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[Insufficient cerebrospinal shunt systems in childhood caused by body growth. A problem solved?]
Insights
A novel peritoneal "reserve" catheter may eliminate the need for revisions in cerebrospinal fluid (CSF) shunting systems. This innovative design accounts for patient growth, potentially reducing surgeries for catheter displacement.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Biomedical Engineering
Abstract:
Causes for operative revisions of CSF shunting systems are displacement of the distal catheter from the heart or the peritoneal cavity due to the patient's growth. This takes place in 40-50% of all revisions. Median time for the first revision is 2 years post implantation. Preliminary experience with a simple peritoneal "reserve" catheter lead us to expect that the revisions may eventually become redundant: the catheter is normally inserted 10 cm into the abdominal cavity and then fixed to the peritoneum. About 20 cm of a catheter tubing are coiled in a spiral line inside a silicone bag placed subcutaneously in the abdominal wall. As the child grows, the catheter uncoils, and this uncoiling may be observed radiologically.