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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2022; 11(01): 030-032
DOI: 10.1055/s-0041-1722826
Original Article

An Indigenous Method of Securing Ventriculoperitoneal Shunt Tube in Peritoneal Cavity

Samir Kumar Kalra 
1   Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India
,
Krishna Shah
1   Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India
,
Sneyhil Tyagi
1   Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India
,
Suviraj John 
2   Department of Minimal Access Surgery, Sir Ganga Ram Hospital and Ganga Ram Institute of Medical Education & Research, New Delhi, India
,
Rajesh Acharya
1   Department of Neurosurgery, Sir Ganga Ram Hospital, New Delhi, India
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Abstract

Introduction Ventriculoperitoneal shunt (VPS) is the most common procedure used for cerebrospinal fluid (CSF) diversion in hydrocephalus. Over the years, many technical, procedural, and instrument-related advancements have taken place which have reduced the associated complication rates. Shunt block is a very common complication irrespective of the shunt system used. The abdominal end of the shunt tube gets blocked usually due to plugging of omentum onto the shunt catheter. We describe a technique of catheter fixation and placement under vision coupled with omentopexy done laparoscopically to prevent this complication.

Materials and Methods This technique was used in 23 patients (11 female, 12 male; range 16–73 years) afflicted with hydrocephalus from June 2016 and December 2019 after obtaining an informed consent, and the outcomes were noted in terms of shunt patency, complications, if any, and the need for revision.

Results The median operation time was 90 minutes (range 35–160 minutes). All shunt catheters were still functional after a mean follow-up of 16.5 months (range 1–34 months) and none required revision.

Conclusion Laparoscopic placement of shunt tube along with omental folding is a safe and effective technique for salvaging the abdominal end of VPS and may be helpful in reducing shunt blockage.

Keywords

Shunt block - ventriculoperitoneal shunt - laparoscopic VP shunt


Publication History

Article published online:
13 May 2021

© 2021. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Acharya R, Ramachandran CS, Singh S. Laparoscopic management of abdominal complications in ventriculoperitoneal shunt surgery. J Laparoendosc Adv Surg Tech A 2001; 11 (03) 167-170
    CrossrefPubMedGoogle Scholar
  • 2 Alabi A, Dholakia S, Ablorsu E. The role of laparoscopic surgery in the management of a malfunctioning peritoneal catheter. Ann R Coll Surg Engl 2014; 96 (08) 593-596
    CrossrefPubMedGoogle Scholar
  • 3 Kavic SM, Segan RD, Taylor MD, Roth JS. Laparoscopic management of ventriculoperitoneal and lumboperitoneal shunt complications. JSLS 2007; 11 (01) 14-19
    PubMedGoogle Scholar
  • 4 Ogunc G. Minilaparoscopic extraperitoneal tunneling with omentopexy: a new technique for CAPD catheter placement. Perit Dial Int 2005; 25 (06) 551-555
    CrossrefPubMedGoogle Scholar
  • 5 Cao W, Tu C, Jia T. et al. Prophylactic laparoscopic omentopexy: a new technique for peritoneal dialysis catheter placement. Ren Fail 2019; 41 (01) 113-117
    CrossrefPubMedGoogle Scholar
  • 6 Popa F, Grigorean VT, Onose G, Popescu M, Strambu V, Sandu AM. Laparoscopic treatment of abdominal complications following ventriculoperitoneal shunt. J Med Life 2009; 2 (04) 426-436
    PubMedGoogle Scholar
  • 7 Park YS, Park IS, Park KB, Lee CH, Hwang SH, Han JW. Laparotomy versus laparoscopic placement of distal catheter in ventriculoperitoneal shunt procedure. J Korean Neurosurg Soc 2010; 48 (04) 325-329
    CrossrefPubMedGoogle Scholar
  • 8 Turner RD, Rosenblatt SM, Chand B, Luciano MG. Laparoscopic peritoneal catheter placement: results of a new method in 111 patients. Neurosurgery 2007; 61 (03) Suppl 167-172
    CrossrefPubMedGoogle Scholar
  • 9 Nigim F, Thomas AJ, Papavassiliou E. et al. Ventriculoperitoneal shunting: Laparoscopically assisted versus conventional open surgical approaches. Asian J Neurosurg 2014; 9 (02) 72-81
    Article in Thieme ConnectPubMedGoogle Scholar