title: Salvaging the "lost peritoneum" after ventriculoatrial shunt failures.
abstract: OBJECTIVE
  Placement of a ventriculoperitoneal (VP) shunt is the long-standing treatment of choice for hydrocephalus. However, in many patients with repeated distal failures, ventriculoatrial (VA) shunts are placed. Should the VA shunt fail, finding appropriate distal sites is often difficult.
  
  
  METHODS
  We identified six patients, over a 3-year period, in whom conversion of VA to VP shunt was successfully performed with the aid of diagnostic laparoscopy or laparotomy. There were no ensuing shunt failures during the follow-up period (mean 1.5 years).
  
  
  CONCLUSIONS
  Because of the benefits of VP over VA shunting, every effort should be made to preserve the peritoneum as the target for the distal catheter. Laparotomy/laparoscopy is useful in locating suitable peritoneal targets when converting to VP shunt after VA shunt failure, or as a final effort before VA shunt conversion.
authors.affiliation: Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
authors.forename: R Rick
authors.initials: RR
authors.lastname: Bhasin
authors.forename: Mike K
authors.initials: MK
authors.lastname: Chen
authors.forename: David W
authors.initials: DW
authors.lastname: Pincus
mesh_terms: D000005:Abdomen / Q000033:anatomy & histology / Q000502:physiology; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D010535:Laparoscopy; D008297:Male; D010529:Peritoneal Cavity / Q000033:anatomy & histology / Q000502:physiology*; D017211:Treatment Failure; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*