DBS Surgery in Delhi

DBS or Deep Brain Stimulation is a painless and minimally invasive surgery that regulates abnormal impulses in the brain. In a DBS surgery, the doctor inserts electrodes on both sides of the brain. The electric signals transmitted to the brain regulate its activity and help treat the symptoms of conditions like Parkinson’s Disease, epilepsy, dystonia, OCD, and Essential tremor. A DBS surgery in Delhi is performed at all the major hospitals by the most experienced surgeons. If you or your loved ones find no improvement in the symptoms of your condition even after medical treatment, DBS can help you.

Complications and Side Effects of DBS Surgery in Delhi

In DBS, electrodes are stimulated as a test to make sure that the proper part of the brain gets targeted. The aim of this surgery is to produce the desired effects, such as stopping tremors or relaxing contracted muscles. Still, the surgery does not cure the underlying condition.

It can have certain complications and side effects, that are often non-reversible. These include

• Lead fracture due to DBS hardware
• Hardware infection
• A tingling sensation in the face and legs.
• Speech and vision problems
• Difficulty in concentrating
• Dizziness
• Seizures
• Slight paralysis
• Temporary pain at the site of implantation

Life Before and After DBS Surgery for Those Living with Parkinson’s

When you undergo DBS surgery in Delhi for Parkinson’s, the surgeons will place tiny electrodes into those places in the brain that are impacted as Parkinson’s progresses. These electrodes emit electrical impulses, which affect the affected parts of the brain positively. As a result, after the DBS surgery, you experience improvements in tremors, slowness, and stiffness. This also makes activities like walking, dressing, and getting up easier. 

One of the prominent features of your life after DBS is a reduced reliance on the number of pills you take by more than 75 percent. Many people can also stop taking medications altogether. It is well-observed that people with Parkinson’s struggle to be active. The persistent difficulty with keeping balance and coordination makes it arduous to walk, talk, and do daily tasks. But after DBS, these symptoms can be managed well.

Although you will face certain side effects a few weeks after undergoing DBS surgery in Delhi, you will find that returning to your normal daily routine is possible. You will also not experience much surgical pain.

Cost of DBS Surgery in Delhi

The average cost of DBS surgery in Delhi differs by a significant margin at different hospitals. So, you will find the price different at super specialty hospitals, big hospitals, and small ones.

Deep Brain Stimulation Cost in Delhi’s Super Speciality Hospitals

Cost of DBS Surgery in Delhi’s Large Hospitals

Cost of DBS Surgery in Delhi’s Small Hospitals

Breakdown of the Cost of DBS Surgery in Delhi

We can divide the cost of DBS surgery into various components. Go through this rough estimate of the different expenses of this surgery, from the pre-operative evaluation to the final hospital stay.

Deep Brain Stimulation Cost in AIIMS

One of the best hospitals for DBS surgery in Delhi is AIIMS. It offers this surgery at cost-effective rates to patients. The DBS surgery cost in AIIMS mainly depends on the experience of the neurosurgeon. You can expect a consultation fee of anywhere between Rs. 1000 to Rs. 2000 here. If you pay online, the fee will be reduced by a significant margin. 

The usual cost of DBS surgery in this hospital ranges from Rs. 1,00,000 to Rs. 5,00,000. The following factors influence this cost.

• Consultation fee 
• Diagnostic tests for the surgery
• Kind of surgery 
• Admission fee 
• The existing medical condition of the patient
• Age of the patient
• The kind of room you choose 

DBS Cost in Delhi in Comparison to Other Cities in India

There is a considerable difference in the cost of DBS surgery in Delhi and the same process in other top Indian cities. This table will make that clear to you.

DBS Cost in Delhi in Comparison to Other Countries

Unlike the top Indian cities, the average cost of DBS surgery varies only slightly in the top countries in the world. 

Why DBS Parkinson’s Cost More In Some Hospitals Than Others?

The cost of DBS surgery in Delhi is higher in some places than others because of various reasons. You will find the overall price of this procedure more in certain hospitals because of the following factors. 

• Highly experienced, board-certified neurosurgeons charge more because they deliver exceptional outcomes. 
• The location from where you are getting the surgery also influences the cost. 
• A rechargeable DBS device is more expensive. So, if your surgeon uses such a device, the cost of the surgery will increase. 
• The latest DBS devices come with robust features and so, their usage increase the overall cost. 
• Your age and medical condition also impact the surgery’s cost. 

What are DBS Devices and Their Cost

A DBS device has three parts. 

1. DBS Lead – It is a thin, insulated wire having four electrodes. The surgeon places these electrodes on a specific part of the brain according to your condition. 
2. Neurostimulator – This part of a DBS device has a battery that produces electrical signals. The surgeon implants it below the skin. The battery of this neurostimulator lasts for up to five years. 
3. Extension – It is an insulated wire that the surgeon passes under the skin. It is like a lead to the stimulator.
4. IPG – The Implantable Pulse Generator or IPG is the third part of a DBS system. The surgeon implants it under the skin on the upper part of the chest.

There are primarily three available DBS devices. These include 

1. Abbott’s Infinity – It is FDA-approved and allows a greater ability for the surgeon to guide stimulation to the regions connected with the symptoms. 
2. Medtronic Activa – This device has chargeable and non-rechargeable batteries. It is programmed with an Android tablet.
3. Boston Scientific Vercise – This DBS device also allows the surgeon to guide stimulation in the regions connected with the illness. Some of its models come with rechargeable batteries. Others allow surgeons to visualize models of the insertion of leads in the brain. 

Cost of Rechargeable and Non-Rechargeable IPGs

Different Techniques of DBS Surgeries and Their Cost

There are various types and techniques of DBS surgeries performed by a neurosurgeon with specialized training. The estimated cost of these techniques is given in this table.

DBS Success Rate in Delhi

Deep brain stimulation surgery at the leading hospitals has a promising success rate. Nearly 85% of patients with Parkinson’s disease have experienced significant alleviation in rigidity, bradykinesia, and resting tremors. Also, patients speak of a marked enhancement in their living as well as a reduction in the need for drugs or medicines. The five-year survival rate of patients who undergo DBS surgery in Delhi is 50%. This procedure allows patients to gain a sense of independence as they can perform their daily activities by themselves.

Is the DBS Treatment Cost in Delhi Covered by Insurance?

Yes. many insurance plans cover the treatment cost of DBS surgery in Delhi. The plans cover medical expenses for hospitalization, pre-hospitalization, ambulance services, and aftercare. Patients can choose a health insurance plan that offers coverage of around Rs 6 crore. However, this coverage is different for every health insurance plan.

Many insurance companies offer packages that provide coverage for deep brain stimulation surgeries. Some of the popular ones in the public sector include:

• The New India Assurance Co. Ltd
• United India Insurance Company
• National Insurance Co. Ltd.
• Oriental Insurance. 

Here are some private health insurance providers that provide coverage in the form of packages for DBS surgery in Delhi. 

• Bajaj Allianz
• Aditya Birla
• Kotak Mahindra
• Care Health
• Star Health
• Reliance Health
• SBI Health Insurance
• Raheja QBE Health Insurance 
• ICICI Lombard Health Insurance
• HDFC Ergo Health Insurance
• Royal Sundaram Health Insurance 
• TATA AIG Health Insurance 
• Zuno Health Insurance

Ways to Minimize the Cost of DBS Surgery in Delhi

Usually, a DBS procedure is performed with two wires. One is used on the left and the other on the right. This process is called bilateral DBS. Sometimes, though, only one wire may be sufficient to provide the desired benefits. This is referred to as the unilateral DBS. Although bilateral DBS is necessary for treating Parkinson’s, in certain cases unilateral DBS can prove useful. 

If your surgeon performs unilateral DBS, the surgery time is minimized as only a single wire is needed. It also requires a shorter battery. In other words, from the surgery time to the cost, everything is minimized by almost 50%. 

So, if you want to reduce the cost of the procedure, ask your surgeon whether they can perform unilateral DBS. This procedure is ideal in the following two cases:

• You experience symptoms only on a single side. 
• You experience thinking problems or depression

How to Determine the Right Cost of Your DBS Surgery in Delhi

You can determine the overall expenses of your DBS surgery in Delhi by focusing on several factors. These include:

• Opt for public sector hospitals: The deep brain simulation cost in Nimhans and other national-level institutes like AIIMS is a lot less than that in private hospitals. 
• Consider getting this surgery at newly established centres: Today, many newly established medical centres offer DBS surgery in Delhi. They carry out this process at huge discounts. If budget is an issue, you can consider getting this surgery from such centres. 
• Note the infrastructure: The cost of DBS surgery will be high if the hospital is equipped with state-of-the-art tools. At this point, we would not want you to see the cost because a brain surgery needs advanced infrastructure. 
• Experience of the team involved: Centres with multidisciplinary teams with years of experience in performing successful DBS have a high cost. Such teams have neurosurgeons, psychologists, neurologists, and the like who help patients at every stage of the DBS procedure.

Why Is DBS A Low-Risk Surgery

DBS surgery is a groundbreaking treatment for neurological conditions. It is considered a low-risk surgery because it’s a minimally invasive procedure. The surgery extends the control you get from the medications for managing Parkinson’s Disease. Approximately 85 to 89 per cent of patients with Parkinson’s have experienced significant improvement with DBS. 

The procedure is able to provide up to extra hours of effective movement control. It is FDA-approved to treat movement symptoms characterized by Parkinson’s. These include stiffness, shaking, and problems in moving. Patients with Parkinson’s already take multiple doses of various medications. Many of them find that the greater their intake of medication, the lesser they feel its benefits. DBS surgery provides more relief than more medications. 

Almost 75% of patients report feeling better emotionally after the surgery as they can move about easily, The effects of this surgery last throughout the day without much effort on the patient’s part. The batteries of DBS devices do not need any removal, cleaning or maintenance at any time of the day.  

What to Consider When Deciding on a DBS Device?

You must discuss this in detail with your neurosurgeon to figure out the right DBS device. Use these points to select an appropriate option.

• Know if you want a rechargeable battery: A rechargeable battery requires less replacement over many years. However, they need recharging at regular intervals. If you think that you can keep up with it, go for a DBS device with a rechargeable battery.
• Assess the user-friendliness of the device: Patients should be capable of checking the battery of their devices and turning them on and off. Your doctor may also instruct you on adjusting the settings at home according to certain parameters. You must be able to interact with the device conveniently.
• Your clinician’s view: Your movement disorder specialist is more knowledgeable about placing a specific DBS device. Do consider their recommendation when deciding on this device. 
• Research studies: Many trials are being conducted on new DBS devices with advanced capabilities. You should review these studies and then present your options to your doctor.

Precautions for Patients with Implanted DBS

Patients with implanted DBS should take certain precautions. These include the following.

• Avoid activities that stress the implanted parts of the neurostimulation system. Some examples of such activities include repetitive or excessive bending, stretching, or twisting.
• Do not manipulate the parts of the implanted systems. 
• Do not burr the hole site. It can cause damage to the component. Besides that, it can also result in lead dislodgement, stimulation at the site of the implant, or skin erosion. 
• Do not dive below 33 feet of water, as it can damage the neurostimulation system. 
• If you use a rechargeable stimulator for Essential Tremor or Parkinson’s Disease, do not put the recharger over a medical instrument with which it is incompatible. It may cause the recharger to modify the functioning of the medical device, resulting in a medical emergency. 
• Do not use the recharger on an unrecovered wound. It’s because the recharger system isn’t sterile, and contact with the wound could result in an infection. 

What Happens When a DBS Battery Dies?

If the battery of your deep brain surgery stimulator runs out, you must contact your neurosurgeon. They will replace it at the earliest. For those with Essential tremor, the dying of the battery will make them unable to control the tremor. Parkinson’s disease patients will find their symptoms returning in a few days if their stimulator battery runs out. This can become a medical emergency only if you cannot move.

Again the symptoms of dystonia, if you have it, will return if the battery of the device runs out. The best solution is to check in with your neurosurgeon.

What You Should Know About DBS-Related Hardware Infections

Infections related to DBS hardware result in substantial morbidity. In such cases, hardware explantation or removal is required. This in turn makes symptoms like stiffness, tremors, and bradykinesia come back again. Also, the requirement for medication for disease management increases.

DBS hardware-related infection rates are as high as 20%. When infections occur, removing the involved components and sparing the intracranial leads is best. Another safe practice is wound revision if removing the whole DBS system is not feasible. It increases the quality of life and prevents the shortening of the DBS treatment. 

More intense DBS hardware-related infections need surgical intervention. Studies also reveal that another effective measure is hydrogen peroxide. If the infections arise from the IPG or implantable pulse generator pocket, IPG removal, antibiotics, and wound treatment can be done. 

Botched DBS Surgery in Delhi – What You Should Know

A few reasons may lead to a botched or failed DBS surgery. DBS failure occurs primarily because of these:

1. Choosing the wrong candidate for the surgery 
2. Problems with the DBS procedure. It includes suboptimal placement of DBS leads and misplaced DBS leads.
3. Post-operative programming 
4. Medication adjustment after the operation 

In 2022, a study was conducted to determine the risks and failures of DBS. 519 patients underwent DBS and 232 patients underwent implantable pulse generator replacement. In the follow-up period, surgery-related issues occurred in 46 cases. These problems included:

1. Confusion in 31 patients
2. Intracerebral hemorrhage in 7 patients
3. Sudden drop in blood pressure and heart rate in 3 patients.
4. Respiratory problems in two patients.
5. Post-operative aggressiveness in one patient.
6. Twitching in one patient.

Also, the likelihood of a botched DBS surgery is higher in older Parkinson’s patients. Those who are in their 60s and 70s at the time of undergoing DBS surgery have an increased risk of death in the following years. 

DBS Surgery Reviews in Delhi

Normality is central to the experience of DBS. A sense of control that patients get after this surgery is a major part of attaining that normality. Many patients report that their tremors are completely gone when the battery is switched on. Patients who experience drug-related complications find that they are under control. Thus, they have been able to reduce the drug dose by almost half. 

Also, many patients in Delhi report zero fluctuations in their motor symptoms after the surgery. They maintain a constant state of motor activity throughout the day after the surgery. 

Frequently Asked Questions

1. What is the average cost of deep brain stimulation in Delhi?

The cost of deep brain stimulation in Delhi can be around Rs. 11 lakhs to Rs. 18 lakhs. It mostly depends on the experience of the surgeon, your location, the facility, your age, lab tests, and the doctor’s charges. 

2. Is it worth getting DBS surgery for Parkinson’s?

A DBS surgery results in a significant reduction in the symptoms of Parkinson’s. Your reliance on medications will not be as much as before. You will be able to do things like sitting, walking, and standing by yourself. However, don’t look at DBS as a cure. 

3. What is the right age to undergo DBS surgery?

You can undergo DBS surgery at any age. However, patients who are younger can tolerate this procedure better. They have more likelihood of experiencing better results. 

4. Are there any alternatives to DBS surgery?

An alternative to DBS is focused ultrasound. It is similar to DBS. In this process, surgeons use focused ultrasound beams to destroy those cells in the brain that lead to movement issues. However, this surgery is approved to treat only a single side of the brain and not both. 

5. Is deep brain stimulation painful?

No, you will not experience much pain after the DBS surgery. There will only be some post-surgical pain, which you can treat using a pain reliever.

6. What is the recovery period after DBS surgery?

There is a two-week recovery period after DBS surgery. It is best to take time off for around 6 weeks after this surgery so you can adjust to the new programming settings. 

Best Doctors for DBS Surgery in Delhi