Surgery: What to Expect – DBS Therapy

People who receive the Medtronic DBS System usually describe the surgical procedure as demanding and exhausting. There may be some discomfort during the initial stages of the surgery. However, the placement of the leads is not painful (your brain is not sensitive to pain). Your doctor will be able to answer any questions you may have about the procedure.

Implant diagram of the brain stimulation system

Detail - Implant diagram of the deep brain stimulation system

Before the Procedure

The evening before surgery, you may be instructed to stop taking all of your medications. This step lets your healthcare team best determine the effect of DBS treatment on your motor symptoms.

You will be admitted to the hospital either the night before or the morning of your surgery. You may have your head shaved prior to surgery to help prevent infection.

During the Procedure

The duration of the procedure and the specific steps involved can vary. The surgery typically lasts 4 to 8 hours. There are many variations to the surgical procedure dependent on the DBS centre. Ask questions to learn fully their particular procedure.

Your surgery may consist of the following steps:

  1. A metal frame may be attached to your head. The head frame is a special instrument that allows the neurosurgeon to find the correct path to the target site in your brain. Your surgeon may also use newer, frameless technology that doesn’t require a frame to be attached to your head during the procedure.
  2. Pictures of your brain will be taken using an MRI, CAT scan, or both. These images will allow your surgeon to determine where to place the leads.
  3. Your scalp and skull will be numbed to minimise any discomfort. In the operating room, a small hole will be drilled in your skull for the lead. Later in the surgery, a cap will be placed over this small hole to seal it.
  4. Your surgeon will stimulate areas of your brain to determine the best lead placement. You will be lightly sedated but awake so that you can help your doctor determine when your symptoms are best controlled.
  5. If your symptoms are suppressed due to stimulation during a test stimulation, the neurostimulator and extension will then be implanted. Your symptom control will be checked again. The lead position will be held in place with the cap covering the hole.
  6. If your surgeon uses a head frame, it will be removed. If you don’t have the extension and the neurostimulator implanted right away (sometimes surgeons implant the DBS System in two stages), you will typically be able to go home in 24 to 48 hours. Your doctor will decide the length of your hospital stay.
  7. When you have the extension and neurostimulator implanted, you will be sedated and asleep. You will typically be allowed to go home in 24 to 48 hours. Your doctor will decide the length of your hospital stay.

After the Procedure

Once your body has healed following the implant procedure, your clinician will programme the neurostimulator to start sending the electrical pulses that help control your motor symptoms. He or she will adjust your stimulation wirelessly. The process is non-invasive and may take a few hours to complete.

It may take several visits to adjust the stimulation before the best settings for you are determined. Over time as the disease progresses, further adjustments may be necessary.

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

Last updated: 19 Apr 2016

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