Laparoscopic insertion and revision of ventriculoperitoneal shunts in children

Background/purpose Ventriculoperitoneal (VP) shunt is a common procedure used to drain cerebrospinal fluid to treat
hydrocephalus. Advances in laparoscopy tools and techniques made it possible to perform this procedure laparoscopically
assisted. Complications of this procedure are also amenable to laparoscopic correction. This study outlines the safety and
feasibility of laparoscopy in performing the procedure and management of its complications.
Methods A retrospective file review for all cases underwent laparoscopic-assisted VP shunt or laparoscopic management
of one of its complications in the period 2015–2019. Laparoscopic-assisted procedure was done either by 3-port technique
or a peritoneocentesis needle technique. Management of complications was done according to its nature.
Results Over 4 years, we performed 36 laparoscopic-assisted VP shunt placement and 17 laparoscopic interventions for
abdominal complications related to VP shunts. There were no intraoperative or postoperative complications related to the
laparoscopic technique. Conversion to conventional laparotomy was done in 3 patients presented with hugely infected CSF
pseudocysts with amalgamated intestine with the wall of the cyst.
Conclusion Laparoscopic-assisted VP shunt placement and revisions in children are feasible and safe. No special tools are
required for the procedure