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Infertility and ventriculoperitoneal shunt.

Amr Azim¹, Mohammad Ashraf, Mostafa I Abuzeid

¹IVF Michigan, Flint and Rochester Hills, Michigan 48503, USA.

The Journal of the American Association of Gynecologic Laparoscopists

|April 24, 2004

Summary

A ventriculoperitoneal shunt may indicate a higher risk during laparoscopy due to extensive peritoneal adhesions. This surgical history should be considered a contraindication for the procedure.

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Area of Science:

Reproductive Medicine
Neurosurgery
Surgical Procedures

Background:

Ventriculoperitoneal shunts are neurosurgical devices used to treat hydrocephalus.
Laparoscopy is a minimally invasive surgical technique used for gynecological and abdominal evaluations.
Primary infertility affects women without a prior history of pregnancy.

Observation:

Two women with primary infertility presented with a history of ventriculoperitoneal shunt placement.
Both patients underwent laparoscopy, revealing extensive peritoneal adhesions.
These adhesions obscured visualization of pelvic organs and elevated the risk of bowel injury.

Findings:

Extensive peritoneal adhesions were observed in both patients with ventriculoperitoneal shunts.

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The adhesions significantly hindered pelvic organ evaluation during laparoscopy.

A heightened risk of iatrogenic bowel injury was noted due to the adhesions.

Implications:

A history of ventriculoperitoneal shunt placement should be carefully considered in the pre-operative assessment for laparoscopy.
Laparoscopy may pose increased risks for patients with ventriculoperitoneal shunts due to potential adhesions.
Further research is warranted to explore alternative diagnostic or surgical approaches for these patients.