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Updated: Oct 14, 2025
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
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Differences in Outcome Between Open vs Laparoscopic Insertion of Ventriculoperitoneal Shunts
Aaron B Lopacinski1, Kevin M Guy1, Jessica R Burgess1
1Department of Surgery, 6040Eastern Virginia Medical School, Norfolk, VA, USA.
The American Surgeon
|November 4, 2021
Summary
Laparoscopic placement of ventriculoperitoneal (VP) shunts offers shorter operating times compared to open surgery. This approach may also lead to fewer postoperative infections, suggesting an advantage for the laparoscopic technique.
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Historically, neurosurgeons used open abdominal approaches for ventriculoperitoneal (VP) shunt insertion.
- Laparoscopic techniques are increasingly utilized, often with general surgery collaboration.
- The study aimed to evaluate the impact of laparoscopic assistance on VP shunt placement outcomes.
Purpose of the Study:
- To compare the outcomes of open versus laparoscopic VP shunt placement.
- To determine if laparoscopic assistance improves procedural efficiency and patient safety.
- To assess the influence of surgical approach on operative time and complication rates.
Main Methods:
- Retrospective analysis of VP shunt placements between September 2012 and August 2020.
- Inclusion of patient demographics, comorbidities, and surgical history.
- Comparison of operative times and 30-day postoperative complications between open and laparoscopic cohorts.
Main Results:
- Laparoscopic placement (78 shunts) demonstrated significantly shorter operative times (61.8 min) than open placement (107 shunts, 75.5 min) (p=0.006).
- In patients without prior abdominal surgery, laparoscopic approach also yielded shorter operative times (57.1 min vs 79.4 min, p=0.015).
- Postoperative shunt infection rates were lower in the laparoscopic group (3.8%) compared to the open group (10.2%), though not statistically significant (p=0.077).
Conclusions:
- Laparoscopic VP shunt placement is a viable alternative to open procedures, associated with reduced operative times.
- A trend towards fewer infections suggests potential benefits of the laparoscopic approach.
- A collaborative team approach utilizing laparoscopy for the peritoneal portion of VP shunt placement appears advantageous.
