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Updated: Apr 30, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous
Fernanda O de Carvalho1, Antonio R Bellas1, Luciano Guimarães2
1Serviço de Neurocirurgia Pediátrica, Instituto Nacional da Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
Insights
Laparoscopic surgery offers a promising solution for pediatric hydrocephalus patients experiencing recurrent ventriculoperitoneal shunt failure. This minimally invasive approach effectively addresses complications arising from multiple shunt revisions and peritoneal issues.
Area of Science:
- Pediatric Neurosurgery
- Minimally Invasive Surgery
- Hydrocephalus Management
Background:
- Multiple shunt failures are a significant complication in pediatric hydrocephalus treatment.
- Repetitive peritoneal cavity manipulation can lead to shunt malfunction and abdominal complications.
Purpose of the Study:
- To evaluate the efficacy of laparoscopic procedures for distal ventriculoperitoneal shunt failure.
- To assess laparoscopy as an option for patients with a compromised peritoneum due to multiple revisions.
Main Methods:
- Retrospective review of six pediatric patients undergoing laparoscopic-assisted ventriculoperitoneal shunt revision.
- Study period: March 2012 to February 2013.
- Inclusion criteria: prior intra-peritoneal complications and multiple shunt revisions.
Main Results:
- All six patients remained shunt-independent with no further failures after a mean nine-month follow-up.
- Laparoscopic revision demonstrated successful management of complex shunt complications.
Conclusions:
- Laparoscopy-assisted shunt revision is an effective option for select pediatric patients with multiple peritoneal complications from ventriculoperitoneal shunting.
- This technique offers a viable solution for challenging hydrocephalus cases with a history of shunt failure.
Unlabelled:
Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus.
Objective:
To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a "non reliable" peritoneum.
Method:
From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy.
Results:
After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far.
Conclusion:
Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting.
