RML Hospital Performs First 'Brain Pacemaker' Surgery to Fight Parkinson's
RML Hospital successfully conducts its first Deep Brain Stimulation surgery to treat Parkinson's tremors for a Nepal government official.
In a significant medical milestone, Dr Ram Manohar Lohia (RML) Hospital has successfully performed its first Deep Brain Stimulation (DBS) functional neurosurgery. The procedure, often referred to as a 'brain pacemaker,' was carried out to provide relief to a 55-year-old woman suffering from severe Parkinson's disease tremors.
A Lifeline for a Government Official
The patient, an Under Secretary in the Nepal government, had been struggling with the debilitating effects of Parkinson's for some time. The disease had left her with tremors and significant difficulty in walking, forcing her to take a long leave of absence from her official duties for the past six months.
While she had previously sought treatment at a private healthcare facility, the astronomical cost of the DBS procedure proved to be a major barrier. According to medical professionals, such surgeries can cost between Rs 25 lakh and Rs 30 lakh at private centers. However, at RML Hospital, the procedure was performed at a nominal cost, making this life-altering treatment accessible to her.
Inside the Complex Procedure
The surgery was a marathon effort, lasting approximately eight to nine hours. Starting at 9 am and concluding around 5:30 pm last week, the operation was led by the neurosurgery department with critical support from the radiology and anaesthesia teams.
Professor Sharad Pandey from the neurosurgery department explained that DBS is typically reserved for patients whose Parkinson's symptoms are no longer adequately managed by medication. The process involves several high-tech steps:
- Electrode Implantation: Electrodes are precisely placed in specific areas of the brain, such as the subthalamic nucleus (STN) or globus pallidus, to deliver electrical impulses that regulate abnormal movements.
- The Power Source: A battery-powered device is implanted in the patient's chest and connected to the brain electrodes.
- External Adjustment: Doctors can adjust the stimulation settings from outside the body to optimize the control of symptoms.
The Margin for Error: Just One Millimetre
The complexity of the surgery cannot be overstated. The team relies on detailed MRI and CT imaging, along with specialized planning software, to target deep-seated brain structures. Dr Pandey emphasized the extreme precision required, noting that even a deviation of a single millimetre can significantly alter the outcome of the surgery. Before the first incision, the team meticulously maps the target and calculates the exact coordinates, angles, and trajectory for the electrodes.
The Road to Recovery
Following the surgery, the patient remained under observation for five to six days. The next phase of treatment involves programming the implanted device and fine-tuning its settings based on her specific symptoms.
Medical experts expect that initial improvements will become visible within a month, with more substantial benefits emerging over the next three to six months. The patient will need regular follow-up visits for device assessment and programming. As her symptoms improve, doctors may gradually adjust her medication under strict medical supervision.
Breaking Barriers in Public Healthcare
This successful surgery highlights a critical gap in public health infrastructure. DBS requires a multidisciplinary team, specialized equipment, and high expenditure, which often makes it unavailable in government hospitals. Doctors noted that many suitable patients are often denied this treatment simply because the necessary facilities are lacking in the public sector. By successfully executing this procedure, the RML team has demonstrated that such advanced neurosurgical interventions can be integrated into government healthcare settings.