A minimally invasive technique for ventriculoatrial shunt placement

Ventriculoperitoneal shunts (VPS) is a first-line option in the surgical management of hydrocephalus. However, a ventriculoatrial shunt (VAS) becomes valuable in conditions where cerebrospinal fluid drainage into the abdomen is unsuitable. Although the VAS technique has been described in previous studies, we present a minimally invasive approach supplemented with step-by-step image and video guidance. Based on our experience with over 200 cases, we have developed a safe and efficient technique for VAS placement. We further discuss the surgical setup, procedure, and complications associated with VAS placement. This procedure should be individualized, considering the patient's anatomy and pathology. Overall, VAS procedure is a reliable, safe, and simple to learn alternative for the management of hydrocephalus in patients with compromised peritoneum or contraindication to VPS.