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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Obsessive-compulsive disorder surgery

Introduction

Overview

Overview

For some patients with severe OCD, neither medication, support groups nor psychological treatments are helpful in alleviating obsessive-compulsive symptoms. These patients may choose to undergo psychosurgery as a last resort. Deep-brain stimulation and vagus nerve stimulation are possible surgical options which do not require the destruction of brain tissue, although their efficacy has not been conclusively demonstrated.[1]

Surgery

Surgery

Psychosurgery

  • For patients whose condition does not improve with other medications and treatments, procedures may be the chosen course of treatment.
  • These patients may choose to undergo psychosurgery as a last resort. In this procedure, a surgical lesion is made in an area of the brain (the cingulate bundle). In one study, 30% of participants benefited significantly from this procedure.
  • Deep-brain stimulation and vagus nerve stimulation are possible surgical options which do not require the destruction of brain tissue, however their efficacy has not been established.[1]

Ablative procedures

The ablative procedures used for OCD treatment include:[1]

  • Anterior cingulotomy
  • Capsulotomy
  • Subcaudate tractotomy
  • Limbic leucotomy (combining anterior cingulotomy and capsulotomy)
Overview

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

Indications

  • Surgical intervention is not recommended for the management of [disease name].

OR

  • Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]
  • The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]
Surgery

Surgery

  • The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

  • Surgery is the mainstay of treatment for [disease or malignancy].
Contraindications

Contraindications

References

References

  1. ↑ 1.0 1.1 1.2 Hirschtritt ME, Bloch MH, Mathews CA (2017). “Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment”. JAMA. 317 (13): 1358–1367. doi:10.1001/jama.2017.2200. PMID 28384832.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyanka Kumari, M.B.B.S[2] Sonya Gelfand, Usama Talib, BSc, MD [3]