What is Vagus Nerve Stimulation (VNS) Device Placement

Vagus nerve stimulation device placement is surgery to put a VNS device in your chest. This device is also called a pulse generator or an implant. It is put in the left side of your chest. It sends mild electrical pulses to your vagus nerve. The vagus nerve runs from your chest, through your neck, to the lower part of your brain. The nerve controls some of your involuntary body functions, such as heart rate.

You may have this surgery if you have a seizure disorder like epilepsy or if you have depression that cannot be controlled with medicine.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.
• Any history you have of heart arrhythmia, lung disease, stomach ulcers, fainting, hoarseness, schizophrenia, or bipolar disorder.
• Any thoughts you have had about suicide.
• Any other type of brain stimulation you receive.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Damage to other nerves in the neck or chest.
• Pain in the chest or neck area.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• Your health care team will wash or sanitize their hands.
• Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic).
• Your surgeon will make a small surgical cut (incision) in the upper part of your chest wall, on the left side.
• Your surgeon will make a pocket under your skin for the device, which is about the size of a U.S. silver dollar coin.
• Your surgeon will make another small incision in the lower part of your neck, on the left side.
• Your surgeon will locate your vagus nerve through the neck incision.
• Your surgeon will wind a wire around the nerve.
• Your surgeon will pass this wire under the skin of your neck down to the chest incision. It then will be connected to the device.
• The incisions will be closed with stitches (sutures) or staples and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will be taken to a recovery room.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.

Care After Vagus Nerve Stimulation Device Placement

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness or pain near your incisions.
• Swelling or bruising near your incisions.

For a while, when you first start to use your vagus nerve stimulator (VNS) device, you may have:

• A hoarse or changed voice.
• A cough.
• A tickle in your throat.
• Shortness of breath.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.

Activity

• Return to your normal activities as told by your health care provider. Ask which activities are safe for you.

Diet

• You can return to your normal diet.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• There are many ways to close and cover a cut (incision). For example, an incision can be closed with stitches (sutures), staples, skin glue, or adhesive strips. Follow instructions from your health care provider about:
  • How to take care of your incision.
  • When and how you should change your dressing.
  • When you should remove your dressing.
  • Removing whatever was used to close your incision.
• Check your incision area every day for signs of infection. Watch for:
  • Redness, swelling, or pain.
  • Fluid, blood, or pus.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking pain medicine.
• Keep all follow-up visits as directed by your health care provider. This is important.

Vagus Nerve Stimulation Device Use Instructions

• Return to your health care provider to have your VNS device programmed and to be taught how to use it. Usually the device is programmed about 2–4 weeks after surgery.
• Visit your health care provider as directed for as long as you have your device. The device battery will need to be changed in 5–10 years.
• Tell all your health care providers that you have this device. Remind them that you have the device before you have a test or procedure done, such as an MRI.

Contact a health care provider if:

• You have redness, swelling, or pain at the site of your incision.
• Your pain is getting worse instead of better.
• You have a bad smell coming from the wound or dressing.
• You have hoarseness, coughing, drowsiness, or shortness of breath that is not going away.
• You have pain, insomnia, indigestion, nausea and vomiting, twitching, or tingling when using your device.
• Your device is no longer working.

Get help right away if:

• You have choking, trouble swallowing, or trouble breathing while using your device.
• You have fluid, blood, or pus coming from your incision.
• You have a fever.