An Ommaya reservoir is a medical device used to deliver chemotherapy drugs directly into the spinal fluid. The reservoir is implanted under the scalp and attached to a threaded catheter in one of the ventricles of the brain. In addition to being used to administer medications, this device can also be used for taps or withdrawals of cerebrospinal fluid. It is implanted under general anesthesia by a neurosurgeon on the recommendation of an oncologist who considers it necessary for cancer treatment.
Cancers in the central nervous system are notoriously difficult to treat. Chemotherapy drugs given by mouth or intravenously may not be able to pass the blood-brain barrier, or may not pass in large enough amounts to provide meaningful treatment. An Ommaya reservoir allows doctors to deliver treatment directly to the source. The device is named after the Pakistani surgeon who invented it in the 1960s.
When an Ommaya reservoir is placed, the patient is placed under general anesthesia and the surgeon makes an incision in the scalp to access the skull. A hole is drilled to place the catheter, and the reservoir is inserted under a bag in the scalp. The incision is closed and the anesthesiologist brings the patient out of anesthesia. Patients may spend several days in the hospital while they heal and have their cognitive deficits and lung function evaluated to confirm the absence of surgical complications.
To deliver medications to the Ommaya reservoir, injections can be made through the scalp and into the reservoir. Catheters may also be inserted to drain cerebrospinal fluid for testing and other reasons. The reservoir can be left in place once the patient goes into remission in case of recurrence. If a patient remains stable for an extended period of time, a surgeon may discuss removal of the Ommaya reservoir in a second surgical procedure.
It is not uncommon to implant devices such as the Ommaya reservoirs and ports to access the venous network for cancer treatment. Cancer treatment can be exhausting, and patients may require multiple chemotherapy sessions. Having an access point ready can improve patient care, reduce the risk of complications, and minimize skin and tissue damage as a result of repeated new injection sites. However, patients should also take care of their indwelling catheters, as there is a risk of infection. Patients will receive detailed instructions on catheter care before and after surgery and are encouraged to ask questions about catheter care so they know what to expect.