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Updated: Jul 10, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Simultaneous endoscopic third ventriculostomy and ventriculoperitoneal shunt for infantile hydrocephalus
Kyu-Won Shim1, Dong-Seok Kim, Joong-Uhn Choi
1Department of Neurosurgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
Simultaneous endoscopic third ventriculostomy and ventriculoperitoneal shunt (ETV/VPS) implantation offers a higher success rate for infant hydrocephalus compared to VPS alone. This combined approach may be the preferred treatment for infants under one year old.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Technology
Background:
- Hydrocephalus is a common condition in infants requiring surgical intervention.
- Ventriculoperitoneal shunts (VPS) and endoscopic third ventriculostomy (ETV) are established treatments.
- Simultaneous ETV and VPS implantation is a less commonly studied approach.
Purpose of the Study:
- To compare the effectiveness of simultaneous ETV and VPS implantation versus VPS alone in infants with hydrocephalus.
- To evaluate shunt success rates and complication profiles for both treatment modalities.
Main Methods:
- Retrospective analysis of 111 hydrocephalic infants treated between 1995 and 2006.
- Comparison of a group undergoing simultaneous ETV and VPS (31 infants) with a group undergoing VPS only (45 infants).
- Assessment of pre- and postoperative ventricular index, shunt failure rates, and complications over a mean follow-up of 53.23 to 75.98 months.
Main Results:
- The simultaneous ETV plus VPS group demonstrated a higher success rate (83.9%) compared to the VPS only group (68.9%).
- The ETV plus VPS group experienced fewer complications, including infections and shunt obstructions.
- Both groups showed statistically significant improvement in the ventricular ratio post-surgery.
Conclusions:
- Simultaneous ETV and VPS implantation is a more effective treatment for infant hydrocephalus than VPS alone.
- This combined procedure is recommended as a first-line treatment for hydrocephalic infants under one year of age.
Objective:
We analyzed a series of consecutive hydrocephalic infants treated with implantation of a ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV) simultaneously.
Materials And Methods:
Between 1995 and 2006, we treated the 111 hydrocephalic infants. Among those patients, 31 infants underwent VPS and ETV simultaneously, and 45 patients underwent only VPS. The ETV plus VPS group had 17 males and 14 females with a mean age of 6.32 months. The VPS only group consisted of 25 males and 20 females with a mean age of 4.43 months. There was no difference in etiology of hydrocephalus or clinical characteristics between the two groups. We compared shunt effectiveness by calculating the pre- and postoperative ventricular index and shunt failure rates during the follow-up period between the two groups. The follow-up period ranged from 6 to 140 months (mean, 53.23 months) in the ETV plus VPS group and from 6 to 148 months (mean, 75.98 months) in the VPS only group. The success rate was 83.9% (26 of 31) in the ETV plus VPS group and 68.9% (31 of 45) in the VPS only group. There were three infections and two shunt obstructions in the ETV plus VPS group versus eight obstructions, five infections, and one overdrainage in the VPS group. The preoperative and postoperative ventricular ratio of both groups showed statistically significant change (P < 0.000).
Conclusion:
This simultaneous procedure could be the first choice of action for the hydrocephalic patients less than 1 year old.
