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Updated: Jun 16, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Laparoscopic treatment of abdominal complications following ventriculoperitoneal shunt
Florian Popa1, Valentin Titus Grigorean, Gelu Onose
1St. Pantelimon Clinical Emergency Hospital, Department of General Surgery, Bucharest, Romania.
Insights
Laparoscopic surgery effectively treats abdominal complications from ventriculoperitoneal shunts, including catheter migration and infections. In some cases, conversion to a ventriculocardiac shunt is necessary for optimal patient outcomes.
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
- Pediatric Surgery
Background:
- Ventriculoperitoneal (VP) shunts are crucial for managing hydrocephalus.
- Abdominal complications can arise from VP shunt placement, necessitating surgical intervention.
- Laparoscopic techniques offer a minimally invasive approach to address these complications.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic treatment for abdominal complications following VP shunt placement.
- To analyze the types of complications encountered and their management strategies.
Main Methods:
- Retrospective study of 17 patients with VP shunt-related abdominal complications treated laparoscopically between 2000 and 2007.
- Data collected included patient demographics, complication types, laparoscopic procedures performed, and outcomes.
- Complications analyzed: shunt disconnection, infections, pseudocysts, CSF ascites, inguinal hernia, and shunt malfunction.
Main Results:
- Shunt disconnection with catheter migration was the most common complication (47.05%).
- Laparoscopic interventions included catheter repositioning, infection management (abscess/peritonitis), and shunt revision.
- No conversions to open surgery were required; overall mortality was 5.88% and morbidity 11.76%.
Conclusions:
- Laparoscopic surgery is a safe and effective treatment for abdominal complications of VP shunts.
- Repositioning of the distal catheter, sometimes as a ventriculocardiac shunt, is frequently required.
- Certain complications like peritoneal irritation syndrome and CSF ascites may not require surgical intervention.
Unlabelled:
The aim of this study is the evaluation of laparoscopic treatment in abdominal complications following ventriculoperitoneal (VP) shunt.
Methods:
We report a retrospective study including 17 patients with abdominal complications secondary to VP shunt for hydrocephalus, laparoscopically treated in our department, between 2000 and 2007.
Results:
Patients' age ranged from 1 to 72 years old (mean age 25.8 years old). Male: female ratio was 1.4. Abdominal complications encountered were: shunt disconnection with intraperitoneal distal catheter migration 47.05% (8/17), infections 23.52% (4/17) such as abscesses and peritonitis, pseudocysts 11.76% (2/17), CSF ascites 5.88% (1/17), inguinal hernia 5.88% (1/17), and shunt malfunction due to excessive length of intraperitoneal tube 5.88% (1/17). Free-disease interval varies from 1 day to 21 years, depending on the type of complication, short in peritoneal irritation syndrome and abscesses (days) and long in ascites, pseudocysts (months-years). Laparoscopic treatment was: extraction of the foreign body in shunt disconnection with intraperitoneal distal catheter migration, evacuation, debridement, lavage and drainage for pseudocysts, abscess and peritonitis, shortening of the tube in shunt malfunction due to excessive length of intraperitoneal tube and hemioraphy. One diagnostic laparoscopy was performed in a peritoneal irritation syndrome, which found only CSF ascites. There were no conversions to open surgery. The overall mortality was of 5.88% and postoperative morbidity was of 11.76%. In 7 patients operated for abscesses, peritonitis, pseudocysts, and CSF ascites the shunting system was converted in to a ventriculocardiac shunt.
Conclusions:
Abdominal complication following VP shunt can be successfully performed laparoscopically. Abdominal surgery required, in selected cases, the repositioning of the distal catheter, frequently as a ventriculocardiac shunt. There are abdominal complications with no indication of surgery, like peritoneal irritation syndrome and CSF ascites. Free-disease interval varies from days (peritoneal irritation syndrome, abscesses) to month-years (pseudocyst, ascites), according to type of complication.
