In the 130 years since Swiss physician Burckhardt first used surgery to treat mental illness in the world, psychosurgery has made great achievements along with the progress of medical science. With the continuous improvement and refinement of medical doctors, modern psychosurgery has further improved the effectiveness, reduced the adverse effects and expanded the indications, so that the once intractable diseases have effective treatment means, which is expected to make the intractable mental diseases become a thing of the past. Unfortunately, such an effective means of treatment is not well understood by the community, and there are even many misconceptions, in order for the public to better understand modern psychosurgery, we would like to introduce the following aspects: Surgery for mental illness has a long history. Obviously, the results were not good due to the technology of the time. But it was a pioneer for the treatment of mental illness. Since then, a number of scientists have conducted head surgery on animals in the laboratory and found that removing certain nuclei or areas of the brain could change the behavior of animals, such as aggressive roosters, male monkeys, and orangutans, etc. By removing the amygdala, these formerly very aggressive males became very gentle, and male monkeys lost their status as monkey kings because they were not aggressive and aggressive. In 1937, Fultion proposed the removal of the cingulate gyrus to treat mental illness. In 1949, the Swedish scientist Leksell and the French physician Talarack proposed the anterior limb of the internal capsule as the surgical target. 1963, the Japanese NarabayashiH proposed the amygdala in 1963 and the inferior bundle of the caudate nucleus in Knight, England, in 1964 as surgical targets. The latest was proposed by French physician BenabidPollacr in 1987 for the treatment of Parkinson’s disease by implantation of electrical stimulators (i.e., deep brain electrical stimulation, DBS) in the thalamic nuclei cluster and the basal thalamic nuclei. This shows that surgical treatment of psychiatric disorders has been available for as early as 130 years, with the earliest surgery generally treated as an exploration and the 1935s as the formal stage of surgical treatment. The surgical targets now in use are as early as 83 years old and as late as 54 years old, and successive congresses of the International Society for Psychosurgery have affirmed that surgery is effective and safe. Ballantine, an American scholar and former president of the World Stereotactic, reported more than 800 cases after long-term senatorial visits, which concluded that the efficacy is reliable and safe. It is inaccurate to say that surgical treatment of psychiatric disorders is an unproven and immature technique. On the contrary, this technique has been clinically proven to be effective, mature and safe in many countries for more than 60-70 years. Of course, there is no end to learning, and this technology, like other medical technologies, is constantly being improved and enhanced. Technical characteristics of surgical treatment of mental disorders From the above analysis, we know that the surgical operation is performed by removing the surgical target, not by actually removing it, but by inserting electrodes into the surgical site, and then energizing the special “head end” of the electrodes to produce heat (usually 72°C-74°C), which causes the tissue adjacent to the electrode head to produce “Ablative coagulation causes the nerve cells there to coagulate, blocking the conduction of pathological nerve impulses and acting as an equivalent to surgical excision. It has been called “AblativeProcedures” instead of “Destructive Procedures” in the past. The most important thing for this procedure is accurate positioning, which is the only way to guarantee the efficacy and avoid serious complications. This technique can operate only on the parts that should be operated on and avoid the parts that should not be operated on, because which parts of the brain can be operated on and which parts should never be touched. In the past, the positioning was done manually by calculating the target points by formula. It was not until the 2000s that German positioning technology was introduced in China, which is digital, real-time, individualized and visualized. Through CT/MRI image fusion, and in the last 2 years, through the fusion technology with DTI images, the positioning error is within ±0.2mm, and it is automatic positioning and automatic display of target point parameters. With this positioning technology, it has developed from blind positioning in the past to visual positioning. The special role of surgery in the treatment of psychiatric disorders Surgery for psychiatric disorders has its own uniqueness, i.e., it has some major differences from drug therapy, which are manifested in the following aspects: first, it eliminates the pathological basis of psychiatric disorders from neurobiology, i.e., it blocks the conduction loop of neuropathic impulses, whereas drug therapy relies on binding to receptors to regulate the neurotransmitter effect; second, it blocks the pathological conduction of psychiatric disorders by eliminating the neurological loop. The second is that by eliminating the pathological conduction of the neural circuit, the “excitatory neurotoxicity” of the psychopathology is blocked, interrupting the vicious cycle of the psychopathology and stopping its development to “chronic progression”; the third is that the effect is fast, because as soon as the surgery is completed, the effect of blocking the conduction of neuropathic impulses will start and take effect immediately, so the surgery Fourth, to improve the sensitivity of psychotropic drugs, that is, the preoperative use of large doses of drugs, the effect is still not good, but after surgery, a small amount or low dose is effective; Fifth, to improve the effectiveness of psychotropic drugs, a variety of drugs before surgery is ineffective, but after surgery, a variety of drugs may be effective, or which drugs before surgery may be ineffective, but after surgery, the main theory of which drugs are effective; Sixth, the “follow-up effect”, that is “follow-up effect”, that is, some patients may not have significant effect after surgery, while 1-2 years later they may remit on their own, this situation can be seen in mental illness, but also in opioid dependence, which is also not available in drug treatment; seventh, surgery can reduce or prevent relapse or prolong the remission period of mental illness, reduce the number or severity of relapse This is also not available with medication; vii) surgery can reduce or prevent relapse or prolong remission of mental illness, reduce the number or severity of relapses, and make medication easier to treat; viii) it improves patient compliance and facilitates management; ix) some patients can easily regain self-knowledge, and some patients’ symptoms all disappear after surgery and sobriety, while self-knowledge is also restored; x) postoperative mild personality can last a lifetime; xi) most patients’ pituitary prolactin can return to normal after surgery; xii) due to the reduction of postoperative medication can avoid or reduce adverse drug reactions, and even alleviate metabolic syndrome. Indications and contraindications for surgical treatment of disease The following conditions are suitable for surgical treatment: first, a clear qualitative diagnosis, such as the exclusion of certain organic diseases; second, refractory psychiatric disorders that have been treated with pharmacological systemic hospitalization and have used at least three different types of medications (including those who have frequent episodes despite effective pharmacological treatment) or who cannot tolerate effective doses of medication; those with obvious psychological factors or psychotherapy in some cases; more than 5 years of duration; between 18-55 years of age; special cases can be relaxed appropriately, such as severe suicide, catastrophic epilepsy, malignant tic disorder, etc. The types of diseases are schizophrenia, paranoid psychosis, mood disorders, obsessive-compulsive disorder, anxiety disorders, phobias, personality disorders, anorexia nervosa, drug dependence, tic disorders, epilepsy and its resulting psychiatric disorders (psychotic disorders, mood disorders, personality changes, cognitive disorders, etc.), Parkinson’s disease, etc. Contraindications, such as involuntary inpatients; unknown qualitative diagnosis, such as those who cannot exclude organic brain somatic diseases; insufficient disease duration; those who have not been treated regularly; medication is still effective; patients and family members with unreasonable requirements for surgery, such as those who require treatment to be “cut off” or do not take medication; those who do not cooperate with postoperative follow-up or lack of management; somatic factors If the surgery is inappropriate, such as poor blood pressure and blood sugar control, poor cardiac function, severe liver and kidney insufficiency, etc. However, the age for deep brain electrical stimulation (DBS) treatment is appropriately relaxed and can be up to 70 years old.