Document Type
Case Report
Disciplines
Higher Education | Interprofessional Education | Medicine and Health Sciences
Abstract
Background
The placement of the distal catheter of a ventriculoperitoneal shunt (VPS) can be challenging in patients with a large body habitus. Given the complications associated with ventriculoperitoneal shunts and known infection risk of obese patients, new techniques for VPS placement that bypass the abdominal fat must be sought. By avoiding the abdominal fat, decreased complications and infection risk may be possible.
Objective
The objective of this technical document is to describe a laparoscopic approach to the abdominal cavity during ventriculoperitoneal shunt surgery that makes use of a direct tunneling technique into the peritoneal space.
Methods
We perform a ventriculoperitoneal shunt placement with distal catheter implantation under laparoscopic guidance. Tunneling of the distal abdominal catheter was done through the abdominal fascia directly, without creation of a stab incision for the insertion site. Intraoperative video media was obtained using video footage from OPTIVIEW camera.
Results
We have found this technique to be feasible and useful for patients with large body habitus. By eliminating the incision overlying the catheter there is decreased risk for infection by skin flora and overall decreased risk of complications.
Conclusion
Our technique of tunneling directly into the abdominal cavity is both novel and feasible. To our knowledge this is the first time this technique has been described. We believe that further study of this technique in a case series may highlight its advantages in a certain subpopulation of patients requiring VPS.
DOI
10.32873/unmc.dc.gmerj.4.1.005
Keywords
Ventriculoperitoneal shunt; Surgical site Infection; Obesity
Embedded Media
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Chen, E., Opperman, P., DeOliveira, E., Rodrigues Armijo, P., Kothari, V., , Surdell, D. Introducer-free MIS-assisted Ventriculoperitoneal Shunt Placement: A Technical Document. Graduate Medical Education Research Journal. 2022 Jul 14; 4(1).
https://digitalcommons.unmc.edu/gmerj/vol4/iss1/8
Figures and Descriptions
MIS VPS Shorter Video.mp4 (506625 kB)
Video
