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Laparoscopic procedures in adults with ventriculoperitoneal shunts
Faisal Al-Mufarrej1, Colum Nolan, Shastri Sookhai
1Department of Surgery, Beaumont Hospital, Dublin 9, Ireland.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|February 17, 2005
Summary
Laparoscopic surgery is safe for patients with a ventriculoperitoneal shunt (VPS). Careful management allows for procedures like laparoscopic cholecystectomy without complications, challenging previous contraindications.
Area of Science:
- Neurosurgery
- Gastrointestinal Surgery
Background:
- Ventriculoperitoneal shunts (VPS) were historically considered absolute contraindications for laparoscopic procedures.
- Intraabdominal insufflation can increase intracranial pressure (ICP), risking hindbrain herniation.
Observation:
- Studies conflict on the necessity of VPS catheter clamping during laparoscopy.
- Some evidence suggests laparoscopy is safe with routine monitoring only.
- Retrograde valve failure risk is minimal even at high intraabdominal pressures.
Findings:
- This case report details the successful management of a hydrocephalic adult with a VPS undergoing laparoscopic cholecystectomy.
- The experience highlights safe anesthetic and surgical techniques for this patient population.
Implications:
- Laparoscopic surgery may be feasible for patients with VPS, expanding surgical options.
- Further research and clinical experience can refine management protocols for these complex cases.