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Updated: Aug 6, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ventriculo peritoneal shunted patient undergoing laparoscopic procedure - A case report and review of the literature
Shikher Shrestha1, Sagun Ghimire1, Dinuj Shrestha1
1Department of Neurosurgery, B and B Hospital, Gwarko, Lalitpur, Nepal.
Insights
Laparoscopic surgery in patients with a Ventriculo Peritoneal (VP) shunt is debated due to potential intracranial pressure (ICP) rise. This case study found no complications, suggesting safety in select VP shunt patients.
Area of Science:
- Neurosurgery
- Gastroenterology
- Surgical Innovation
Background:
- A positive correlation exists between intracranial pressure (ICP) and intraabdominal pressure (IAP).
- Laparoscopic procedures create pneumoperitoneum, potentially increasing IAP and consequently ICP.
- Patients with a Ventriculo Peritoneal (VP) shunt have a device to manage cerebrospinal fluid (CSF) pressure.
Introduction And Importance:
It has been more than century since the establishment of relationship between the intracranial pressure (ICP) and intraabdominal pressure (IAP) was suspected and confirmed backed up by several studies. The studies clearly demonstrate a link and the positive correlation between the two.
Case Summary:
18 years old lady with previous history of ventricular peritoneal shunt during 6 months of age was planned for laparoscopic cholecystectomy. Intraoperatively free flow of CSF was observed without any intraoperative and post-operative complications.
Discussion:
Pneumoperitoneum created during laparoscopic procedures may lead to the rise in ICP and thus, lead to serious consequences. This has been of a growing concern in a patient with Ventriculo Peritoneal Shunt (VP Shunt) in situ. The uncertainty regarding the safety of laparoscopic procedures in VP shunted patients thus, has been a subject of debate over the years.
Conclusion:
Our aim therefore is to depict similar case we encountered in our department and based on it, we reviewed the literature in the quest of determining the safety of Laparoscopic procedure in patients with VP shunt.
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