Minimally invasive implantation of the peritoneal catheter in ventriculoperitoneal shunt placement for hydrocephalus: analysis of data in 151 consecutive adult patients

2006 ◽  
Vol 105 (6) ◽  
pp. 869-872 ◽  
Author(s):  
Alan Bani ◽  
Dieter Telker ◽  
Werner Hassler ◽  
Matthias Grundlach
Keyword(s):  
Minimally Invasive ◽  
Ventriculoperitoneal Shunt ◽  
General Surgery ◽  
Interdisciplinary Approach ◽  
Shunt Infection ◽  
Adult Patients ◽  
Peritoneal Catheter ◽  
Distal Catheter ◽  
Laparoscopy Group ◽  
Shunt Placement

Object The authors report on their experience with laparoscopy-guided implantation of a peritoneal catheter in ventriculoperitoneal shunt placement procedures in adults. Methods In performing the conventional method of shunt placement in 2001, 8% of the cases resulted in malposition and dislocation of the distal catheter; therefore, the authors together with personnel from the Department of General Surgery decided to utilize an interdisciplinary approach involving laparoscopy-guided implantation of the catheter. Between October 2001 and January 2005, 202 ventriculoperitoneal shunt placement procedures were conducted in adult patients for hydrocephalus of various origins. In 152 patients, laparoscopy-guided implantation of the distal catheter was performed. In all except one of these patients, implantation was successful. Laparoscopy and the cranial part of the surgery were performed simultaneously. There was an 8% rate of malposition of the distal catheter in the nonlaparoscopy group. In contrast, there was no dislocation or malposition of the distal catheter in the laparoscopy group. Two cases (1.3%) of shunt infection occurred in the laparoscopy group. Conclusions Laparoscopic implantation of a distal catheter is a simple, minimally invasive, and easy procedure to perform and allows exact localization of the peritoneal catheter and confirmation of its patency.

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.

scholarly journals Ventriculoperitoneal Shunt Peritoneal Catheter Knot Formation

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Anwar Ul-Haq ◽  
Faisal Al-Otaibi ◽  
Saud Alshanafey ◽  
Mohamed Diya Sabbagh ◽  
Essam Al Shail
Keyword(s):  
Literature Review ◽  
Ventriculoperitoneal Shunt ◽  
Case Reports ◽  
Abdominal Cavity ◽  
Pediatric Neurosurgery ◽  
Shunt Infection ◽  
Peritoneal Catheter ◽  
Common Procedure ◽  
Vp Shunt ◽  
Laparoscopic Exploration

The ventriculoperitoneal (VP) shunt is a common procedure in pediatric neurosurgery that carries a risk of complications at cranial and abdominal sites. We report on the case of a child with shunt infection and malfunction. The peritoneal catheter was tethered within the abdominal cavity, precluding its removal. Subsequently, laparoscopic exploration identified a knot at the distal end of the peritoneal catheter around the omentum. A new VP shunt was inserted after the infection was healed. This type of complication occurs rarely, so there are a limited number of case reports in the literature. This report is complemented by a literature review.

Ventriculoperitoneal shunt with a rare twist: small-bowel ischemia and necrosis secondary to knotting of peritoneal catheter

2014 ◽  
Vol 14 (3) ◽  
pp. 234-237 ◽  
Author(s):  
Lee A. Tan ◽  
Manish K. Kasliwal ◽  
Roham Moftakhar ◽  
Lorenzo F. Munoz
Keyword(s):  
Small Bowel ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
External Ventricular Drain ◽  
Bowel Ischemia ◽  
Shunt Revision ◽  
Peritoneal Catheter ◽  
High Grade Fever ◽  
Shunt System ◽  
Distal Catheter

Small-bowel ischemia and necrosis due to knotting of the peritoneal catheter is an extremely rare complication related to a ventriculoperitoneal shunt (VPS). A 3-month-old girl, with a history of Chiari II malformation and myelomeningocele (MM) after undergoing right occipital VPS insertion and MM repair at birth, presented to the emergency department with a high-grade fever. Examination of a CSF sample obtained via shunt tap raised suspicion for the presence of infection. Antibiotic therapy was initiated, and subsequently the VPS was removed and an external ventricular drain was placed. Intraoperatively, as attempts at pulling the distal catheter from the scalp incision were met with resistance, the distal catheter was cut and left in the abdomen while the remainder of the shunt system was successfully removed. While the patient was awaiting definitive shunt revision surgery to replace the VPS, she developed abdominal distension due to small-bowel obstruction. An emergency exploratory laparotomy revealed a knot in the distal catheter looping around and strangulating the distal ileum, causing small-bowel ischemia and necrosis in addition to the obstruction. A small-bowel resection with ileostomy was performed, with subsequent placement of ventriculoatrial shunt for treatment of hydrocephalus. The authors report this exceedingly rare clinical scenario to highlight the fact that any retained distal catheter must be carefully managed with immediate abdominal exploration to remove the distal catheter to avoid bowel necrosis as pulling of a knotted peritoneal catheter may strangulate the bowel and cause ischemia, with significant clinical morbidity and possible mortality.

scholarly journals Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement

2016 ◽  
Vol 25 ◽  
pp. 46-49 ◽  
Author(s):  
Kingsley O. Abode-Iyamah ◽  
Ryan Khanna ◽  
Zachary D. Rasmussen ◽  
Oliver Flouty ◽  
Nader S. Dahdaleh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ventriculoperitoneal Shunt ◽  
Distal Catheter ◽  
Catheter Migration ◽  
Factors Associated ◽  
Shunt Placement

scholarly journals Survival Rate and Shunt Infection Incidence Following Gastrostomy in Adult Patients with an Existing Ventriculoperitoneal Shunt

2021 ◽  
Author(s):  
Fumihiro MAWATARI ◽  
Tadashi SHIMIZU ◽  
Hisamitsu MIYAAKI ◽  
Tetsuhiko ARIMA ◽  
Sachiko FUKUDA ◽  
...  
Keyword(s):  
Survival Rate ◽  
Ventriculoperitoneal Shunt ◽  
Shunt Infection ◽  
Adult Patients ◽  
Infection Incidence

scholarly journals Repeated Peritoneal Catheter Blockage Caused by Neurocysticercosis Following Ventriculoperitoneal Shunt Placement for Hydrocephalus

2018 ◽  
Vol 09 (02) ◽  
pp. 268-271
Author(s):  
Zhi Hua Li ◽  
Zhong Quan Wang ◽  
Jing Cui ◽  
Fu You Guo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ventriculoperitoneal Shunt ◽  
Rare Case ◽  
Histopathological Examination ◽  
Resonance Imaging ◽  
Peritoneal Catheter ◽  
Shunt Placement ◽  
Low Field ◽  
Inappropriate Treatment ◽  
Cerebral Cysticercosis

ABSTRACTCerebral cysticercosis is common, but the possibility for repeated occurrence of peritoneal catheter blockage caused by neurocysticercosis (NCC) after two revisions following ventriculoperitoneal shunt placement for hydrocephalus is unusual. Herein, we describe one rare case in which peritoneal catheter revision was performed two times unsuccessfully. Endoscopic cysternostomy rather than peritoneal catheter adjustment was performed successfully, and histopathological examination of excised cystic samples confirmed NCC in our hospital. The present case highlights the need for awareness of NCC as a possible etiology of hydrocephalus, especially in developing countries. Uncommon findings in both lateral ventricles following low-field magnetic resonance imaging scans as well as the rarity of this infection involved in unusual location play important roles in misdiagnosis and incorrect treatment for hydrocephalus; thus, endoscopic cysternostomy, rather than multiple shunt adjustment of the peritoneal end, is recommended in the selected patient. To the best of our knowledge, this is the first report describing the misdiagnosis and inappropriate treatment of hydrocephalus caused by cerebral cysticercosis in China.

Laparoscopic versus open approach for implantation of the peritoneal catheter during ventriculoperitoneal shunt placement

2008 ◽  
Vol 23 (7) ◽  
Author(s):  
Joshua L. Argo ◽  
Durgamani K. Yellumahanthi ◽  
Naveen Ballem ◽  
Mark R. Harrigan ◽  
Winfield S. Fisher ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Open Approach ◽  
Peritoneal Catheter ◽  
Shunt Placement

Preventing Distal Catheter Obstruction in Laparoscopic Ventriculoperitoneal Shunt Placement in Adults: The “Falciform Technique”

2015 ◽  
Vol 25 (8) ◽  
pp. 642-645 ◽  
Author(s):  
Shane M. Svoboda ◽  
Habeeba Park ◽  
Neal Naff ◽  
Zeena Dorai ◽  
Michael A. Williams ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Distal Catheter ◽  
Shunt Placement ◽  
Catheter Obstruction

Laparoscopic Peritoneal Catheter Placement: Results of a New Method in 111 Patients

2007 ◽  
Vol 61 (suppl_3) ◽  
pp. ONS-167-ONS-174 ◽  
Author(s):  
Raymond D. Turner ◽  
Steven M. Rosenblatt ◽  
Bipan Chand ◽  
Mark G. Luciano
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Insertion Site ◽  
Signs And Symptoms ◽  
Shunt Infection ◽  
Laparoscopic Technique ◽  
Neurosurgical Procedures ◽  
Abdominal Incision ◽  
Shunt Insertion ◽  
Distal Catheter ◽  
Ventriculoperitoneal Shunting

Abstract Objective: Although cerebrospinal fluid shunting remains one of the most common neurosurgical procedures, it is fraught with high infection, blockage, and reoperation rates. It has been estimated that the economic cost of ventriculoperitoneal shunting exceeds $1 billion annually. A new laparoscopic technique that eliminates abdominal incisions overlying shunt hardware was applied to 111 patients requiring ventriculoperitoneal shunts in an effort to decrease the morbidity associated with shunting. Methods: All patients who required ventriculoperitoneal shunt insertion were eligible for this surgical technique. Patient selection was based on availability of both surgical teams (general surgery and neurological surgery) at the time of surgery. Using this technique, the distal shunt catheter is tunneled directly from the head into the peritoneal cavity under laparoscopic guidance without a skin incision directly overlying the distal catheter insertion site. Patients were followed prospectively for signs and symptoms related to shunt dysfunction, shunt infection, and incision morbidity. Results: One hundred eleven patients underwent 113 laparoscopic ventriculoperitoneal shunt surgeries between February 2003 and December 2004. The average follow-up period was 21.7 months (range, 12–34 mo). Nearly half of the patients (49%) were discharged the next morning and the majority (81%) was discharged within 2 days of surgery. Overall, 15 patients experienced complications requiring reoperation (13.5%) with a 1-year shunt survival rate of 91%. One patient (0.9%) acquired a new shunt infection, whereas two patients (1.8%) developed recurrence from a previous shunt infection. There were no abdominal incision-related complications. Conclusion: This simplified laparoscopic shunt placement technique, which requires no overlying abdominal incisions, can be performed quickly with high shunt survivability and low infection rates. Furthermore, the laparoscopic method has the advantage of fast recovery time, elimination of preperitoneal or misplaced catheters, and decreased abdominal incision morbidity. The procedure can be performed by either a multidisciplinary team or entirely by neurosurgeons.

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