A New Type Of Peritoneocentesis Trocar Assisted Distal Ventriculoperitoneal Shunt Placement In The Treatment Of Hydrocephalus With The Supervision Of One Port Laparoscope

Hydrocephalus is a common brain condition that is treated by neurosurgery. Thediversion of cerebrospinal fluid to relieve hydrocephalus can be accomplished by severaldifferent methods, the most commonly used of which is the ventriculoperitoneal shunt (VPS).Complications occur with VPS in5-47%of cases, the majority of which involve theperitoneal catheter. In conventional VPS, the peritoneal catheter is inserted at laparotomy. Afurther laparotomy is often necessary to solve complications with the VPS, thus increasing therisk of adhesions and their related problems. Laparoscopy guided placements of the distalcatheter have been described, but this technique is not routinely used. Both methods can,however, lead to dangerous complications such as trauma, infection and malfunctions of thedistal or proximal sections of the shunt. The present study was designed to investigate a newtechnique for placing the distal catheter using a peritoneocentesis trocar that does not requirelaparotomy.Objective: To investigate the value of peritoneocentesis trocar and laparoscopy underumbilical single port in the treatment of ventriculoperitoneal shunt. Methods:32patients withhydrocephalus underwent the new type of peritoneocentesis trocar assisted VP shunt and thedistal shunt catheter were analyzed. Results: The mean length and the incision length of theprocedure to place the distal catheter was significantly shorter in the trocar group comparedwith the laparotomy group. Infection and obstruction rates were significantly higher in thelaparotomy group than in the trocar group. Conclusion: Our novel approach may significantlyreduce the risk of malfunction complications in the patients who has abdominal abnormality,especially in the patients who have obese, abdominal adhesion or shunt revisions.