Laparoscopy-Assisted Abdominal Shunt Revisions in Children with Hydrocephalus

摘要

After placement of ventriculoperitoneal shunts in children with hydrocephalus, revisions are often necessary. We investigated the efficacy of a video-assisted laparoscopic technique for abdominal shunt revisions.Among 1894 patients requiring revisions of shunts from 1960 to 1998, 31 seen between June 1996 and December 1998 were treated laparoscopically.Laparoscopy enabled inspection of the abdominal cavity, assessment of the peritoneum, identification of pseudocyts, and localization of the peripheral end of the catheter. Additionally, riskless implantation of a new extended catheter was possible using the Seldinger technique. Completely dislocated catheters could be removed. The laparoscopic method provides simple handling, excellent intra-abdomi-nal views, short operation time, and, especially in obese patients, good cosmetic results. The hospitalization time also can be reduced.