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Updated: May 28, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Management of ventriculo-peritoneal shunts in the paediatric population
David Low1, James M Drake, Wan Tew Seow
1Department of Neurosurgery, National Neuroscience Institute, Singapore.
Insights
Pediatric hydrocephalus treatment involves shunts, but failures are common. Endoscopic procedures offer a potential alternative to Ventriculoperitoneal Shunts (VPS) for improved outcomes.
Area of Science:
- Neuroscience
- Pediatric Neurosurgery
- Medical Devices
Background:
- Hydrocephalus significantly impacts pediatric patients' quality of life.
- Shunt devices improve survival but have high failure rates (40-50% within 2 years).
- Common shunt failures include obstruction, misplacement, infection, and over drainage.
Purpose of the Study:
- To discuss challenges in treating pediatric hydrocephalus.
- To review Ventriculoperitoneal Shunts (VPS) in pediatric hydrocephalus management.
- To explore endoscopic procedures as an alternative to VPS.
Main Methods:
- Literature review on pediatric hydrocephalus treatment.
- Analysis of shunt dysfunction common in pediatric neurosurgery.
- Comparison of VPS and endoscopic third ventriculostomy (ETV) for hydrocephalus.
Main Results:
- Shunt dysfunction remains a major challenge in pediatric hydrocephalus.
- Various pathologies contribute to hydrocephalus in children.
- Endoscopic procedures present a viable alternative to traditional shunting.
Conclusions:
- Effective management of pediatric hydrocephalus requires addressing shunt failures.
- Understanding shunt failure nuances is crucial for neurosurgeons.
- Endoscopic techniques offer a promising alternative or adjunct to VPS in pediatric hydrocephalus.
Abstract:
The treatment of hydrocephalus is a challenging one. The development of shunt devices have greatly improved the survival and quality of life of paediatric patients with hydrocephalus; however, shunt dysfunction is a common problem which represents a significant scope of work for paediatric neurosurgeons with shunt failures occuring in up to 40 to 50% of patients during the first two years after shunt surgery.Numerous pathologies ranging from congenital to acquired conditions can result in the development of hydrocephalus in the paediatric population. Obstruction of proximal or distal catheter ends, misplacement, infections and over drainage are some of the common problems accounting for shunt failures.We discussed some of the pertinent problems and nuances involved in treatment of paediatric hydrocephalus with VPS as well as to review the role of endoscopic procedures as an alternative to VPS.
