Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement and Reduction in Operative Time and Total Hospital Charges

Catapano, Joshua S; Mezher, Andrew W; Wang, Derrick; Whiting, Alexander C; Mooney, Michael A.; Bohl, Michael A.; Sheehy, John P.; DiDomenico, Joseph D.; Sarris, Christina E.; Smith, Kris A.; Lawton, Michael T.; Zabramski, Joseph M.

doi:10.1016/j.wneu.2019.12.086

Cited by 22 publications

(19 citation statements)

References 12 publications

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“…The cohort portion of our study is additive to the currently available literature in that we present 188 first-time ventriculoperitoneal shunt placements, performed consecutively, with direct analysis of outcomes between single-surgeon laparotomy and co-surgeon laparoscopy assisted placement. In a search of the literature, few studies have directly compared outcomes between mini-laparotomy and laparoscopic-assisted procedures [ 14 - 21 ]. Additionally, the data from these studies often included patients receiving revision shunt surgeries, which is less contentious having demonstrated benefit of laparoscopic-assisted ventriculoperitoneal shunt placement due to the ability to visualize adhesions, minimize shunt kinking, and optimize placement of the catheter.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Co-surgeon Ventriculoperitoneal Shunt Placement Versus Single Surgeon Mini Laparotomy

Mulvaney¹,

Arnold²,

Reinke³

et al. 2022

Cureus

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Introduction: Ventriculoperitoneal (VP) shunt placement is one of the most common treatments for pediatric hydrocephalus. However, device failures often occur, requiring operative revision of either the intraventricular or intraperitoneal shunt catheters. Historically, shunt placement was performed via laparotomy, but there has been a trend towards laparoscopic-assisted placement of the intraperitoneal portion of the shunt. We examined the outcomes of laparoscopic-assisted versus open VP shunt placement utilizing a local institutional retrospective review. Methods: Single institution 2012-2017 retrospective review of all cases was performed. Patients were divided into two groups - laparoscopic and open. Thirty-day outcomes, patient age, surgery performed, surgical control time (SCT), length of stay (LOS), and readmission were analyzed. Results: Cohort analysis inclusion criteria included 188 patients. The cohort analysis showed both decreased laparoscopic-assisted SCT (56.4 vs 32.1 min, p<0.0001) and postop complications (16.7% vs 7.1%, p<0.07). There was no significant difference in surgical site infection or readmission rates. Conclusion: Local analysis show advantages for laparoscopic-assisted VP shunt placement over open single surgeon techniques with decreased SCT, LOS, and unplanned interventions.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Co-surgeon Ventriculoperitoneal Shunt Placement Versus Single Surgeon Mini Laparotomy

Mulvaney¹,

Arnold²,

Reinke³

et al. 2022

Cureus

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“…12 Laparoscopic-assisted ventriculoperitoneal shunt (LAVPS) placement has become the common approach for treating HCP because it has been shown to decrease the need for shunt revisions secondary to malposition, obstruction, or catheter migration. 13 The LAVPS placement procedure involves both a neurosurgeon and general surgeon. The neurosurgeon cannulates one of the ventricles and then tunnels the distal peritoneal tubing into the abdomen.…”

Section: Overview Of Treatment For Hcpmentioning

confidence: 99%

“…12 The laparoscopic approach offers many advantages over the minilaparotomy (eg, direct visualization of the peritoneal cavity to confirm position and patency; the ability to perform a lysis of adhesions; shorter operative time; decreased risk of postoperative adhesions; smaller incisions, which reduce postoperative complications; a quicker recovery; 14 fewer shunt revisions). 13 Risks involving the laparoscopic approach include irritation to the peritoneum from insufflation, hemodynamic compromise from elevated abdominal pressures, inguinal hernia, and abdominal pseudocyst. 14 The minilaparotomy approach involves risks such as peritonitis, abdominal adhesions, bowel obstruction, and volvulus.…”

Section: Overview Of Treatment For Hcpmentioning

confidence: 99%

“…Recently, general surgeons have begun assisting the neurosurgeon by placing the distal or abdominal end of the shunt using a laparoscopic technique 12 . Laparoscopic‐assisted ventriculoperitoneal shunt (LAVPS) placement has become the common approach for treating HCP because it has been shown to decrease the need for shunt revisions secondary to malposition, obstruction, or catheter migration 13 …”

Section: Overview Of Treatment For Hcpmentioning

confidence: 99%

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Laparoscopic‐Assisted Ventriculoperitoneal Shunt Placement: A Less Invasive Approach to Treating Hydrocephalus

Karasin¹,

Eskuchen²,

Hardinge³

et al. 2021

AORN Journal

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Hydrocephalus is caused by the disruption of the normal flow of cerebrospinal fluid (CSF), which results in a buildup of CSF. Hydrocephalus comprises two key categories: communicating and noncommunicating. Normal‐pressure hydrocephalus, a type of communicating hydrocephalus, currently has no cure; the main treatment option is ventriculoperitoneal shunt (VPS) placement surgery. This procedure is performed to reestablish the balance between CSF production, flow, and absorption. Recently, general surgeons have begun assisting the neurosurgeon by placing the distal or abdominal end of the shunt using a laparoscopic technique. This article briefly reviews the pathophysiology and treatment options for hydrocephalus; presents a thorough review of the laparoscopic‐assisted VPS placement procedure, as well as the expected perioperative course and care considerations; and concludes with a case study of a 68‐year‐old patient who undergoes a laparoscopic‐assisted VPS placement.

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Diversion of the cerebrospinal fluid (CSF) from the ventricular system to the peritoneal cavity through the VPS catheter is one of the most frequently performed surgical procedures for treatment of hydrocephalus. [1][2][3] VPS insertion is associated with a wide variety of complications. The extrusion of the distal VPS catheter through the natural orifices is more common.

…”

mentioning

confidence: 99%

Extrusion of the distal ventriculoperitoneal shunt catheter through the umbilicus: a systematic literature review from 1973 to 2021

Ghritlaharey

2021

Int Surg J

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Trans-umbilical extrusion of the distal ventriculoperitoneal shunt catheter is a rare complication of the VPS insertion. The objectives of this review were to analyze various variables like the age, sex, indication for VPS insertion, clinical presentation, the operative therapy offered for the management, and outcome of the cases published/managed for the trans-umbilical extrusion of the distal VPS shunt catheter. In 1973, the maiden case of trans-umbilical extrusion of the distal VPS catheter was published. Literature/case reports were retrieved from 1973 to October 31, 2021. A total of n=24 (12 males, 12 females) cases were recruited for this systematic review. All of them were children below the age of 13-years. In four-fifths (n=19) of children, the initial VPS catheter was inserted during the first 6-months of life. The median age of children at the time of diagnosis of the above-described VPS complication was 7.5 (42.21 SD) months, and it ranged from 2 months to 13 years of age. The median interval from the initial VPS insertion/last VPS revision to the diagnosis of complication was 4 (24.77 SD) months, and it ranged from 3 weeks to 8 years. The main complaint was the extrusion of the distal VPS catheter through the umbilicus. Surgical procedures performed for the management were (a) removal of the entire VPS catheter n=15, (b) removal of distal/part of distal VPS catheter n=5, and (C) others n=2. For VPS catheter revision; delayed re-VPS insertion was performed in n=10, immediate revision of the distal VPS catheter in n=3, and others. Three (12.5%) children died during the postoperative and follow-up period. The distal VPS catheter extrusion through the umbilicus is a rare complication of VPS insertion, and it occurred exclusively in children. In 70% (n=17) of children, it was documented ≤6 months afterward of the VPS insertion. Delayed re-VPS catheter insertion was preferred for 40% of the children for VPS revision procedures.

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Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement and Reduction in Operative Time and Total Hospital Charges

Cited by 22 publications

References 12 publications

Laparoscopic Co-surgeon Ventriculoperitoneal Shunt Placement Versus Single Surgeon Mini Laparotomy

Laparoscopic Co-surgeon Ventriculoperitoneal Shunt Placement Versus Single Surgeon Mini Laparotomy

Laparoscopic‐Assisted Ventriculoperitoneal Shunt Placement: A Less Invasive Approach to Treating Hydrocephalus

Extrusion of the distal ventriculoperitoneal shunt catheter through the umbilicus: a systematic literature review from 1973 to 2021

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