Minimally Invasive Support for Placement of Ventricular Shunts

 

Martin et al. [4]

Buhligen et al. [15]

Handler et al. [16]

Total n

17

29

126

Significant adhesions at initial placement

13

a

a

Failed due to adhesions

7

2

4

VA shunt

a

1

1

V pleural shunt

a

a

2

Laparotomy

a

1

1

Failed peritoneal placement

4

1

3


aData not included in the study





Complications


The complications of primary or redo VPS insertion are the same as those discussed under indications for surgery for complications of VPS. Those patients who require shunt revisions have a history of progressive difficulties reaching the abdominal cavity, intra-abdominal adhesions, CSF pseudocyst formation, and difficulty retrieving dislocated catheters [20]. Laparoscopic techniques have not decreased the overall shunt failure rate [45].


Summary






  • Laparoscopy is safe and useful in inserting primary and redo VPS and in managing distal complications of VPS.


  • Minimize CO2 insufflation to reduce hypercapnia.


  • Abdominal surgical history is important in operative planning and may dictate port placement.


References



1.

Kirshtein B, Benifla M, Roy-Shapira A, Merkin V, Melamed I, Cohen Z, et al. Laparoscopically guided distal ventriculoperitoneal shunt placement. Surg Laparosc Endosc Percutan Tech. 2004;14(5):276–8.CrossRefPubMed


2.

Armbruster C, Blauensteiner J, Ammerer H, Kriwanek S. Laparoscopically assisted implantation of ventriculoperitoneal shunts. J Laparoendosc Surg. 1993;3(2):191–2.CrossRefPubMed


3.

Goitein D, Papasavas P, Gagne D, Ferraro D, Wilder B, Caushaj P. Single trocar laparoscopically assisted placement of central nervous system-peritoneal shunts. J Laparoendosc Adv Surg Tech A. 2006;16(1):1–4.CrossRefPubMed


4.

Martin K, Baird R, Farmer J, Emil S, Laberge JM, Shaw K, et al. The use of laparoscopy in ventriculoperitoneal shunt revisions. J Pediatr Surg. 2011;46:2146–50.CrossRefPubMed


5.

Khosrovi H, Kaufman HH, Hrabovsky E, Bloomfield SM, Prabhu V, el-Kadi HA. Laparoscopic-assisted distal ventriculoperitoneal shunt placement. Surg Neurol. 1998;49:127–35.CrossRefPubMed


6.

Schubert F, Fijen BP, Krauss JK. Laparoscopically assisted peritoneal shunt insertion in hydrocephalus: a prospective controlled study. Surg Endosc. 2005;19:1588–91.CrossRefPubMed


7.

Argo JL, Yellumahanthi DK, Ballem N, Harriga MR, Fisher 3rd WS, Wesley MM, et al. Laparoscopic versus open approach for implantation of the peritoneal catheter during ventriculoperitoneal shunt placement. Surg Endosc. 2009;23:1449–55.CrossRefPubMed


8.

Naftel RP, Argo JL, Shannon CN, Taylor TH, Tubbs RS, Clements RH, et al. Laparoscopic versus open insertion of the peritoneal catheter in ventriculoperitoneal shunt placement: review of 810 consecutive cases. J Neurosurg. 2011;115:151–8.CrossRefPubMed


9.

Yu S, Bensard DD, Partrick DA, Petty JK, Karrer FM, Hendrickson RJ. Laparoscopic guidance or revision of ventriculoperitoneal shunts in children. JSLS. 2006;10:122–5.PubMedPubMedCentral


10.

Rodgers BM, Vries JK, Talbert JL. Laparoscopy in the diagnosis and treatment of malfunctioning ventriculo-peritoneal shunts in children. J Pediatr Surg. 1978;13(3):247–53.CrossRefPubMed


11.

Acharya R, Ramachandran CS, Singh S. Laparoscopic management of abdominal complications in ventriculoperitoneal shunt surgery. J Laparoendosc Adv Surg Tech. 2001;11(3):167–70.CrossRef


12.

Julian TB, Ribeiro U. Laparoscopic removal of a displaced ventriculoperitoneal shunt. J Laparoendosc Surg. 1995;5(1):55–8.CrossRefPubMed

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Oct 25, 2017 | Posted by in PEDIATRICS | Comments Off on Minimally Invasive Support for Placement of Ventricular Shunts

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