title: Transumbilical approach for ventriculoperitoneal shunt placement in infants and small children: a 6-year experience.
abstract: BACKGROUND
  Improved cosmesis has been demonstrated using a transumbilical incision for placement of the peritoneal end of a ventriculoperitoneal shunt. We now present our experience with this technique.
  
  
  METHODS
  From January 2005 until present, a prospective cohort of 25 children underwent placement of a ventriculoperitoneal shunt with the peritoneal shunt catheter being introduced into the peritoneum via an incision into the umbilicus. There were 17 boys and 8 girls. The age range at insertion was 6 days to 5 years (mean 1.2 years).
  
  
  RESULTS
  The mean follow-up for this group was 3.2 years (range 2 months to 6 years). Of all patients, only one complication (4%) has occurred, although this did not lead to long-term issues. The infection rate for this small group was 0%.
  
  
  CONCLUSIONS
  Placement of the peritoneal end of a ventriculoperitoneal shunt via an umbilical incision is effective, cosmetically appealing, and not more prone to complications than other standard incisions used on the anterior abdominal wall. Additionally, and based on our experience, this approach is quicker and almost bloodless with no long-term complications.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South, Birmingham, AL 35233, USA. shane.tubbs@chsys.org
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Lilian C
authors.initials: LC
authors.lastname: Azih
authors.forename: Martin M
authors.initials: MM
authors.lastname: Mortazavi
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Chern
authors.forename: Todd
authors.initials: T
authors.lastname: Hankinson
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014472:Umbilicus / Q000601:surgery*; D017287:Ventriculoperitoneal Shunt / Q000379:methods*