Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications.
Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus.


OBJECTIVE
To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a "non reliable" peritoneum.


METHODS
From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy.


RESULTS
After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far.


CONCLUSIONS
Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.
Serviço de Neurocirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Fernanda O de
FO
Carvalho
Serviço de Neurocirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Antonio R
AR
Bellas
Departamento de Cirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Luciano
L
Guimarães
Serviço de Neurocirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
José Francisco
JF
Salomão
D034841:Abdominal Cavity / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010538:Peritonitis / Q000601:surgery; D015203:Reproducibility of Results; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods*; D020535:Video-Assisted Surgery / Q000379:methods*