title: A novel method for passing cerebrospinal fluid shunt tubing: a proof of principle study.
abstract: BACKGROUND
  Few innovations in the method of tunneling shunt tubing for cerebrospinal fluid (CSF) shunt diversion have been made since this treatment of hydrocephalus was first developed. Therefore, this feasibility study was performed with the hope of identifying an improved technique that could potentially carry fewer complications.
  
  
  METHODS
  On 10 cadaver sides and when placed in the supine position, small skin incisions were made at the clavicle and ipsilateral subcostal region, and magnets were used to pass standard shunt tubing between the two incisions.
  
  
  RESULTS
  Nickel-plated magnets were less effective in pulling the shunt tubing below the skin compared with ceramic magnets. Of these, magnets with pull strengths of 150-200 lbs were the most effective in dragging the subcutaneous tubing between the two incisions. No obvious damage to the skin from the overlying magnet was seen in any specimen.
  
  
  CONCLUSIONS
  Few options exist for tunneling distal shunt tubing for CSF shunt procedures. Future patient studies are needed to determine if the technique described herein is superior to current methods, particularly when examining patient groups that are at a greater risk for injury during tunneling shunt catheters.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital of Alabama, Birmingham, AL, USA, Shane.Tubbs@childrensal.org.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Dylan
authors.initials: D
authors.lastname: Goodrich
authors.forename: Isaiah
authors.initials: I
authors.lastname: Tubbs
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002516:Ceramics; D002557:Cerebrospinal Fluid Shunts / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D059346:Magnets; D008297:Male; D008875:Middle Aged; D009532:Nickel
chemical_list: D009532:Nickel