Safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt

Ichikawa, Yoshitoshi; Matsuda, Chu; Mizushima, Tsunekazu; Takahashi, Hidekazu; Miyoshi, Norikatsu; Haraguchi, Naotsugu; Hata, Taishi; Yamamoto, Hirofumi; Doki, Yuichiro; Mori, Masaki

doi:10.1111/ases.12640

Cited by 5 publications

(7 citation statements)

References 17 publications

(25 reference statements)

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“…Laparoscopic surgery in patients with VPS has been reported in cholecystectomy [3][4][5][6][7], salpingectomy [8], ileocecal resection [9], colectomy [2,10], gastrectomy [10], adrenal adenoma excision [11], stomas, cystoplasty, bladder neck reconstruction, testicular vessel clipping and fascial slinging [12].…”

Section: Discussionmentioning

confidence: 99%

“…Neale and Falk reported that the modern anti-reflux systems had not shown any retrograde flow when exposed to pressures as high as 350 mmHg in an in-vitro experiments [15]. Thus, the clamping or externalization of the shunt catheter is probably unnecessary, and on the other hand, whether clamping of the shunt could actually exacerbate increases in ICP is not known [2]. Uzzo, et al described the results of intraoperative intracranial pressure monitoring in 2 patients in whom intracranial pressure increased promptly at abdominal insufflation.…”

Section: Discussionmentioning

confidence: 99%

“…Thanks to the advance in neurosurgery, patients with ventriculoperitoneal shunt (VPS) as a part of the treatment of hydrocephalus, either congenital or acquired causes have a longer survival and thus are at increasing risk of developing abdominal pathology necessitating surgery [2].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Hysterectomy in a Patient with Ventriculo-Peritoneal Shunt after Multiple Cesarean Sections

H¹,

Mohamed²,

M³

et al. 2021

Ann Minim Invasive Surg

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Patients with ventriculo-peritoneal shunt (VPS) for hydrocephalus had an improved survival and are more encountered in need of abdominal surgery. Laparoscopic surgery has been reported safe for these patients, although infrequently. At least 3 types of complications had been recorded: shunt obstruction, infection, and vaginal migration. We report a case of middle-aged female with endometrial hyperplasia and VPS who has done laparoscopic hysterectomy safely. The authors encourage laparoscopic surgery in this subset of patients when indicated with some precautions, including minimal insufflation pressure, CO2 monitoring, minimal Trendelenburg, and vaginal stump closure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Hysterectomy in a Patient with Ventriculo-Peritoneal Shunt after Multiple Cesarean Sections

H¹,

Mohamed²,

M³

et al. 2021

Ann Minim Invasive Surg

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“…They reported that all cases experienced an uneventful postoperative course, with no shunt-associated complications. A retrospectively from japan reported safe laparoscopic colorectal surgery in four patients with VP shunt who were operated with the pneumoperitoneum pressure set at 10 mmHg under routine anesthetic monitoring and without any manipulations such as clamping or externalization of the VP catheters [51]. One case of VP shunt failure in a patient with shuntdependent hydrocephalus after laparoscopic placement of feeding jejunostomy was reported by Baskin et al [52] postoperatively; the patient developed clinical and radiographic evidence of shunt failure and underwent emergent shunt revision that revealed an isolated distal shunt obstruction.…”

Section: Laparoscopic Surgery In Patients With Vp Shuntsmentioning

confidence: 99%

Safety of Laparoscopy in Patients with Ventriculoperitoneal Shunts

Mohamed¹,

Mohamed²

2021

Iberoam J Med

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The relationship between the intra-abdominal pressure (IAP) and intracranial pressure (ICP) has been suspected for more than 100 years and was subsequently confirmed by numerous studies in both animals and humans which demonstrate the link and the positive correlation between IAP and ICP. There are mounting concerns that the pneumoperitoneum created during laparoscopic surgery to create space for instrument placement and to allow safe tissue dissection may result in an increase in the ICP secondary to the increase in the IAP which may result in serious consequences in patients with Ventriculoperitoneal (VP) shunts. There is uncertainty about the safety of laparoscopic surgery in VP shunt patients. The aim of this article is to review the literature to answer the question [Is laparoscopic surgery safe in VP shunt patients with and without intraoperative monitoring of ICP]?

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“…Other concerns include shunt dysfunction 4 and shunt infection/retrograde meningitis 5,6 . Several previous case reports have demonstrated the safety of laparoscopic surgery in patients with a VPS or LPS; however, perioperative shunt management has differed between the various reports 7–32 …”

Section: Introductionmentioning

confidence: 99%

Safety of laparoscopic cholecystectomy in patients with a cerebrospinal fluid shunt in the peritoneal cavity

Inaba

Iguchi

Iseda

et al. 2023

Asian J Endoscop Surgery

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Introduction:The management of patients with a cerebrospinal fluid (CSF) shunt located in the peritoneal cavity undergoing laparoscopic surgery is an issue that has not yet been settled. These patients are at risk of increased intracranial pressure caused by peritoneal insufflation, shunt dysfunction, and shunt infection/retrograde meningitis. This study aimed to determine the need for perioperative shunt intervention in CSF shunt patients undergoing laparoscopic cholecystectomy. Methods: We reviewed and analyzed five shunt patients who underwent laparoscopic cholecystectomy in our institution between 2012 and 2022, as well as 17 patients described in previous reports.Results: Among the 22 patients, shunt type was ventriculoperitoneal in 14 and lumboperitoneal in eight. The most common indication for CSF shunt was hydrocephalus caused by cerebral vascular accident (50.0%). Laparoscopic cholecystectomy was performed for cholecystolithiasis in 13 patients (59.1%), acute cholecystitis in eight (36.4%), and gallbladder polyp in one (4.5%). Shunt clamping or externalization was performed in six patients. Two patients in the group that did not undergo shunt clamping or externalization experienced complications (intra abdominal abscess and subcutaneous emphysema). However, the incidence of short-term complications (both overall and shunt-related) and median length of hospital stay did not significantly differ between the two groups. Conclusion:Routine shunt clamping, externalization, or removal might not be necessarily required in patients with a ventriculoperitoneal or lumboperitoneal shunt undergoing laparoscopic cholecystectomy.

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Safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt

Abstract: Our study suggests that laparoscopic colorectal surgeries in patients with VPS without any manipulations may be safe. Future studies should aim to better standardize the perioperative management of VPS during laparoscopic colorectal surgery.

Cited by 5 publications

References 17 publications

Laparoscopic Hysterectomy in a Patient with Ventriculo-Peritoneal Shunt after Multiple Cesarean Sections

Laparoscopic Hysterectomy in a Patient with Ventriculo-Peritoneal Shunt after Multiple Cesarean Sections

Safety of Laparoscopy in Patients with Ventriculoperitoneal Shunts

Safety of laparoscopic cholecystectomy in patients with a cerebrospinal fluid shunt in the peritoneal cavity

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