Surgical technique for preventing subcutaneous migration of distal lumboperitoneal shunt catheters

Kawahara, Takashi; Tokimura, Hiroshi; Higa, Nayuta; Hirano, Hirofumi; Bohara, Manoj; Hanaya, Ryosuke; Takasaki, Koji; Atsuchi, Masamichi; Yamahata, Hitoshi; Arita, Kazunori

doi:10.1515/ins-2013-0016

Cited by 8 publications

(9 citation statements)

References 5 publications

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“…Moreover, Kawahara et al . [ 13 ] performed LPS using local anesthesia on elderly patients and suggested that LPS is possible with local anesthesia. Our case experience suggests the possibility of using a TAP block for LPS in terms of postoperative quick pain reduction.…”

Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block for lumboperitoneal shunt surgery in idiopathic normal pressure hydrocephalus: a case report

Cho

Yeo

Chang

et al. 2021

Journal of Surgical Case Reports

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The transversus abdominis plane (TAP) block is an ideal pain control method used in surgeries that require abdominal wall incisions through the injection of an anesthetic solution into the plane between the internal oblique muscle and transversus abdominis muscle. Herein, we report an 83-year-old man who was diagnosed with idiopathic normal pressure hydrocephalus (iNPH) and underwent lumboperitoneal shunt surgery (LPS). The TAP block was performed before LPS, and the numerical rating scale for pain was 0 at day 1 after the surgery. The patient was discharged early at day 3 after surgery despite the patient being extremely old, as he reported quick relief from the postoperative abdominal pain. The TAP block can hence be considered for use before LPS in elderly patients with iNPH.

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Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block for lumboperitoneal shunt surgery in idiopathic normal pressure hydrocephalus: a case report

Cho

Yeo

Chang

et al. 2021

Journal of Surgical Case Reports

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“…There have been reports about the migration of peritoneal catheters of VP or LP shunt to various sites including subcutaneous space, sigmoid colon, intestine, stomach, and heart. [ 1 2 5 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…One month later, he underwent the VP shunt surgery, and peritoneal catheter was placed in the pelvic cavity using the method previously reported. [ 5 ]…”

Section: Case Reportmentioning

confidence: 99%

Intra-bronchial migration of peritoneal catheter of lumboperitoneal shunt

Kawahara¹,

Yanagi²,

Hirano³

et al. 2015

Surg Neurol Int

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Background:A rare case of intra-bronchial migration of peritoneal catheter of lumboperitoneal (LP) shunt was treated under the bronchoscopic and fluoroscopic observation.Case Description:A 71-year-old man, who underwent LP shunt installation due to idiopathic normal pressure hydrocephalus a year before, presented with history of high fever and sputum production. Roentgenography and computed tomography of the chest revealed migration of distal end of the peritoneal catheter into the left main bronchus. Migrated catheter was gently extracted through the abdominal wound incision under the bronchoscopic and fluoroscopic observation. Contrast material infused into the catheter did not spread into the pleural cavity. The patient was free of the symptoms within 2 postoperative weeks. Moreover, he underwent the ventriculo-peritoneal shunt surgery 1-month later.Conclusion:This is the first case of the migration of peritoneal catheter of LP shunt into the main bronchus.

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“…All 45 patients had an LPS under neuroleptanalgesia and local anesthesia with a minimally invasive technique as previously reported. [ 10 , 12 ] In this series, a pressure programmable valve equipped with an anti-siphon device (CERTAS Plus, Codman, NJ, USA) was used. The valve was initially set at the highest opening pressure: 40 cm H 2 O or more, higher than those set in the past randomized trial and large case series.…”

Section: Methodsmentioning

confidence: 99%

Dural sac shrinkage signs on spinal magnetic resonance imaging indicate overdrainage after lumboperitoneal shunt for idiopathic normal pressure hydrocephalus

Kawahara

Atsuchi

Arita

et al. 2022

Surgical Neurology International

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Background: We previously found the usefulness of dural sac shrinkage signs (DSSSs), which are the anterior shift of the spinal cord and dura mater behind the cord, detected by magnetic resonance imaging (MRI) at the thoracic level for the diagnosis of spontaneous intracranial hypotension (IH). This is a retrospective survey on the usefulness of DSSSs for the early detection of iatrogenic IH caused by overdrainage through a lumboperitoneal shunt (LPS) for patients with idiopathic normal pressure hydrocephalus (INPH). Methods: Forty-five INPH patients had an LPS using a pressure programmable valve equipped with an anti-siphon device. Results: Nine patients complained of orthostatic headache after the LPS, indicating IH due to overdrainage, which persisted for more than a week in three patients and 2–7days in six patients. The headache was transient/ nonorthostatic in ten patients and absent in 26 patients. The DSSSs and accompanying enlargement of the venous plexus were observed in all three patients with prolonged orthostatic headaches. Only the anterior shift of the dura mater was observed in 1 (4%) among 25 patients who had short-term orthostatic headache, transient/ nonorthostatic headache, or absent headache, and underwent spinal MRI. A patient with prolonged severe orthostatic headache with both DSSSs eventually developed intracranial subdural effusion and underwent tandem valve surgery, which provided a quick improvement of symptoms. The DSSSs on thoracic MRI also disappeared promptly. Conclusion: DSSSs may serve as objective signs for the diagnosis of IH due to overdrainage through an LPS for INPH.

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Surgical technique for preventing subcutaneous migration of distal lumboperitoneal shunt catheters

Cited by 8 publications

References 5 publications

Transversus abdominis plane block for lumboperitoneal shunt surgery in idiopathic normal pressure hydrocephalus: a case report

Transversus abdominis plane block for lumboperitoneal shunt surgery in idiopathic normal pressure hydrocephalus: a case report

Intra-bronchial migration of peritoneal catheter of lumboperitoneal shunt

Dural sac shrinkage signs on spinal magnetic resonance imaging indicate overdrainage after lumboperitoneal shunt for idiopathic normal pressure hydrocephalus

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