scholarly journals Shunt scissors: technical note

2018 ◽  
Vol 129 (5) ◽  
pp. 1200-1202
Author(s):  
Ralph G. Dacey ◽  
Oliver E. Flouty ◽  
M. Sean Grady ◽  
Matthew A. Howard ◽  
Marc R. Mayberg
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Technical Note ◽  
Shunt Surgery ◽  
Blunt Dissection ◽  
Technical Advance ◽  
Shunt Valve ◽  
New Device ◽  
Sharp Dissection ◽  
Dissection Technique ◽  
Subgaleal Space

OBJECTIVEWhen performing ventriculoperitoneal shunt surgery it is necessary to create a subgaleal pocket that is of sufficient size to accommodate a shunt valve. In most cases the valve is placed over the posterior skull where the galea begins to transition to suboccipital neck fascia. Dense fibrous attachments in this region of the skull make it technically awkward to develop the subgaleal valve pocket using standard scissors and a blunt dissection technique. In this report the authors describe a new device that enables surgeons to create the shunt valve pocket by using a simple semi-sharp dissection technique.METHODSThe authors analyzed the deficiencies of the standard valve pocket dissection technique and designed shunt scissors that address the identified shortcomings. These new scissors allow the surgeon to sharply dissect the subgaleal space by using an efficient hand-closing maneuver.RESULTSStandard surgical scissors were modified to create shunt scissors that were tested on the benchtop and used in the operating room. In all cases the shunt scissors proved easy to use and allowed the efficient and reliable creation of a subgaleal valve pocket in a technically pleasing manner.CONCLUSIONSShunt scissors represent an incremental technical advance in the field of neurosurgical shunt operations.

Endoscopic bimanual sharp dissection technique for gross-total resection of colloid cysts: technical note

2020 ◽  
pp. 1-9
Author(s):  
Sascha Marx ◽  
Henry W. S. Schroeder
Keyword(s):  
Surgical Technique ◽  
Endoscopic Resection ◽  
Technical Note ◽  
Gross Total Resection ◽  
Total Resection ◽  
Colloid Cysts ◽  
Cyst Recurrence ◽  
Sharp Dissection ◽  
Dissection Technique ◽  
Patient At Risk

Neuroendoscopic resection of colloid cysts has gained tremendous popularity over the last 2 decades because of good clinical outcomes and a low complication profile. However, in comparison to microsurgical resections, endoscopic resection has a lower rate of gross-total resection, which leaves the patient at risk for cyst recurrence. At present, there is still ongoing debate as to the best surgical approach for colloid cysts. Endoscopic resection as a technique has to compete with the good outcomes of microsurgical resections with respect to a long-term recurrence-free outcome. It is the authors’ belief that gross-total resection should be the aim of endoscopic cyst resection. In this technical note, they describe their surgical technique for achieving safe gross-total resection of colloid cysts by using a ventriculoscopic system. The surgical technique includes a far anterolateral entry point, navigational guidance, bimanual sharp dissection, use of the endoscopic sheath as a retractor, the small-chamber irrigation technique, and the dry-field technique for hemostasis.

scholarly journals Reconsidering Ventriculoperitoneal Shunt Surgery and Postoperative Shunt Valve Pressure Adjustment: Our Approaches Learned From Past Challenges and Failures

2022 ◽  
Vol 12 ◽  
Author(s):  
Shigeki Yamada ◽  
Masatsune Ishikawa ◽  
Madoka Nakajima ◽  
Kazuhiko Nozaki
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Early Period ◽  
Csf Shunt ◽  
Symptom Improvement ◽  
Shunt Surgery ◽  
Shunt Valve ◽  
Improvement Rate ◽  
Shunt Implantation ◽  
Csf Drainage ◽  
Valve Pressure

Treatment for idiopathic normal pressure hydrocephalus (iNPH) continues to develop. Although ventriculoperitoneal shunt surgery has a long history and is one of the most established neurosurgeries, in the 1970s, the improvement rate of iNPH triad symptoms was poor and the risks related to shunt implantation were high. This led experts to question the surgical indication for iNPH and, over the next 20 years, cerebrospinal fluid (CSF) shunt surgery for iNPH fell out of favor and was rarely performed. However, the development of programmable-pressure shunt valve devices has reduced the major complications associated with the CSF drainage volume and appears to have increased shunt effectiveness. In addition, the development of support devices for the placement of ventricular catheters including preoperative virtual simulation and navigation systems has increased the certainty of ventriculoperitoneal shunt surgery. Secure shunt implantation is the most important prognostic indicator, but ensuring optimal initial valve pressure is also important. Since over-drainage is most likely to occur in the month after shunting, it is generally believed that a high initial setting of shunt valve pressure is the safest option. However, this does not always result in sufficient improvement of the symptoms in the early period after shunting. In fact, evidence suggests that setting the optimal valve pressure early after shunting may cause symptoms to improve earlier. This leads to improved quality of life and better long-term independent living expectations. However, in iNPH patients, the remaining symptoms may worsen again after several years, even when there is initial improvement due to setting the optimal valve pressure early after shunting. Because of the possibility of insufficient CSF drainage, the valve pressure should be reduced by one step (2–4 cmH2O) after 6 months to a year after shunting to maximize symptom improvement. After the valve pressure is reduced, a head CT scan is advised a month later.

scholarly journals Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note

2019 ◽  
Vol 62 (1) ◽  
pp. 123-129
Author(s):  
Claudia L. Craven ◽  
Simon D. Thompson ◽  
Ahmed K. Toma ◽  
Laurence D. Watkins
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Povidone Iodine ◽  
Technical Note ◽  
Shunt Surgery ◽  
Skin Preparation

Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases

2000 ◽  
Vol 54 (5) ◽  
pp. 388-396 ◽  
Author(s):  
Satish Sathyanarayana ◽  
Esther L Wylen ◽  
Mustafa K Baskaya ◽  
Anil Nanda
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Bowel Perforation ◽  
Shunt Surgery

scholarly journals A study on Complications of ventriculoperitoneal shunt surgery in Bir Hospital, Kathmandu, Nepal

2012 ◽  
Vol 1 (2) ◽  
pp. 119-122 ◽  
Author(s):  
BG Karmacharya ◽  
P Kumar
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Shunt Infection ◽  
Shunt Surgery ◽  
Inclusion Criteria ◽  
Medical Sciences ◽  
Referral Centre ◽  
Neurosurgical Procedure ◽  
Ventriculoperitoneal Shunts ◽  
Shunt Procedure ◽  
A Prospective Study

Background: Ventriculoperitoneal shunt is one of the most commonly performed neurosurgical procedure, both on the elective and emergency basis. However this procedure is dreaded because of complications. There is lack of prospective studies on complications of shunt procedure. In this study, the indications for shunt, the types used and complications of ventriculoperitoneal shunts were studied. Methods: This was a prospective study carried out in the national neurosurgical referral centre, Bir hospital, Kathmandu from April 2004 to March 2005. Results: There were 109 ventriculoperitoneal shunt procedures during the study period. Among them 60 consecutive patients who fulfilled the inclusion criteria were enrolled for the study. There were 43 male and 17 female patients, with age ranging from 4 months to 75 years. Fourteen patients (23.3%) developed complications which included shunt block, shunt infection, over drainage and shunt extrusion. Conclusion: About one fourth all patients who underwent ventriculoperitoneal shunt surgery developed complications. Shunt block and infections were the major complications. DOI: http://dx.doi.org/10.3126/njms.v1i2.6612 Nepal Journal of Medical Sciences. 2012;1(2): 119-22

The Value of Computed Tomography Imaging of the Head After Ventriculoperitoneal Shunt Surgery in Adults

2019 ◽  
Vol 121 ◽  
pp. e159-e164 ◽  
Author(s):  
Bedjan Behmanesh ◽  
Fee Keil ◽  
Daniel Dubinski ◽  
Sae-Yeon Won ◽  
Johanna Quick-Weller ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ventriculoperitoneal Shunt ◽  
Shunt Surgery ◽  
Computed Tomography Imaging ◽  
Tomography Imaging

scholarly journals Subgaleal Migration of the Distal Catheter of a Ventriculoperitoneal Shunt

2009 ◽  
Vol 52 (2) ◽  
pp. 77-79 ◽  
Author(s):  
Fatih Serhat Erol ◽  
Bekir Akgun
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Ventricular Catheter ◽  
Peritoneal Catheter ◽  
Shunt Valve ◽  
Distal Catheter ◽  
X Ray ◽  
Proximal Migration ◽  
Shunt Dysfunction ◽  
Valve Placement ◽  
The Brain

Proximal migration of the distal end of a ventriculoperitoneal shunt has been observed much more rarely than other numerous shunt-related complications. Subgaleal migration of the peritoneal end is one of the samples. In the preset report we have discussed a case of subgaleal migration of the peritoneal end detected as a result of the examinations performed for shunt dysfunction. There was ventricular dilatation on CT scan of the brain. X-ray examinations confirmed proper ventricular catheter and shunt valve placement but a complete migration of distal (peritoneal) catheter into the subgaleal space. Then the patient’s shunt was revised. When our case and the literature were examined, we observed that this complication was frequently encountered during the first postoperative months, in the pediatric ages and in patients with advanced hydrocephalus. Besides, we have detected that the peritoneal catheters had tendency to migration into the subgaleal tissues similar to pre-insertion forms of the preoperatively original packages.

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