WHAT HAPPENS DURING DBS SURGERY?
In order to receive DBS Therapy, a device similar to a pacemaker is placed under the skin of the chest. Very thin wires connect the device to the brain to enable the signals to reach the source of the symptoms. Here's what to expect during and after the procedure that makes therapy possible.
Having the Procedure
The duration and steps of the implant procedure can vary, and the procedure typically lasts several hours. The hospital stay is usually a few days for the preoperative tests, planning, implant procedure, and initial recovery before home care.
People who have had the procedure usually describe it as demanding and exhausting rather than painful. Afterwards, there may be some discomfort and soreness that can be managed with pain medication.
Implanting the Neurostimulator
The neurostimulator may be implanted the same day or later. The patient will be sedated and asleep for this part of the procedure. The surgeon begins by checking to see that the leads are properly positioned.
The neurostimulator is placed under the skin of the chest just below the collar bone. The surgeon will also connect the lead to the neurostimulator with extensions that are placed under the skin, leading up from the chest to the neck and head.
THE HEALING PROCESS
People usually go home a few days after the surgery. Healing can take several weeks. Discomfort or pain at the incision sites can be managed with medication. When patients are sent home to heal, typically the device will not be turned on until the first programming session.
For several weeks, patients should avoid strenuous activity, arm movements over the shoulder, and excessive stretching of the neck. One may gradually want to try activities that were difficult before the surgery. Talk about this with the doctor first, and be sure to follow all of the doctor's instructions.
Programming Sessions
After healing from the procedure, the doctor will program the device to best control the individual symptoms while minimising side effects. Patients should return for follow-up sessions to further adjust the settings. Periodic adjustments are a routine part of DBS Therapy.
The full effect of the therapy may not be immediate. The best results will be seen after the system has been fine-tuned for the specific symptom control needs. It may take several months to reach maximum effect.
Depending on the system and the therapy needs, patients may have a controller that allows the system to be turned on and off, adjust the stimulation, and check the battery level.
WHAT ARE THE RISKS OF THE DBS SURGERY?
Placing the DBS system requires brain surgery, which could have serious and even fatal complications including coma, bleeding inside the brain, stroke, seizures, and infection. Once implanted, the system may become infected, parts may wear through the skin, and the lead and/or extension connector may move. DBS Therapy could stop suddenly because of mechanical or electrical problems. Any of these situations may require additional surgery or cause symptoms to return or worsen, which may be life-threatening. DBS Therapy may cause new or worsening neurological or psychiatric symptoms.
In patients receiving DBS Therapy, depression, suicidal thoughts, and suicide have been reported.
This therapy is not for everyone. This therapy should not be used for patients who will be exposed to diathermy (deep heat treatment) or transcranial magnetic stimulation. Magnetic Resonance Imaging (MRI) should only be performed as described in the product labeling. The DBS system may interact with other medical devices and electromagnetic interference.
Talk to the doctor about the risks that may be applicable to your specific situation.