Transumbilical approach for ventriculoperitoneal shunt placement in infants and small children: a 6-year experience

Tubbs, R. Shane; Azih, Lilian C.; Mortazavi, Martin M.; Chern, Joshua J.; Hankinson, Todd C.; Oakes, W. Jerry; Cohen-Gadol, Aaron

doi:10.1007/s00381-011-1403-3

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…However, direct placement of ventriculoperitoneal shunts has recently been performed at various sites, including our hospital, with good success and no greater complications than with other traditional access points into the peritoneum [3,9]. Additionally, patients were not subjected to 2 different surgeries and anesthesias and the potential risks associated with these.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of such an approach include easy passage into the peritoneum, sparing the transrectus approach with a subsequent reduction in postoperative pain and decreased intraoperative blood loss by avoiding the abdominal wall [2,3]. This approach also minimizes injuries to nerves and arteries, and it avoids muscular dissection and the potential for subsequent muscle atrophy.…”

Section: Introductionmentioning

confidence: 99%

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Simultaneous Umbilical Hernia Repair with Transumbilical Ventriculoperitoneal Shunt Placement

Montalbano

Loukas²,

Oakes³

et al. 2017

Pediatr Neurosurg

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Introduction: Recently, placement of a ventriculoperitoneal shunt via a transumbilical approach has been reported. Patients and Methods: Herein, we report the repair of an umbilical hernia via the same incision and introduction of the distal end of a ventricultoperitoneal shunt into the peritoneal cavity in 3 patients. A case illustration is included. Results: Both hernia repair and placement of the distal end of the ventriculoperitoneal shunt were uncomplicated in our small case series. Conclusions: To our knowledge, simultaneous repair of an umbilical hernia followed by transumbilical shunt placement has not been reported. As umbilical hernias are so common in infants, this finding, based on our experience, should not exclude placement of peritoneal tubing in the same setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Simultaneous Umbilical Hernia Repair with Transumbilical Ventriculoperitoneal Shunt Placement

Montalbano

Loukas²,

Oakes³

et al. 2017

Pediatr Neurosurg

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“…Given that patients who undergo shunt placement are living longer and distal revisions are less common than proximal revisions, minimally invasive approaches to the peritoneum are preferred for cosmetic reasons and are increasingly being used. 6,18,19 Several groups have reported less invasive approaches using laparoscopy for placement of the peritoneal portion of a VP shunt. 1,9,[18][19][20] The purported advantages of this technique are increased visualization to ensure correct placement of the distal catheter, decreased blood loss, shorter operative time, and minimal scar formation.…”

mentioning

confidence: 99%

“…6,18,19 Several groups have reported less invasive approaches using laparoscopy for placement of the peritoneal portion of a VP shunt. 1,9,[18][19][20] The purported advantages of this technique are increased visualization to ensure correct placement of the distal catheter, decreased blood loss, shorter operative time, and minimal scar formation. 18,19 Object.…”

mentioning

confidence: 99%

“…1,9,[18][19][20] The purported advantages of this technique are increased visualization to ensure correct placement of the distal catheter, decreased blood loss, shorter operative time, and minimal scar formation. 18,19 Object. The aim of this study was to examine the feasibility and safety of ventriculoperitoneal (VP) shunt placement using a periumbilical approach for distal peritoneal access.…”

mentioning

confidence: 99%

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The periumbilical approach in ventriculoperitoneal shunt placement: technique and long-term results

Recinos

Pindrik²,

Bedri

et al. 2013

PED

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Object The aim of this study was to examine the feasibility and safety of ventriculoperitoneal (VP) shunt placement using a periumbilical approach for distal peritoneal access. By using this minimally invasive approach, the authors hypothesized that the cosmetic outcomes would be better than could be achieved by using a traditional minilaparotomy and that clinical results would be comparable. Methods A periumbilical approach was used for distal catheter insertion during a first-time VP shunt placement in 20 patients (8 males and 12 females). Median age at time of surgery was 3.0 months (range 7 days–11.9 years) and mean follow-up time was 17.8 months (range 1.2–28.0 months). The median weight of the patients was 3.99 kg (range 1.95–57.0 kg). A single incision was made along the natural crease inferior to the umbilicus. The linea alba was exposed and a 1-mm incision made while the patient was temporarily held in a Valsalva maneuver. A peritoneal trocar was then inserted through the fascial incision and the distal catheter was passed into the peritoneal space. Results The incision line in all patients healed well, did not require operative revision, and was described as minimally visible by the patients' families. Mean operative time was 35 minutes. Eight patients required revision surgery. One distal failure occurred when the distal shunt tubing retracted and became coiled in the neck; this was repaired by conversion to a minilaparotomy for distal replacement. There was 1 shunt infection (5%) requiring shunt removal and replacement. One patient had significant skin thinning around the valve and proximal catheter, which required replacement of the entire shunt system, and another patient underwent a conversion to a ventriculoatrial shunt due to poor peritoneal absorption. In the remaining 4 patients who required operative revision, the peritoneal portion of the shunt was not involved. Conclusions The periumbilical approach for peritoneal access during VP shunt placement is technically feasible, has low infection rates, and has cosmetically appealing results. It may be considered as an alternative option to standard VP shunt placement techniques.

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How to Perform a V-P CSF Shunt?

Scavarda¹,

Choux²

2018

Textbook of Pediatric Neurosurgery

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Transumbilical approach for ventriculoperitoneal shunt placement in infants and small children: a 6-year experience

Cited by 5 publications

References 6 publications

Simultaneous Umbilical Hernia Repair with Transumbilical Ventriculoperitoneal Shunt Placement

Simultaneous Umbilical Hernia Repair with Transumbilical Ventriculoperitoneal Shunt Placement

The periumbilical approach in ventriculoperitoneal shunt placement: technique and long-term results

How to Perform a V-P CSF Shunt?

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