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Updated: Nov 11, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
The "SHIFT" technique: Suprahepatic IntraFalciform tubing for placement of ventriculoperitoneal shunts
Cody Lendon Mullens1, Joanna Twist1, Hal S Meltzer2
1West Virginia University School of Medicine, Morgantown, WV, United States.
Insights
This study introduces the SupraHepatic IntraFalciform Tubing (SHIFT) technique for pediatric ventriculoperitoneal shunts. This novel approach aims to reduce complications and improve outcomes in hydrocephalus management.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Device Innovation
Background:
- Ventriculoperitoneal (VP) shunts are crucial for pediatric hydrocephalus management.
- High surgical revision rates necessitate improved VP shunt placement techniques.
- Current methods carry risks of intra-abdominal complications and adhesions.
Purpose of the Study:
- To introduce a novel VP shunt placement technique, the "SupraHepatic IntraFalciform Tubing" (SHIFT) technique.
- To hypothesize that the SHIFT technique can reduce morbidity in pediatric patients.
- To enhance VP shunt outcomes by minimizing iatrogenic injuries and improving device management.
Main Methods:
- A novel surgical approach utilizing the falciform ligament and suprahepatic recess for shunt suspension.
- Fashioning the SHIFT shunt by creating a window through the falciform ligament.
- Placing shunt tubing within the suprahepatic recess for securement and absorption.
Main Results:
- Hypothesized reduction in iatrogenic intra-abdominal injuries.
- Anticipated enhanced ease of shunt removal.
- Potential for increased cerebrospinal fluid absorption surface area and fewer adhesions.
Conclusions:
- The SHIFT technique offers a promising innovation for pediatric VP shunt placement.
- This method may mitigate common complications associated with VP shunts in children.
- Further clinical evaluation is warranted to confirm the benefits of the SHIFT technique.
Abstract:
Ventriculoperitoneal (VP) shunts in pediatric patients are an important aspect of management for patients with hydrocephalus and are fraught with complications. Surgical revision rates for VP shunts in the pediatric population are currently high, which necessitates innovation in operative techniques for placing VP shunts in attempt to decrease complication risks. Here we describe a novel approach for placement of VP shunts that we hypothesize can reduce potential morbidity among pediatric patients. By utilizing the falciform ligament of the liver and the suprahepatic recess to suspend and maintain the shunt, outcomes may portend fewer iatrogenic intra-abdominal injuries, enhanced ease of shunt removal, provide a large surface area for absorption of drained cerebrospinal fluid, and result in fewer adhesions secondary to device placement. We are referring to the operative technique as the "SupraHepatic IntraFalciform Tubing" (SHIFT) technique. In summary, the SHIFT shunt is fashioned by creating a window through the falciform ligament, inserting the shunt, and placing tubing in the suprahepatic recess.
