title: Laparoscopic shunt revision avoids many complications of open shunt revision and has outcomes similar to first-time shunt placement.
abstract: Open revision of abdominal shunts is associated with increased risk of wound infection, visceral injury, hernia, and shunt complications. We hypothesized that laparoscopic revision mitigates these risks to a level similar to initial (i.e., first-time) shunt placement. This was a single-center, multisurgeon, retrospective cohort study of patients who underwent either laparoscopic initial shunt placement or laparoscopic shunt revision over a 5-year period. Outcomes were operative time, length of stay, and 30-day complication rate. Sixty-nine patients underwent laparoscopic shunt revision and 99 patients underwent laparoscopic initial shunt placement. Operative times were nearly identical (75 vs 73 minutes, P = 0.63). There were no significant differences in blood loss or hospital length of stay. Abdominal complications and total complications did not differ between groups. Laparoscopic shunt revision avoided many of the known complications of open shunt revision and had outcomes similar to initial laparoscopic shunt placement.
authors.affiliation: Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Logghe
authors.forename: John
authors.initials: J
authors.lastname: Maa
authors.forename: Michael
authors.initials: M
authors.lastname: Mcdermott
authors.forename: Michael
authors.initials: M
authors.lastname: Oh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018579:Patient Selection; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult