Minim Invasive Neurosurg 2011; 54(1): 44-47
DOI: 10.1055/s-0031-1271680
Technical Note

© Georg Thieme Verlag KG Stuttgart · New York

A Laparoscopic Approach to Ventriculoperitoneal Shunt Placement with a Novel Fixation Method for Distal Shunt Catheter in the Treatment of Hydrocephalus

Y. Shao1 , M. Li2 , J.-L. Sun2 , P. Wang2 , X.-k. Li2 , Q.-L. Zhang2 , L. Zhang3
  • 1Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, People's Republic of China
  • 2Department of Neurosurgery, Qianfoshan Hospital, Shandong University, Jinan, People's Republic of China
  • 3Biological Sciences Section, Office of Scientific Evaluation, Therapeutic Goods Administration, Woden, ACT, Australia
Further Information

Publication History

Publication Date:
19 April 2011 (online)

Abstract

Background: The laparoscopically assisted ventriculoperitoneal (VP) shunt has been widely used in the clinical treatment of hydrocephalus for its simplicity and reliability. Despite significant improvements in shunt procedures, shunt complications remain common. Our clinical experiences suggest that the fixation of the distal (peritoneal) shunt catheter using threads and hemoclips may partially contribute to complications of the distal shunt including obstruction of the shunt and infection. In this study, we explored a novel fixation method in the laparoscopically assisted VP shunt with use of the liver falciform ligament as a natural support for fixation of the distal shunt catheter.

Methods: 10 patients with hydrocephalus underwent laparoscopically assisted VP shunt and the distal shunt catheter was placed into the hepatodiaphramatic space and the catheter was traversed through 2–3 drilled holes in the liver falciform ligament without using any artificial material for fixation.

Results: In all the patients who received surgery with the adopted new procedure the clinical symptoms were alleviated. The size of cerebral ventricles returned to normal after 1 week. The distal catheters were in the hepatodiaphragmatic space in 9 of 10 patients, while in 1 patient it migrated to the peritoneal cavity underneath the liver. All the 9 patients were followed up for 1 year and no surgery-related catheter obstructions and infections were observed.

Conclusions: The modified laparoscopically assisted VP shunt in the treatment of hydrocephalus with fixation of the distal shunt catheter to a natural anatomic structure could potentially reduce the necessity of repeat surgery for addressing the complications caused by catheter obstruction and infections, reduce the chance of adhesions, and would be of benefit to those patients who need future revisions.

References

Correspondence

J.-L. Sun

Department of Neurosurgery

Qianfoshan Hospital

Shandong University

Jinan 250014

People's Republic of China

Phone: + 86/133/7051 8010

Email: Jinlong_sun@yahoo.com.cn

Y. Shao

Department of Neurosurgery

Qilu Hospital

Shandong University

Jinan 250012

Shandong

People's Republic of China

Phone: + 86/135/0640 8386

Email: Shaoyi777@yahoo.com.cn