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Updated: Jun 21, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
The safety of laparoscopy in pediatric patients with ventriculoperitoneal shunts
Jason D Fraser1, Pablo Aguayo, Susan W Sharp
1Department of Surgery, The Children's Mercy Hospital, Kansas City, Missouri, USA.
Insights
Laparoscopy is safe for pediatric patients with ventriculoperitoneal (VP) shunts undergoing abdominal surgery. This study found no increased risk of complications compared to open procedures, supporting its use.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Minimally Invasive Surgery
Background:
- Ventriculoperitoneal (VP) shunts for hydrocephalus are common in pediatric patients undergoing abdominal operations.
- Limited data exist on the safety and long-term function of VP shunts during laparoscopic abdominal procedures.
- Concerns include insufflation pressure effects on shunts.
Purpose of the Study:
- To evaluate the safety of laparoscopic versus open abdominal surgery in pediatric patients with VP shunts.
- To compare complication rates and shunt function between laparoscopic and open approaches.
Main Methods:
- Retrospective review of 99 pediatric patients with VP shunts undergoing abdominal operations (1998-2008).
- Comparison of laparoscopic (n=51) versus open (n=48) procedures.
- Complications defined as shunt- or surgery-related events within 6 months; statistical analysis using t-tests and Fisher's exact test.
Main Results:
- No episodes of air embolism into the shunt were observed in either group.
- Shunt infection rates were low and not significantly different (1 in laparoscopic vs. 3 in open; P=0.56).
- The most common procedure was fundoplication with gastrostomy in both groups.
Conclusions:
- Laparoscopic abdominal surgery appears to be safe in pediatric patients with VP shunts.
- The findings suggest no increased risk of shunt-related complications with laparoscopy.
Introduction:
In pediatric patients requiring abdominal operations, ventriculoperitoneal (VP) shunts for hydrocephalus are a frequently encountered comorbidity. Laparoscopy has not been extensively evaluated in this population, and there are concerns about the safety of insufflation under pressure with the shunt in place. There are a paucity of data in the literature to address this issue. Further, there is a relative lack of long-term follow-up in the literature to document shunt function over time after abdominal procedures. Therefore, we reviewed our experience in patients with VP shunts who underwent either open or laparoscopic abdominal procedures to determine the safety of laparoscopy in these patients.
Methods:
We conducted a retrospective review of all pediatric patients with VP shunts who underwent laparoscopic and/or open abdominal operations at a single institution from 1998 to 2008. Complications were defined as a shunt- or surgery-related event (including any shunt revisions) within 6 months of abdominal surgery. Continuous variables were compared by using an independent sampled, two-tailed Student's t-test. Discrete variables were analyzed with Fisher's exact test with Yates correction, where appropriate. Significance was defined as P < or = 0.05.
Results:
A total of 99 intra-abdominal operations were performed on patients with VP shunts: 51 were laparoscopic and 48 were open. Mean age was 3.17 versus 2.93 years, respectively (P = 0.77). The most common procedure performed in both groups was fundoplication with gastrostomy. There were no episodes of air embolism into the shunt. There was 1 shunt infection in the laparoscopic group and 3 in the open group (P = 0.56).
Conclusions:
Our data suggest that laparoscopy is safe in patients with ventriculoperitoneal shunts.
