How Much Does Deep Brain Stimulation Surgery Cost?

Procedure

• DBS surgery can be performed under local anesthesia while you are awake (with minimal sedation) or under general anesthesia (while you are asleep). During some procedures, patients may be awake for a portion and asleep for the remainder.
• If the surgery is performed while the patient is awake, local anesthesia is given to numb the scalp; the brain, which lacks pain receptors, does not need anesthetic.
• Doctors might suggest that the patient stop using their Parkinson’s drugs. In order to help the surgeon place electrodes in the appropriate area of the brain during surgery, the patient is asked to do specific tasks.
• However, some patients could find it uncomfortable to refuse medication or to stay awake during brain surgery. General anesthesia is an alternative because the patient would not be conscious during the procedure.

The procedures for deep brain stimulation surgery are as follows:

Attaching the stereotactic frame

• The patient’s head is first fitted with a stereotactic frame by the surgeon.
• To reduce pain, local anesthesia is administered to the scalp at the four locations where pins will be implanted.
• As the pins are tightened, the patient can feel some pressure.

Imaging scans – MRI or CT scan

• The physician will perform imaging tests like magnetic resonance imaging (MRI) or computerized tomography (CT).
• The brain is mapped using these images and specialized computer software to determine the location of the electrodes.

An incision on the skin and skull

• In order to bring out the skull, the top of the head’s skin is cut and the hair is shaved.
• On the left and right sides of the skull, the surgeon will then drill two burr holes.
• Electrodes are inserted into the brain via these openings.

Insertion of the electrode in the brain

• The tiny burr holes in the skull are used to insert the electrodes, which are then positioned inside the brain.
• The electrode is placed into the brain at a precise depth and angle using the planning software and images from the MRI and CT scans.
• Since the brain does not experience pain, there won’t be any discomfort.
• One lead wire may be inserted into either side of the brain by the surgeon.
• The cable will pass through the skin and arrive at an implanted pulse generator (neurostimulator) close to the collarbone.

Stimulation of the brain cells

• Test stimulation is carried out after the permanent DBS electrode or lead is positioned on the appropriate nerve.
• The surgical team will enquire as to whether the patient believes any of their symptoms have diminished or vanished entirely.

Closure of the incision

• To keep the lead in place, the surgeon will cover the tiny hole on the head with a plastic cap.
• Sutures or staples are used to seal the scalp incision. After that, the surgical wounds are bandaged.
• A week later, the chest stimulator is implanted through an outpatient procedure.
• The patient will be rendered unconscious and this will be done while under general anaesthesia.

Implanting the stimulator

• To access the leads, the surgeon will partially reopen the scalp incision in the operating room. The neurostimulator will then be inserted under the skin through a little incision made close to the collarbone.
• To connect to the stimulator/battery in the chest, the electrode is fastened to an extension wire that is inserted under the skin and down the neck.
• A little protrusion under the skin could be the only indication that the stimulator is present, however, it is typically covered by clothing.
• As the incision heals, it is best to avoid straining the neck excessively or moving the arm over the shoulder.

Programming the stimulator

• The patient will have their stimulator programmed in a follow-up appointment a few days after the operation.
• The doctor uses a unique remote control to program the pulse generator in his office.
• Finding the ideal environment may require 3 to 4 programming sessions, which could take some time.
• Depending on the person’s condition, a specific level of stimulation is needed.
• The simulator’s programming will change the dosage of the drug.