title: Lumboperitoneal shunt placement using computed tomography and fluoroscopy in conscious patients.
abstract: The authors have developed a minimally invasive lumboperitoneal shunt placement procedure conducted after administration of a local anesthetic. The procedure involves placing a guide wire and a peel-away sheath under fluoroscopic and CT guidance. Between June 2004 and August 2006, 40 patients (21 men and 19 women; mean age 72.5 years [range 33-86 years]) underwent surgery. A Codman Hakim programmable valve system (82-3844, Codman & Shurtleff, Inc.) was used for the procedure. The mean operating time was 53 minutes, and 7 patients (17.5%) developed shunt dysfunction complications. These complications comprised an infected shunt valve in 2 patients, postoperative lower-limb pain in 1 patient, and shunt obstruction (caused by debris and hemorrhage) at the ventral and lumbar ends in 2 patients each. This procedure is less invasive than conventional lumboperitoneal shunt insertion and could be performed as an outpatient surgery for treatment of idiopathic normal-pressure hydrocephalus.
authors.affiliation: Department of Neurosurgery, Juntendo University, Tokyo, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Nakajima
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Bando
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyajima
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed