Comparative Study Between Laparoscopic and Open Techniques for Insertion of Ventriculperitoneal Shunt for Treatment of Congenital Hydrocephalus

Hanna, Ragai Sobhi; Essa, Abdelhakeem A.; Makhlouf, Gamal A; Helmy, Ashraf A

doi:10.1089/lap.2017.0594

Cited by 13 publications

(29 citation statements)

References 15 publications

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“…The more minimally invasive technique decreases the length of stay in the hospital as well as prompts a faster recovery rate [9,14]. This allows for less resource use by individual patients and increased patient satisfaction by leaving the hospital soon after surgery and returning to regular activities faster than with the mini-laparotomy technique [9,11,14].…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that patients require 2-3 surgical revisions on average due to shunt failures in the 20 years after the original shunt placement [8], with the majority of shunt revisions occurring in the first 6-12 months [4,8]. Specifically, 25-30% of all shunt revisions result from distal peritoneal catheter failure [5,11,12], such as preperitoneal placement, obstruction due to adhesions or pseudocysts, and malabsorption with secondary ascites [12].…”

Section: Ventriculoperitoneal Shuntmentioning

confidence: 99%

“…Multiple studies have demonstrated that relative to the mini-laparotomy technique, a laparoscopically assisted approach has a shorter operative time and length of stay in the hospital, a decreased distal shunt failure rate [4,9,14], and a decreased risk of visceral injury [10]. Laparoscopy has also been shown to offer favorable outcomes with smaller incisions leading to reduced post-operative pain [11], faster mobilization and a preferred cosmetic appearance [5]. Many of the proposed benefits associated with laparoscopicassisted VP shunts are a direct result of the increased visualization offered by laparoscopy.…”

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

“…Laparoscopy allows for the verification of accurate peritoneal placement of the distal catheter as well as the proper functioning of the shunt by observing CSF outflow [5]. Laparoscopy can also be used to perform adhesiolysis, useful in the presence of excess adhesions, often found in patients who have undergone previous abdominal surgeries [11]. As shunt obstruction can commonly result from the distal catheter becoming lodged in a collection of adhesions, adhesiolysis offers a potential solution to prevent this from occurring, reducing complications and future shunts failures.…”

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

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Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Wilson¹,

Crozier²,

Helou³

2020

New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review

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Hydrocephalus is an abnormal accumulation of excess cerebrospinal fluid (CSF) in the brain causing increased intracranial pressure, which can arise from a variety of causes, including congenital, acquired, or idiopathic pathologies. Ventriculoperitoneal (VP) shunting is most commonly used to treat hydrocephalic patients, relieving the increased intracranial pressure by draining excess CSF from the ventricles to the peritoneal cavity. VP shunts are primarily completed using either an open or a more minimally invasive neuronavigated laparoscopic-assisted surgical technique. There is a high level of surgical complications, shunt failures and revision rates following VP shunting. It is suggested that different surgical techniques are associated with varying degrees of patient outcomes, surgical complications, and revision rates, with the less invasive laparoscopic-assisted approach producing improved results. We present our results on 14 consecutive hydrocephalic patients, analyzed retrospectively between 2017 and 2019, investigating the benefits offered by the neuronavigated laparoscopic-assisted insertion of VP shunts. Additionally, we explain our workflow and procedural technique. By investigating these differences, changes can be implemented in current routine procedures to ameliorate patient safety, surgical complications, and revision rates.

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Section: Discussionmentioning

confidence: 99%

Section: Ventriculoperitoneal Shuntmentioning

confidence: 99%

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

Section: Ventriculoperitoneal Shunt: Challengesmentioning

confidence: 99%

See 2 more Smart Citations

Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement

Wilson¹,

Crozier²,

Helou³

2020

New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review

View full text Add to dashboard Cite

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“…In the pediatric population, the data is scarce, consisting mainly of retrospective cohort analysis. These studies showed that laparoscopic VPS placement is safe in children and a possible alternative to the traditional mini-laparotomy and suggest an improvement in outcome [1,9,10,[19][20][21][22][23]. Laparoscopy has been shown to have very low failure rates, with some studies reporting no distal failure [21,24].…”

Section: Distal Placementmentioning

confidence: 99%

Distal shunt placement in pediatric ventriculoperitoneal shunt surgery: an international survey of practice

et al. 2023

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Objective Ventriculoperitoneal shunt (VPS) surgery is a common treatment for hydrocephalus in children and adults, making it one of the most common procedures in neurosurgery. Children being treated with a VPS often require several revisions during their lifetime with a lifetime revision rate of up to 80%. Several different techniques exist for inserting the distal catheter, while mini-laparotomy, trocar, or laparoscopy is traditionally used. As opposed to adults, only few studies exist, comparing the outcome of the different distal catheter placement techniques in children. This international survey aims to investigate the current daily practice concerning distal shunt placement techniques in children. Material and methods An online questionnaire investigating the different techniques used to place the distal catheter in pediatric VPS surgery was distributed internationally. All results were analyzed using descriptive and comparative statistics. Results A total of 139 responses were obtained. Mini-laparotomy was reported to be the most frequently used technique (n = 104, 74.8%) for distal shunt placement in children, while laparoscopic or trocar-assisted placements were only used by 3.6% (n = 5) and 21.6% (n = 30) of all respondents, respectively. Over half (n = 75, 54.0%) of all respondents do not believe that laparoscopic placement improves the outcome. Conclusion This international survey shows that mini-laparotomy is the most frequently used technique for distal VPS placement in children all over the world. Further randomized trials are needed to elucidate this matter.

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