HYDERABAD: The Neurosurgery department at the Nizam’s Institute of Medical Sciences (NIMS) has reduced the duration of Deep Brain Stimulation (DBS), or brain pacemaker surgery, from around six hours to less than two. The institute has also introduced MRI-guided Radiofrequency Ablation (RFA), a minimally invasive procedure for patients with severe tremors that do not respond to medication.
DBS is used to treat movement disorders such as Parkinson’s disease, dystonia and certain cases of severe tremor by implanting electrodes in specific areas of the brain to regulate abnormal electrical signals.
Speaking to TNIE, Prof Dr Y Vamsi Krishna, Professor and Head of Neurosurgery at NIMS, said the institute has performed around 200 DBS procedures over the past two-and-a-half years.
“Most centres take four to six hours for DBS surgery. By optimising our workflow after studying practices at University College London and adapting them at NIMS, we have brought the procedure down to less than two hours,” he said.
The shorter operating time is particularly beneficial for elderly patients, as parts of the surgery are performed while they are awake and the rest under general anaesthesia. Reducing the duration lowers exposure to anaesthesia and helps patients recover faster, he added.
NIMS has also begun offering MRI-guided RFA for patients with disabling tremors and selected cases of dystonia. Tremors, commonly seen in people with Parkinson’s disease and Essential Tremor, can make routine activities such as writing, eating and dressing difficult. While medication remains the first line of treatment, some patients continue to have severe symptoms.
Unlike DBS, RFA does not require electrodes, wires or batteries. Doctors use specialised MRI sequences to identify the nerve fibres responsible for the tremor, following which a probe is inserted to create a 3-4 mm lesion using radiofrequency heat.
“The procedure takes about 90 minutes and is performed with the patient awake. We can assess the tremor during surgery itself, and once the target is confirmed, a very small area is ablated. The improvement is often visible on the operating table,” Dr Vamsi Krishna said.
He said the advanced MRI sequences improve visualisation of the target area, allowing greater precision during the procedure. “Our objective is to provide world-class functional neurosurgical care within a government healthcare institution. These advances can help carefully selected patients regain independence and improve their quality of life,” he added.