splashing of radioactive material and exposure from beta radiation (if applicable). Two layers of gloves shall also be used, and the outer layer should consistently be exchanged to avoid buildup of contamination of the outer gloves.
  4. The radiation safety staff will direct personnel in methods to keep doses ALARA during surgical procedures.
  5. If an injury occurs during surgery that results in a cut or tear in the glove used, the individual involved will be monitored to determine if radioactive material was introduced into the wound. The RSO will be informed of any possible radiation hazard.
  6. In the case of brachytherapy the radioactive sources should be removed from the patient prior to surgery by the Authorized User.
  7. If the brachytherapy sources can not be removed, Radiation Safety must be consulted.
  8. After the procedure, all personnel involved in the surgery and the procedure room shall be surveyed for radioactive contamination. All contaminated items and radioactive waste shall be collected by radiation safety and sequestered in their decay-in-storage facility.