Risks of Surgery

Any surgery carries certain risk with it. This includes :

• Anesthetic complications such as reaction to anesthesia drugs, though rare, may be life-threatening.
• Problems may arise while intubating a patient (inserting the breathing tube).
• Aspiration of food or liquids into the lungs.
• Increased heart rate, blood pressure, or rapid increase in body temperature (malignant hyperthermia).
• Hemorrhage or excessive bleeding during surgery or in the post-operative period.
• Accidental injury to other organs during surgery.
• Deep vein thrombosis (DVT) is a serious risk of surgery which may occur due to prolonged immobilization after surgery. Blood clots may travel to the lungs and cause pulmonary embolism or to the brain, causing a stroke.
• Pneumonia.
• Urinary tract infection.
• Breathing problems after surgery.
• Post-operative infection.
• Poor post-operative healing of wounds, especially in case of diabetic patients.
• Paralysis caused by surgery is a possibility, especially in case of brain or spinal surgery.
• Less than satisfactory outcome after surgery is a possibility if the problem was worse than anticipated or due to development of complications during surgery which necessitated cutting short the procedure. Inexperience of the surgeon may be the reason for poor results of surgery.
• The risk of death is there even in minor surgeries, although compounded in more complicated surgeries.

Parkinson’s patients, because of their frailty, advanced age, lowered immunity, medication, complications, and/or other diseases, are more likely to be at risk while undergoing surgery.

Surgery for Treatment of Parkinson’s Disease

Specific surgery to control the symptoms of Parkinson’s disease may be considered when medication becomes less effective or the side effects become intolerable.

Any of the three available surgical procedures may be undertaken.

1. Ablative surgery. A clearly-defined area of the brain affected by PD is isolated and destroyed by a heated probe (electrode) or a super-cooled probe (cryosurgery). Either a pallidotomy or a thalamotomy is done by this procedure.
2. Deep brain stimulation (DBS). The subthalamic nucleus is inactivated by an implanted electrode.
3. Transplantation or restorative surgery -  stem cell therapy.

Risks of Parkinson’s Disease Surgery

In addition to the risks associated with any surgery, these procedures carry some additional risks such as :

• Speech problems, visual defects, and other complications if the electrodes are placed too near to other brain regions.
• Allergic response to implanted material.
• Mechanical or electrical problem with the implant.
• Secondary surgery may become necessary for removal of the implant in case of breakage or malfunction.
• Intracranial hemorrhage (bleeding inside the brain).
• Neurological complications.
• Seizures.
• Confusion.
• Delirium.
• Headaches.
• Dizziness.
• There may be no improvement or there may be worsening of symptoms after surgery.
• Abnormal involuntary movements (chorea, dystonia, dyskinesia).
• Tingling and numbness.
• Paralysis.
• Stroke.
• Coma.
• Death.

]]> http://pdring.com/risks-of-surgery-in-parkinson%e2%80%99s-disease.htm/feed 0 http://pdring.com/parkinsons-disease-surgery-options.htm http://pdring.com/parkinsons-disease-surgery-options.htm#comments Tue, 12 May 2009 13:46:42 +0000 Dr. P.D. http://pdring.com/?p=25 Understanding Parkinson’s disease

When medication has ceased to be effective or the side effects from them have become no longer tolerable, surgery might be an option your Doctor will consider and advise to help alleviate your symptoms and improve your quality of life. However not all sufferers of Parkinson’s will be a candidate for surgery, an example would be a person who didn’t respond very well to Levodopa treatment.

Of all the people suffering from this disease it is thought that only around 10% of them could be classed as possible suitable candidates for surgery. Another factor to consider when thinking of surgery is that while improvements could be gained there is also the risk factor to take into account that surgery of any kind has.

There is also the risk that the surgery might not make any improvements and could in fact make the symptoms worse. There are three main types of surgery which can be used in the treatment of Parkinson’s disease; these are ablative, stimulation, deep brain stimulation, transplantation and restorative surgeries.

Ablative surgery

This type of surgery aims to locate, target and then destroy the defined area of the brain which is affected by the disease. The aim is get rid of all the tissue which produces the abnormal electrical or chemical impulses which in turn produce the symptoms of tremor in the patient.

This type of surgery is performed by inserting an electrode into the part of the brain affected by the disease; this method is often very difficult to guess correctly for if too much tissue is taken then it could lead to stroke or paralysis while if too little is taken the tremor might not be eliminated or could return.

The patient will remain awake during this procedure with a local anaesthetic being given to dull the feeling in the outer part of the brain. The brain itself cannot feel pain so it can be probed without any discomfort to the patient.

Deep brain stimulation

This type of surgery specifically targets the subthalamic nucleus; it is a part which is extremely difficult to reach and is found below the thalamus. This type of surgery doesn’t destroy tissue but instead renders it inactive.

An electrode is connected via a wire which is inserted below the skin and attached to a stimulator and battery pack in the patient’s chest. The operation is totally reversible and the risk of stroke is reduced and allows for more precise control of symptoms.

Transplantation or restorative surgery

This type of surgery relies on the implantation of dopamine producing cells being implanted directly into the striatum. Cells used for this process are taken from a variety of sources which include the patients own body, human embryos and pig embryos.