title: Single-Incision laparoscopic surgery (SILS) for ventriculoperitoneal shunt placement.
abstract: BACKGROUND
  Single-incision laparoscopic surgery (SILS) may facilitate safer shunt placement and lower distal obstruction rate than is seen in conventional surgery.
  
  
  OBJECTIVE
  We reviewed our 2-year experience in SILS for ventriculoperitoneal shunt placement to evaluate its usefulness and safety.Materials and Methods In this retrospective study, we enrolled patients older than 18 years with dilated ventricle and syndromes of hydrocephalus. A total of 31 patients underwent 31 primary ventriculoperitoneal shunt placement surgery and two underwent revision surgery. All the procedures were performed by the SILS technique.
  
  
  RESULTS
  The entire duration of ventriculoperitoneal shunt implantation ranged from 45 to 80 minutes, with mean operation time of 65 ± 15.3 minutes. No major laparoscopy-related complications were noted. Shunt infection, peritonitis, and distal catheter malfunction occurred in one case (3.2%), proximal malfunction in one case (3.2%), and subcutaneous emphysema occurred in two cases (6.4%). The emphysema resolved within 2 days. Cosmetic results were "very good to good" in 17 patients (54.8%) and "satisfactory" in 14 patients (45.2%). The abdominal scars in most cases were nearly invisible.
  
  
  CONCLUSIONS
  SILS is a safe and effective technique for ventriculoperitoneal shunt placement and can be accomplished with no higher risk of shunt infection and distal malfunction. Without an additional port, SILS allows good visualization of the peritoneal cavity to avoid major intra-abdominal complications. Only one 6-mm incision at the umbilicus area is required and is almost invisible after wound healing.
authors: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
authors: Wei-Chen
authors: WC
authors: Hong
authors: Peng-Sheng
authors: PS
authors: Lai
authors: Yin-Hsuan
authors: YH
authors: Chien
authors: Yong-Kwang
authors: YK
authors: Tu
authors: Jui-Chang
authors: JC
authors: Tsai
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010529:Peritoneal Cavity / Q000033:anatomy & histology; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000033:anatomy & histology / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects; D014945:Wound Healing