title: Presurgical Rehearsals for Patients Considering "Awake" Deep Brain Stimulation.
abstract: Simulated surgical environments are rapidly gaining adoption in training students, residents, and members of specialized surgical teams. However, minimal attention has been given to the use of simulated surgical environments to educate patients on surgical processes, particularly procedures that require the active participation of the patient. "Awake" neurosurgery provides a unique situation in which patients openly participate in their operation. We describe a case report, in which a 62-year-old male was referred for "awake" deep brain stimulation implantation, in relation to medically refractory Parkinson's disease. The patient had significant concerns regarding anxiety and claustrophobia, and toleration of the "awake" procedure. Consequently, we designed a simulated OR environment and process, to recreate the physical experience of the procedure, with minimal cost or risk. This experience was crucial in determining the care plan, as after this experience, the patient opted for an "asleep" alternative. Thus, in certain settings, presurgical rehearsals may have a dramatic impact in the overall course of care.
authors.affiliation: Department of Neurology, Inova Neuroscience and Spine Institute , Falls Church, VA , USA.
authors.forename: Ramsey A
authors.initials: RA
authors.lastname: Falconer
authors.affiliation: Department of Neurology, Inova Neuroscience and Spine Institute , Falls Church, VA , USA.
authors.forename: Sean L
authors.initials: SL
authors.lastname: Rogers
authors.affiliation: Department of Neurosurgery, Inova Neuroscience and Spine Institute , Falls Church, VA , USA.
authors.forename: Cristie M
authors.initials: CM
authors.lastname: Brewer
authors.affiliation: Advanced Surgical Technology and Education Center, Inova Fairfax Hospital , Falls Church, VA , USA.
authors.forename: Franco
authors.initials: F
authors.lastname: Piscitani
authors.affiliation: Department of Neurosurgery, Inova Neuroscience and Spine Institute , Falls Church, VA , USA.
authors.forename: Mahesh B
authors.initials: MB
authors.lastname: Shenai
keywords: DBS; Parkinson’s disease; awake neurosurgery; patient experience; surgical simulation