Abstracts
Background Single-incision laparoscopic surgery (SILS) may facilitate safer shunt placement
and lower distal obstruction rate than is seen in conventional surgery.
Objective We reviewed our 2-year experience in SILS for ventriculoperitoneal shunt placement
to evaluate its usefulness and safety.
Materials and Methods In this retrospective study, we enrolled patients older than 18 years with dilated
ventricle and syndromes of hydrocephalus. A total of 31 patients underwent 31 primary
ventriculoperitoneal shunt placement surgery and two underwent revision surgery. All
the procedures were performed by the SILS technique.
Results The entire duration of ventriculoperitoneal shunt implantation ranged from 45 to
80 minutes, with mean operation time of 65 ± 15.3 minutes. No major laparoscopy-related
complications were noted. Shunt infection, peritonitis, and distal catheter malfunction
occurred in one case (3.2%), proximal malfunction in one case (3.2%), and subcutaneous
emphysema occurred in two cases (6.4%). The emphysema resolved within 2 days. Cosmetic
results were “very good to good” in 17 patients (54.8%) and “satisfactory” in 14 patients
(45.2%). The abdominal scars in most cases were nearly invisible.
Conclusion SILS is a safe and effective technique for ventriculoperitoneal shunt placement and
can be accomplished with no higher risk of shunt infection and distal malfunction.
Without an additional port, SILS allows good visualization of the peritoneal cavity
to avoid major intra-abdominal complications. Only one 6-mm incision at the umbilicus
area is required and is almost invisible after wound healing.
Keywords
complication - hydrocephalus - single incision laparoscopic surgery (SILS) - ventriculoperitoneal
shunt
