| The Role of Laparoscopy in Proximal and Distal Shunt Malfunction |
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Jae Sung Eom1 , So Hee Park1 , Jong-Hoon Kim1 , Jung Min Bae2 , Seong Ho Kim1 |
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Departments of 1Neurosurgery and 2Surgery, College of Medicine, Yeungnam University, Daegu, Korea |
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| Abstract |
Objective
Ventriculoperitoneal shunts (VPSs) are a commonly used in the treatment of hydrocephalus. In recent times, the use of laparoscopy in VPS surgery has increased. The aim of this study is to evaluate the role of laparoscopy in patients who underwent laparoscopy-assisted VPS revision.
Methods
Retrospective reviews of patients who underwent laparoscopy-assisted VPS revision from 2015 August to 2016 June were conducted. All patients had a shunt failure. All surgeries were performed jointly by a neurosurgeon and a specialized laparoscopic surgeon.
Results
Eleven laparoscopy-assisted VPS revisions were performed among nine patients. In these 9 cases with distal shunt malfunction, the indications included retrieval of the broken device and distal catheter reinsertion (4 cases), externalization for infection control (2 cases), distal catheter reinsertion after infection control (1 case), diagnostic laparoscopy (1 case), and distal catheter change due to shortening length pursuant to the growth in children (1 case). VPS revision was performed for 2 cases of proximal catheter failure and laparoscopy was done to confirm that the flow was well maintained. In 1 case, partial obstruction of the distal catheter was confirmed and distal catheter reposition was performed. There was no case of postoperative infection or mortality and morbidity after the revision surgery.
Conclusion
Laparoscopy might be a useful tool for proximal as well as distal VPS malfunction patients. This approach allows avoiding a conventional laparotomy, providing a safe and precise visual control of the shunt function and insertion in both, proximal and distal shunt malfunction cases. |
| Key Words:
Ventriculoperitoneal shunt, Complications, Reoperation, Laparoscopy |
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