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Updated: Jun 4, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Transumbilical approach for ventriculoperitoneal shunt placement in infants and small children: a 6-year experience
R Shane Tubbs1, Lilian C Azih, Martin M Mortazavi
1Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South, Birmingham, AL 35233, USA. shane.tubbs@chsys.org
Insights
Transumbilical incision for ventriculoperitoneal shunt placement offers improved cosmesis and is effective. This technique resulted in a low complication rate and zero infections in pediatric patients.
Area of Science:
- Pediatric Neurosurgery
- Surgical Innovation
- Hydrocephalus Management
Background:
- Ventriculoperitoneal shunts are crucial for treating hydrocephalus.
- Transumbilical incisions have shown potential for improved cosmetic outcomes in shunt placement.
- This study evaluates the efficacy and safety of the transumbilical approach for peritoneal shunt insertion.
Purpose of the Study:
- To assess the effectiveness and cosmetic benefits of using a transumbilical incision for ventriculoperitoneal shunt placement.
- To compare complication rates associated with the transumbilical approach versus traditional incisions.
- To evaluate the safety and feasibility of this minimally invasive technique in pediatric patients.
Main Methods:
- A prospective cohort study involving 25 pediatric patients (17 boys, 8 girls) aged 6 days to 5 years.
- Ventriculoperitoneal shunt placement with peritoneal catheter insertion via a transumbilical incision.
- Prospective data collection on complications, infections, and follow-up duration.
Main Results:
- Mean follow-up duration was 3.2 years (range 2 months to 6 years).
- A single complication (4%) occurred, with no long-term sequelae.
- The infection rate was 0% in this cohort.
Conclusions:
- Transumbilical incision for ventriculoperitoneal shunt placement is an effective and cosmetically superior technique.
- This approach is associated with low complication and infection rates, comparable to standard abdominal incisions.
- The transumbilical method is quick, minimally bloody, and yields no long-term complications.
Introduction:
Improved cosmesis has been demonstrated using a transumbilical incision for placement of the peritoneal end of a ventriculoperitoneal shunt. We now present our experience with this technique.
Patients And Methods:
From January 2005 until present, a prospective cohort of 25 children underwent placement of a ventriculoperitoneal shunt with the peritoneal shunt catheter being introduced into the peritoneum via an incision into the umbilicus. There were 17 boys and 8 girls. The age range at insertion was 6 days to 5 years (mean 1.2 years).
Results:
The mean follow-up for this group was 3.2 years (range 2 months to 6 years). Of all patients, only one complication (4%) has occurred, although this did not lead to long-term issues. The infection rate for this small group was 0%.
Conclusions:
Placement of the peritoneal end of a ventriculoperitoneal shunt via an umbilical incision is effective, cosmetically appealing, and not more prone to complications than other standard incisions used on the anterior abdominal wall. Additionally, and based on our experience, this approach is quicker and almost bloodless with no long-term complications.
