Original articleThe use of laparoscopy in ventriculoperitoneal shunt revisions
Section snippets
Methods
A retrospective chart review was conducted on 17 patients who underwent 19 consecutive laparoscopic-assisted VPS revisions at the Montreal Children's Hospital, a tertiary care pediatric institution, between January 2005 and December 2010. A comprehensive search of our institution's patient database revealed 184 patients who underwent VPS revision during the study period. Patients were identified using all applicable Canadian Classification of Intervention codes for VPS revision.
The operative
Results
The study population consisted of 5 men and 12 women with a median age at laparoscopic-assisted VPS revision of 12 years (range, 5 months to 20 years). The primary causes of hydrocephalus in our study were congenital neurologic abnormalities, intraventricular hemorrhage, and intracerebral tumors. Comorbidities are listed in Table 1. Forty-one percent of the study population had previous, non–VPS-related, abdominal surgery including congenital diaphragmatic hernia repair, bowel resection for
Discussion
Ventriculoperitoneal shunts are critical devices required for the management of hydrocephalus. Many of these devices have good durability, but malfunction can lead to life-threatening symptoms that mandate urgent revision or replacement of the shunt. Although the timing of malfunction is unpredictable, proximal dysfunction often occurs in the first 2 years of shunt life, whereas distal dysfunction predominates after 2 years [3]. Recently, the division of pediatric general surgery has been
References (12)
- et al.
Failure of cerebrospinal fluid shunts: part I: obstruction and mechanical failure
Pediatr Neurol
(2006) - et al.
Failure of cerebrospinal fluid shunts: part II: overdrainage, loculation, and abdominal complications
Pediatr Neurol
(2006) - et al.
Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus
J Neurosurg
(2000) - et al.
Time-related patterns of ventricular shunt failure
Childs Nerv Syst
(1994) - et al.
Laparoscopically assisted peritoneal shunt insertion in hydrocephalus
Surg Endosc
(2005) - et al.
Laparoscopic revision of a ventriculoperitoneal shunt
J Laparoendosc Adv Surg Tech
(2004)