Laparoscopic management of ventriculoperitoneal and lumboperitoneal shunt complications.
OBJECTIVE
Minimally invasive approaches for the initial placement of ventriculoperitoneal (VP) and lumboperitoneal (LP) shunts have been well described. A laparoscopic approach has multiple advantages over open techniques, including decreased morbidity, more rapid recovery, and ability to visually assess catheter function. However, few series have addressed the role of laparoscopy in the management of VP and LP shunt complications.


METHODS
We present here the largest published series of laparoscopic treatment of VP and LP shunt complications in adults, by retrospectively reviewing all cases performed in a 1-year interval by a single surgeon.


RESULTS
Ten patients presented with complications of previous shunting; all were managed laparoscopically. Eighty percent of these patients had a successful single laparoscopic intervention. One patient developed a cerebrospinal fluid leak from the lumbar wound, and 2 patients required additional laparoscopic shunt revisions.


CONCLUSIONS
We conclude that laparoscopy has great utility in the assessment of shunt function. Laparoscopic techniques should be considered not only for placement of peritoneal catheters, but also for the management of distal shunt malfunction and diagnosis of abdominal pain in these patients.
Kavic
Stephen M
SM
Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Segan
Ross D
RD
Taylor
Michelle D
MD
Roth
J Scott
JS
D000328:Adult; D000368:Aged; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D010535:Laparoscopy; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects