Parkinson’s disease is one of the most common neurological disorders. In Switzerland alone, more than 15,000 people are affected. When the burden of the disease becomes severe and medication no longer provides sufficient relief, deep brain stimulation becomes a valuable treatment option. In Swiss hospitals, this procedure is often performed while the patient is awake. At Inselspital, however, Parkinson’s patients are routinely operated on under general anesthesia. This approach requires a high level of expertise and extensive experience from the treating medical team.
Procedure under general anesthesia vs. awake surgery
According to Prof. Dr. med. Claudio Pollo, Deputy Head of Department and Head of Functional Neurosurgery at Inselspital in Bern, the advantages are clear. During deep brain stimulation, electrodes can be implanted just as precisely under general anesthesia as during awake surgery. However, being awake during the procedure is psychologically much more stressful for patients. The outcomes are at least as good — and often even better, says Claudio Pollo. «Since 2021, we have been recommending and routinely performing electrode and pacemaker implantation under general anesthesia.»
Neurologist Dr. med. Ines Debove, Deputy Head of the Center for Parkinson’s and Movement Disorders, explains that even in patients under general anesthesia, electrophysiological signals can be recorded with precision, ensuring the patient’s safety throughout the procedure at all times.
Video: A behind-the-scenes look at DBS
A film crew from Inselspital followed the team led by Claudio Pollo and Ines Debove during one such procedure. Take a behind-the-scenes look and hear firsthand how our Parkinson’s patient experienced the surgery under general anesthesia — and how satisfied she is with the outcome. The video is only available in German.
Advantages of surgery under general anesthesia
«We’ve found that virtually all of our Parkinson’s patients prefer the surgery under general anesthesia,» Claudio Pollo adds. They also benefit from a shorter operation time, which makes the procedure overall less taxing. Another advantage is that Parkinson’s medication does not need to be discontinued before the deep brain stimulation when performed under general anesthesia. This means that distressing symptoms can be avoided until the brain stimulator begins to take effect.
The positive experiences at Inselspital are supported by scientific publications from major Parkinson’s centers abroad. This innovative approach has been made possible by advances in modern imaging techniques and the technological development of the implanted systems.