Use of Mick Applicator in Transperineal Ultrasound-Guided 125 I Seed Implantation

A modification for the technique for transrectal ultrasound-guided perineal interstitial implantation with radioactive seeds for the treatment of prostate cancer is described. The transducer is fixed in position. Placement of all needles into the prostate prior to seed insertion provides stabilization of the gland. By placing all of the needles into the prostate at the 0 retraction position and using the Mick applicator to withdraw the needle to the correct retraction plane, we save time and gain accuracy. We avoid drilling the pubic arch by pulling the prostate downward using the multiple needles as a lever. The division of labor between the urologist and the radiation oncologist allows each to work more efficiently and thereby reduce operating room time.