J Neurol Surg A Cent Eur Neurosurg 2024; 85(02): 192-194
DOI: 10.1055/a-1961-9942
Technical Note

Oblique Angled Retractor for Lumboperitoneal Shunt Implantation via Lateral Abdominal Laparotomy

Shigeomi Yokoya
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, Japan
,
Hideki Oka
1   Department of Neurosurgery, Saiseikai Shiga Hospital, Imperial Gift Foundation Inc., Shiga, Japan
› Author Affiliations
Funding None.

Abstract

Background A normal retractor often interferes with the ribs and/or thighs of the ipsilateral side when the skin and abdominal muscles are towed while performing the lumboperitoneal shunt (LPS) procedure in the lateral position. To overcome this, we developed an obtuse-angled retractor.

Methods We modified the traditional retractors into oblique-angled retractors. The blade of the new retractors was bent to 60 degrees, the entire blade was thinned, and the tip of the blade was tapered.

Results To date, we have performed approximately 30 LPS procedures in the lateral position using the new oblique-angled retractor and confirmed its usefulness.

Conclusion An oblique-angled retractor helps confirm the accurate placement of the tip of the retractor blades, even in obese patients in whom the retractor often interferes with the ribs and/or thighs.

Ethical Approval

All procedures performed in this study were in accordance with the 1964 Helsinki Declaration. Although a series of treatment had been performed after obtaining appropriate written informed consent from the patients, additional written consent for inclusion in this study was waived by the Ethics Committee of Saiseikai Shiga Hospital (Permission number: 508) because of the retrospective and observational nature of the study.




Publication History

Received: 25 April 2022

Accepted: 14 October 2022

Accepted Manuscript online:
17 October 2022

Article published online:
20 January 2023

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  • References

  • 1 Kazui H, Miyajima M, Mori E, Ishikawa M. SINPHONI-2 Investigators. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 2015; 14 (06) 585-594
  • 2 Kuriyama N, Miyajima M, Nakajima M. et al. Nationwide hospital-based survey of idiopathic normal pressure hydrocephalus in Japan: epidemiological and clinical characteristics. Brain Behav 2017; 7 (03) e00635
  • 3 Tanaka T, Ogata A, Iwashita H. et al. Lumbo-peritoneal shunt ventral catheter placement using the lateral approach without repositioning. No Shinkei Geka 2020; 48 (11) 1021-1027
  • 4 Goto Y, Oka H, Nishii S, Takagi Y, Yokoya S, Hino A. Lumboperitoneal shunt surgery via lateral abdominal laparotomy. J Neurosurg Spine 2019; 32 (04) 548-553
  • 5 Miyajima M, Kazui H, Mori E, Ishikawa M. on behalf of the SINPHONI-2 Investigators. One-year outcome in patients with idiopathic normal-pressure hydrocephalus: comparison of lumboperitoneal shunt to ventriculoperitoneal shunt. J Neurosurg 2016; 125 (06) 1483-1492
  • 6 Nakajima M, Miyajima M, Ogino I. et al. Shunt intervention for possible idiopathic normal pressure hydrocephalus improves patient outcomes: a nationwide hospital-based survey in Japan. Front Neurol 2018; 9: 421