What is an intraoperative consultation?

An intraoperative consultation is a special type of procedure that involves a surgeon sending a tissue sample to be examined by a pathologist while the patient was still in the operating room.

Alternative names for this type of procedure are 'quick section' and 'frozen section'.

Why are intraoperative consultations performed?

Intraoperative consultations are usually performed to provide your surgeon with information that will help with decision making during the surgical procedure. A common reason for an intraoperative consultation is the assessment of normal tissue adjacent to a tumour for microscopic amounts of cancer that cannot be seen with the naked eye (this normal appearing tissue is called a 'margin').

 

In some situations an intraoperative consultation may be used to provide a rapid diagnosis or to confirm that the diseased tissue has been sampled before sending it for additional tests.

How is an intraoperative consultation different from other tissues sent to pathology?

Unlike most tissue sent to pathology, tissue examined as part of an intraoperative consultation is not placed in a preservative called formalin and embedded in wax before to being cut and placed on a slide. Instead the tissue is rapidly frozen, cut, and immediately stained so that it can be examined under the microscope within minutes of being received (which is why the procedure is also called a 'frozen section'). The rapid processing and analysis of your tissue allows your pathologist to provide the surgeon with information in 'real-time'.

However, because this tissue is not preserved in formalin, many advanced tests cannot be performed at the time of an intraoperative consultation. For this reason, most diagnoses provided during an intraoperative consultation are considered preliminary and may be revised when the rest of your tissue sample is examined.

A description of the intraoperative consultation will be included in your pathology report if your surgeon requested that a pathologist examine a sample of your tissue at the time of your surgery. 

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