With the advent of an aging society, the number of Parkinson’s patients is increasing. Coupled with the localization of pacemakers and the decrease in prices, and the fact that the cost of pacemaker surgery and materials are covered by medical insurance in some regions, the number of patients who can afford this surgery is also increasing. Many patients who have progressed to a certain level and whose symptoms are not satisfactorily controlled by medication seek surgery to control their symptoms. So, how much do you know about surgery? In order for patients to have a good understanding of surgery and overcome their fear of surgery, I have written a series of scientific articles on the procedure for you to read. As a doctor, I would like patients to know more about the procedure because the main steps of the procedure are performed while the patient is awake, and the patient’s cooperation is needed during intraoperative tests. Only when the patient fully understands the surgery and overcomes the fear of surgery, we can cooperate perfectly during the surgery to achieve the best surgical outcome. After the admission procedure, some routine tests such as routine blood, urine, stool, coagulation, liver and kidney function, virus test, chest X-ray, electrocardiogram, cardiac ultrasound, etc. are necessary, and pulmonary function is also required for older patients, and special sequences of MRI or CT may be required before surgery. The examination will be fine. After the examination and evaluation, we will start preparing for the surgery. On the morning of the surgery, no medication, water or breakfast is allowed, and the surgeon starts to install the head frame around 8:00 a.m. The surgeon makes some marks and draws lines on the patient’s head with a marker, and in the picture A, the two white marks in the arc are the locations of the surgical incisions. The surgical incision is in principle inside the hairline, and the hair can cover the incision when it grows up a few months after the surgery, so that it can meet the cosmetic requirements. However, some people have a high hairline, in this case part of the surgical incision has to be outside the hairline, so it is impossible to take into account the cosmetic requirements. 2. Anesthesia with lidocaine is used at the location where the nail is fixed. There will be some pain or swelling during the anesthesia, but it can be tolerated, so I hope the patient will insist and cooperate. After the anesthetic takes effect, the pain disappears. 3.After the anesthesia is done, we will start to fix the cephalic frame with nails. The threads at the end of the nail match the threads of the hole of the cephalic column, and the cephalic frame is fixed by tightening the nail with a tool. The nails for fixing the cephalic frame need to pass through the skin and be fastened to the skull, but not to penetrate the skull. Therefore, it is necessary to pay attention to the strength when tightening the nails. If the force is not enough, the cephalic frame will not be fixed firmly and it will be easily displaced, which will affect the surgery result; on the contrary, if the force is too strong, the nails may penetrate the skull and increase the risk of surgery. These details will be well grasped by the doctor. It is good for the patient to listen to the doctor’s arrangement. When the doctor tightens all the four nails, the head frame is fixed. At this time, the patient will feel like having a tight band on his head, there is a feeling of tight band, but not very uncomfortable. After the head frame is fixed, the doctor will escort the patient to the MRI or CT room for the scan. The patient will be accompanied by the doctor throughout the process and will listen to the arrangements.