In the operating room, the patient is placed under general or spinal anesthesia. The physician pushes stainless steel needles through the pre-determined holes in the template, into the perineum and then the prostate, guided by the images seen on the ultrasound. After each needle is in the proper position, the seeds are inserted, according to the pre-plan dosimetry. The physician can modify the seed placement from the pre-plan based on skill and experience. Once a seed is deposited, nothing that can be done to change its position.
Physician experience is paramount in doing a successful seed implant.
The number of seeds used depends on the size of the prostate. Most prostate implants require 60 to 120 seeds. With the insertion of the seeds, the patient is now radioactive. Radiation safety precautions are followed to minimize the radiation exposure to hospital staff and family members. It is recommended that pregnant women, and children should avoid close contact with the patient for about two months, until the sources have decayed to a lower level of radioactivity.