Firstly, the surgical frame is attached to the skull. Sydney DBS performs this in a seated position, under light sedation. Generally patients have very little recollection of this stage of the procedure.
With the frame in place, patients then undergo a CT scan (see below). These images are then fused using BrainLab neuro-navigation software to MRI images obtained within the week prior to surgery. These fused images are then used for surgical planning, so that the patient’s own brain becomes the map for computational planning of their procedure.
Surgical planning is then performed in the operating theatre using neurosurgical navigation software. This allows planning of the target and trajectory of electrode implantation. Specifically, the software allows three dimensional tracking of the probe through the brain, maximising accuracy and minimising risk. In the below image, Drs Silberstein and Cook discuss the surgical planning in the Operating Theatre.