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Updated: Jul 16, 2026
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Salvaging the "lost peritoneum" after ventriculoatrial shunt failures
R Rick Bhasin1, Mike K Chen, David W Pincus
1Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Summary
Ventriculoatrial (VA) shunt failure can be challenging, but converting back to ventriculoperitoneal (VP) shunts is possible. Diagnostic laparoscopy or laparotomy helps identify suitable peritoneal sites for VP shunt placement, avoiding further VA shunt issues.
Area of Science:
- Neurosurgery
- Pediatric Surgery
Background:
- Ventriculoperitoneal (VP) shunts are standard for hydrocephalus treatment.
- Repeated distal failures of VP shunts may lead to ventriculoatrial (VA) shunt placement.
- Finding new distal sites for shunts becomes difficult after VA shunt failure.
Observation:
- Six patients underwent successful conversion from VA to VP shunts over three years.
- Diagnostic laparoscopy or laparotomy was utilized to facilitate the conversion process.
- No shunt failures were observed during the mean 1.5-year follow-up period.
Findings:
- Laparotomy or laparoscopy is effective in locating suitable peritoneal targets for distal catheter placement.
- This surgical approach aids in converting VA shunts to VP shunts after prior VA shunt failure.
- It serves as a final option before considering VA shunt conversion.
Implications:
- Preserving the peritoneum for VP shunt placement is crucial due to its advantages over VA shunts.
- Surgical exploration can salvage the peritoneal cavity for future VP shunt use.
- This method offers a viable solution for complex shunt revision cases.
