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J Neurol Surg A Cent Eur Neurosurg 2013; 74(06): 351-356
DOI: 10.1055/s-0032-1333125
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Single-Incision Laparoscopic Surgery (SILS) for Ventriculoperitoneal Shunt Placement

Wei-Chen Hong
1   Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
2   Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
,
Peng-Sheng Lai
3   Division of General Surgery, Department of Surgery, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
,
Yin-Hsuan Chien
4   Department of Pediatrics, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan
,
Yong-Kwang Tu
5   Divison of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
,
Jui-Chang Tsai
5   Divison of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
6   Center of Optoelectronic Biomedicine, College of Medicine, National Taiwan University, Taipei, Taiwan
› Author Affiliations
Further Information

Publication History

20 April 2012

11 August 2012

Publication Date:
26 February 2013 (online)

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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
 

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