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Updated: Jul 27, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Long-term risks and benefits of a separate CSF access device with ventriculoperitoneal shunting in childhood
T Y M Lo1, L M Myles, R A Minns
1Department of Paediatric Neuroscience, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
Insights
Adding a separate cerebrospinal fluid (CSF) reservoir to shunts for hydrocephalus in children significantly reduces complications like ventriculitis and shunt blockage, offering a safe long-term management option.
Area of Science:
- Pediatric Neurosurgery
- Neurological Surgery
- Medical Device Management
Background:
- Hydrocephalus is a common neurological condition in children requiring cerebrospinal fluid (CSF) shunting.
- Shunted hydrocephalus management presents long-term challenges including shunt failure and central nervous system (CNS) infections.
- The efficacy and safety of separate CSF reservoirs in pediatric hydrocephalus management require long-term evaluation.
Purpose of the Study:
- To assess the long-term risks and benefits of incorporating a separate CSF reservoir in pediatric hydrocephalus management.
- To compare complication rates and clinical outcomes between shunted hydrocephalus with and without a reservoir.
- To evaluate the utility of CSF reservoirs for diagnostic and therapeutic access.
Main Methods:
- Retrospective study design involving 52 children with shunted hydrocephalus.
- Comparison of outcomes between a period with reservoir insertion and a pre-reservoir control period.
- Long-term follow-up data analysis for shunt-related complications and clinical outcomes.
Main Results:
- No mortality attributed to shunt failure or CNS infection was observed.
- Significantly fewer episodes of ventriculitis (p < 0.01) and shunt blockage (p < 0.0001) were recorded with reservoir use.
- No adverse events such as hemiplegia, epilepsy, or visual/cognitive loss were associated with the reservoir.
Conclusions:
- A separate CSF reservoir is a valuable tool for the long-term management of pediatric shunted hydrocephalus.
- The use of CSF reservoirs does not increase mortality or significant morbidity.
- Reservoirs provide effective access for diagnosis and treatment of complications in shunted hydrocephalus patients.
Abstract:
To determine the long-term risks and benefits of a separate CSF reservoir in the management of 52 children (23 males, 29 females) with shunted hydrocephalus, a retrospective study was performed comparing the use and complications after separate reservoir insertion, with a prereservoir control period. Median age at first shunt insertion was 1 month and median age at reservoir insertion was 2 years 6 months. Median follow-up for shunt with the additional reservoir was 19 years 1 month. There was no mortality due to shunt failure nor CNS infection, and there were significantly fewer episodes of ventriculitis (p < 0.01) and shunt blockage (p < 0.0001) compared with the prereservoir period. There was no hemiplegia, epilepsy, visual, nor cognitive loss from the additional reservoir. The reservoir was used for access in 344 attendances (mean 6.62 attendances per patient) for diagnosis or treatment of raised pressure or CNS infection. It was concluded that a separate CSF reservoir is useful in the long-term management of patients with shunted hydrocephalus and is without mortality or significant increased morbidity.
