title: Ventriculoportal Shunt, a New Transomphalic Extraperitoneal Surgical Technique in Treatment of Hydrocephalus.
abstract: OBJECTIVE
  The aim of this article was to report a new transomphalic extraperitoneal surgical technique for treatment of hydrocephalus, called ventriculoportal shunt.
  
  
  METHODS
  We performed ventriculoportal shunt on an experimental animal (pig). The particularity of ventriculoportal shunt consists in the fact that the distal end of the catheter is inserted transomphalic extraperitoneally in the portal system through reopened umbilical vein. We present technical details regarding this new surgical technique.
  
  
  CONCLUSIONS
  The animal had favorable outcome, without any postoperative early or late morbidity. We discuss indications, contraindications, possible complications in humans and advantages of ventriculoportal shunt compared with ventriculocardiac and ventriculoperitoneal drainages and possibilities to avoid complications specific to classic shunt procedures.
  
  
  CONCLUSIONS
  Ventriculoportal shunt is a new surgical technique for treatment of hydrocephalus. The distal end of the catheter introduced into reopened umbilical vein, drains cerebrospinal fluid into the portal system. Ventriculoportal shunt is safe and easy to perform. With ventriculoportal shunt specific complications of ventriculoperitoneal or ventriculocardiac drainages can be potentially avoided. Ventriculoportal shunt combines advantages of vascular shunt with those of having an immunological barrier for cerebrospinal fluid before entering the systemic circulation. Theoretically, indications for surgery are extended, and ventriculoportal shunt can be performed in patients former contraindicated for ventriculoperitoneal shunt. Further research is needed and this surgical technique must be performed on human subjects with hydrocephalus.
authors.affiliation: 1 Emergency Clinical Hospital Bagdasar-Arseni, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
authors.forename: Valentin Titus
authors.initials: VT
authors.lastname: Grigorean
authors.affiliation: 2 Emergency Clinical Hospital Bagdasar-Arseni, Fourth Department of Neurosurgery, Bucharest, Romania.
authors.forename: Aurelia Mihaela
authors.initials: AM
authors.lastname: Sandu
authors.affiliation: 3 University Pitesti, Emergency County Hospital Arges, Pitesti, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Popescu
authors.affiliation: 4 Clinical Nephrology Hospital Carol Davila, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
authors.forename: Victor
authors.initials: V
authors.lastname: Strambu
mesh_terms: D000328:Adult; D000818:Animals; D002404:Catheterization; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D019736:Prostheses and Implants; D013552:Swine; D014471:Umbilical Veins / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000379:methods*
keywords: neurosurgery; simulation; surgical education