Subsection 10: Neurosurgery

The full-time neurosurgery inpatient units have a sufficient number of dedicated beds to be able to care for neurosurgery patients at all times. Full inpatient, day inpatient and consultation neurosurgery units provide access and care for severely disabled patients with reduced mobility. Intensive care or continuous monitoring of neurosurgery patients is the subject of a protocol agreed between the medical managers of the neurosurgery units and the intensive care and…

The medical staff working in a neurosurgery inpatient unit include: 1° At least two qualified doctors specialising in neurosurgery ; 2° Anaesthetists on the basis of a protocol agreed with the neurosurgeons; 3° Qualified doctors specialising in other disciplines for non-operative care activities to ensure the management of neurosurgical patients as required. In addition to nurses and care assistants, the non-medical staff working on a daily basis in neurosurgery hospital…

A neurosurgeon fulfilling the conditions mentioned in 1° of article D. 6124-137 and an anaesthetist-resuscitator are responsible for the continuity of care mentioned in article R. 6123-101 on each site. These people carry out their duties on site or on operational call. In the case of operational on-call duty, the arrival time must be compatible with safety requirements. When on-call care is provided for several sites, the agreement referred to…

The practice of neurosurgery requires access at all times, possibly by agreement with another establishment, to : 1° Bacteriology, haematology, biochemistry examinations as well as those relating to haemostasis, blood gases and extemporaneous anatomopathology examinations; 2° Magnetic resonance imaging and computer tomography examinations; 3° Labile blood products. And where necessary : 1° Equipment for measuring and continuously recording intracranial pressure; 2° A transcranial echo-Doppler. Intracranial and extracranial radiosurgery operations under…

The operating theatre has at least two operating theatres, one of which is permanently accessible and equipped for neurosurgery and the other may be shared. Where applicable, an additional room, equipped for performing functional neurosurgery or intracranial and extracranial radiosurgery under stereotactic conditions, is required when the authorisation specifies the implementation of the therapeutic practices mentioned in 1° and 2° of article R. 6123-100.

The authorisation holder ensures that data from professional practices is collected and analysed with a view to improving practices and managing risks. The medical team mentioned in 1° of article D. 6124-137 fills in the professional practice observation registers mentioned in 3° of article D. 4021-2-1, as soon as these registers are operational.

The provisions of sub-section 9 relating to cancer treatment using external radiotherapy are applicable to the neurosurgery authorisation holders referred to in article R. 6123-100-1, with the exception of articles D. 6124-133-1 and D. 6124-133-3 and subject to the following adaptations for articles D. 6124-133-4 and D. 6124-133-5: 1° Final validation of the delineation of target volumes and organs at risk is the responsibility of a surgeon specialising in neurosurgery…