title: A novel solution to reduce the complications of distal shunt catheter displacement associated with obesity.
abstract: Despite the varied sources of hydrocephalus, all shunt-treated conditions involve redirection of CSF to the body, commonly the peritoneum. Migration of the distal catheter tip out of the peritoneal space can occur, leading to the need for reoperation. Although uncommon, the authors have recently had 3 such cases in obese patients involving distal tubing retropulsion in otherwise uncomplicated surgeries. In addressing this issue, the authors performed anchoring of the distal catheter tubing through a small abdominal mesh, which is commonly used for hernia repair to increase catheter tube friction without compromising CSF flow. The results suggest this method may mitigate the chance of peritoneal catheter displacement in patients with higher than normal intraabdominal pressure.
authors.affiliation: Department of Neurosurgery, Lahey Clinic, Burlington, MA 01805, USA. john.f.morrison@lahey.org
authors.forename: John F
authors.initials: JF
authors.lastname: Morrison
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Sung
authors.forename: Ari M
authors.initials: AM
authors.lastname: Bergman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Rosenblatt
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Arle
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005548:Foreign-Body Migration / Q000517:prevention & control*; D006547:Hernia / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D009765:Obesity / Q000150:complications*; D010529:Peritoneal Cavity; D013526:Surgical Mesh; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*