Related Experiment Video
Updated: Aug 24, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
The incidence of inguinal complications after ventriculoperitoneal shunt for hydrocephalus
Ahmet Celik1, Orkan Ergün, M Surhan Arda
1Department of Paediatric Surgery, Faculty of Medicine, Ege University, 35100 Bornova, Izmir, Turkey. celika@med.ege.edu.tr
Insights
Infants undergoing ventriculoperitoneal (VP) shunt procedures face a significant risk of acquired clinical inguinal manifestations (CIM). Younger age at VP shunt placement correlates with higher CIM incidence, suggesting fluid accumulation and processus vaginalis patency contribute.
Area of Science:
- Pediatric Surgery
- Pediatric Urology
- Clinical Research
Background:
- Ventriculoperitoneal (VP) shunts are common for hydrocephalus treatment in infants.
- Acquired clinical inguinal manifestations (CIM) are a potential complication.
- Understanding CIM incidence and mechanisms is crucial for patient management.
Purpose of the Study:
- To determine the incidence of acquired clinical inguinal manifestations (CIM) in infants after VP shunt procedures.
- To explore potential mechanisms contributing to CIM development in this population.
Main Methods:
- Retrospective chart review of pediatric patients who underwent VP shunt procedures (1992-2002).
- Telephone interviews and outpatient clinic examinations to assess for groin manifestations.
- Analysis of patient demographics, age at surgery, and manifestation details.
Main Results:
- Twenty-one out of 88 (23.8%) patients developed CIM, with most diagnosed within 5.3 months post-procedure.
- Higher CIM incidence observed in infants aged 0-12 months at the time of VP shunt placement.
- Seventy-six percent had bilateral processus vaginalis patency, and 20% of CIM were bilateral.
Conclusions:
- Younger age at VP shunt surgery is linked to increased CIM incidence.
- Increased intra-abdominal fluid and processus vaginalis patency are likely contributing factors.
- Consideration for bilateral repair and careful surgical technique is recommended due to recurrence risk.
Aim:
This study outlines the incidence of acquired clinical inguinal manifestations (CIM) in infants undergoing ventriculoperitoneal (VP) shunt procedures, and the possible underlying mechanisms in the development of these pathologies.
Material And Methods:
The charts of children who had undergone VP shunt procedures for hydrocephalus between 1992 and 2002 were reviewed. All patients were contacted by a telephone interview, and they were invited to be examined in the outpatient clinic of paediatric surgery for the development of groin manifestation.
Results:
Eighty-eight patients responded to the inquiry. Twenty-one (23.8%) patients developed a CIM. Three of them were premature infants. The mean interval between the shunt procedure and the diagnosis of CIM was 5.3 months (20 days to 48 months). Nineteen of the patients who developed a CIM were in the 0- to 12-month age group when the VP shunt procedures were initially performed. Ten CIM occurred on the right (47%), 7 on the left (33%) and 4 were bilateral (20%). The rate of bilateral patency as an operative finding was 76%. There was one recurrence (4.8%).
Conclusion:
The younger the age at which the VP shunt was performed, the higher the incidence of CIM. Bilateral manifestations were higher than in the normal population. Increased intra-abdominal pressure by accumulation of fluid in combination with the high patency rate of processus vaginalis possibly plays a role in the development of CIM in VP shunt patients. Bilateral repair should be considered even when CIM is unilateral. Special care should be given to repair procedures since the recurrence rate is relatively high.
