What Should I Expect from VNS Therapy?

The Procedure

The actual procedure takes only about an hour. It is often done on an outpatient basis, meaning that most people are in and out of the hospital on the same day.

The procedure is straightforward, and typically performed under general anesthesia. Two small incisions are made:

  • One in the left chest area, below the collarbone, 1 1/2 to 2 1/2 inches long. The VNS Therapy pulse generator is placed just under the skin
  • One in a natural crease in the left side of the neck, 1 to 2 inches long. From here, tiny wires called electrodes are wrapped around the vagus nerve in the neck. A thin, flexible wire then connects the electrodes to the pulse generator

After these items are in place, the surgeon tests them to make sure everything works properly. Then the incisions are carefully closed. The incisions heal in 1 to 2 weeks, and the scars fade over time. The neck scar is usually located in a natural crease of the skin and is therefore not very visible.

As with any procedure, there is a very low risk of infection—1.7%1,2

"VNS Therapy is delivered by a small implantable device, and that is typically implanted in the left chest, just under the skin. From there, electrical leads are connected...through a second incision to the left vagus nerve. This whole procedure takes about an hour. It's typically conducted as an outpatient and the patient is free to go home, typically, after the procedure is completed....After that the dose is adjusted by the physician at office visits."

A. John Rush, MD, Department of Psychiatry and Neurosurgery
University of Texas Southwestern Medical Center, Dallas, Texas

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1. Data on file. Cyberonics, Inc.; Houston, Tex.
2. as of March 2005, post marketing surveillance data

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The VNS Therapy System is indicated for use as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over 12 years of age with partial onset seizures, which are refractory to antiepileptic medications.

VNS Therapy (or the VNS Therapy System) is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.