Laparoscopically assisted implantation of ventriculoperitoneal shunts

Laparoscopically-assisted minimally invasive procedures have been applied to a broad spectrum of abdominal interventions. Neurosurgeons performing ventriculoperitoneal shunt operations for hydrocephalus used to place the peritoneal catheter by performing an upper abdominal midline or subcostal incision. In this report, to reduce the patient's inconvenience caused by the laparotomy wound, three consecutive ventriculoperitoneal shunts were implanted, assisted by laparoscopy. By means of three incisions (one 10 mm supraumbilical for the camera and two 5 mm in the right hypochondric region for instrumentation) the peritoneal catheter was placed next to the epiploic foramen. After subcutaneous pull-through of the catheter to the right supraclavicular region, the operation was continued by the neurosurgeon. The postoperative course was uneventful in all cases. The patients were dismissed 3-7 days after surgery. Short time follow-up (212, 202, and 169 days after surgery) showed no complications and perfect function of the ventriculoperitoneal shunts.