Laparoscopy assisted ventriculoperitoneal shunt placement in children

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Minimally Invasive Surgery

Background:

• Ventriculoperitoneal shunt (VPS) placement can be complex in pediatric patients with prior abdominal surgeries or adhesions.
• Laparoscopy aids in identifying adhesions and selecting optimal distal catheter insertion sites.

Purpose of the Study:

• To evaluate the feasibility and safety of laparoscopy-assisted VPS placement (lapVPS) in children.
• To assess the utility of laparoscopy in managing challenging VPS insertions.

Main Methods:

• Retrospective review of 110 lapVPS procedures (January 2015 - December 2018).
• Laparoscopy performed via a 5 mm trans-umbilical port.
• Distal VPS catheter insertion guided by Seldinger technique under direct laparoscopic visualization.

Main Results:

• Successful lapVPS in 97.3% of 110 pediatric patients.
• Median operative time was 36 minutes.
• Complications included one intestinal perforation and three reoperations for postoperative issues.

Conclusions:

• Laparoscopy is a valuable tool for assessing peritoneal suitability for VPS placement.
• Laparoscopy-assisted VPS placement is safe and feasible across all pediatric age groups.