Breast reconstruction in a patient with an implanted deep brain stimulator
Yukiyo Tsunekawa,
Hideyoshi Sato,
Chisato Koyama,
Yuichi Oka,
Kazuhiro Toriyama
Affiliations
Yukiyo Tsunekawa
Department of Plastic and Reconstructive Surgery, Nagoya City University Graduate School of Medical Sciences and medical School, Nagoya, Japan
Hideyoshi Sato
Department of Plastic and Reconstructive Surgery, Nagoya City University Graduate School of Medical Sciences and medical School, Nagoya, Japan
Chisato Koyama
Department of Plastic and Reconstructive Surgery, Nagoya City University Graduate School of Medical Sciences and medical School, Nagoya, Japan
Yuichi Oka
Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences and medical School, Nagoya, Japan
Kazuhiro Toriyama
Department of Plastic and Reconstructive Surgery, Nagoya City University Graduate School of Medical Sciences and medical School, Nagoya, Japan; Correspondence author. Department of Plastic and Reconstructive Surgery, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8602, Japan.
Summary: Deep brain stimulators (DBSs) are sometimes used to treat refractory movement disorders such as Parkinson's disease. When DBSs are implanted in a subcutaneous pocket in the chest region, breast reconstruction becomes a challenge because monopolar electrocautery can lead to DBS dysfunction or brain tissue damage caused by heat. We report a patient with a DBS who underwent one-stage implant-based breast reconstruction. We switched off the DBS before surgery and used monopolar electromagnetic cautery with minimum power settings to undermine the subcutaneous pocket for the breast implant. The DBS was switched back on immediately after completion of the surgery. The patient's postoperative recovery was uneventful with the DBS fully functional.
