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World J Gastrointest Endosc. Sep 16, 2014; 6(9): 415-418
Published online Sep 16, 2014. doi: 10.4253/wjge.v6.i9.415
Laparoscopy for ventriculoperitoneal shunt implantation and revision surgery
Fernando Campos Gomes Pinto, Matheus Fernandes de Oliveira
Fernando Campos Gomes Pinto, Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, São Paulo 05403-000, Brazil
Matheus Fernandes de Oliveira, Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, São Paulo 04029-000, Brazil
Author contributions: Pinto FCG and de Oliveira MF were equally involved in designing paper, revising literature and writing article.
Correspondence to: Matheus Fernandes de Oliveira, MD, Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, Av. Pedro de Toledo, 1800 - Vila Clementino, São Paulo 04029-000, Brazil. mafernoliv@yahoo.com.br
Telephone: +55-11-45738379 Fax: +55-11-45738379
Received: May 17, 2014
Revised: July 22, 2014
Accepted: September 4, 2014
Published online: September 16, 2014
Abstract

Ventriculoperitoneal shunting (VPS) is a widely accepted technique for the treatment of hydrocephalus. The probability of shunt dysfunction is pretty high throughout life. Laparoscopy has become a valuable tool to perform VPS and treat abdominal complications. An electronic literature search was performed to reveal the published data relating laparoscopy and ventriculoperitoneal shunt in Medline, Embase, Scielo and Lilacs databases. The keywords employed were “laparoscopy” OR “laparoscopic surgery” AND “ventriculoperitoneal shunt” OR “shunt” AND “surgery” OR “implantation” OR “revision” OR “complication”. No high quality trials were developed comparing conventional laparotomic incision vs laparoscopic approach. Both approaches have evolved and currently there are less invasive options for laparotomy, like periumbilical small incisions; and for laparoscopy, like smaller and less incisions. Operating room time, blood loss and hospital stay may be potentially smaller in laparoscopic surgery and complications are probably the same as laparotomy. In revision surgery for abdominal complications after VPS, visualization of whole abdominal cavity is fundamental to address properly the problem and laparoscopic approach is valuable once it is safe, fast and much less invasive than laparotomy. Ventriculoperitoneal shunting is a widely accepted technique for the treatment of hydrocephalus. Laparoscopy assisted shunt surgery in selected cases might be a less invasive and more effective option for intrabdominal manipulation. The laparoscopic approach allows a better catheter positioning, lysis of fibrotic bundles and peritoneal inspection as well, without any additional complication.

Keywords: Cerebrospinal fluid shunt, Hydrocephalys, Laparoscopy

Core tip: Review of application of laparoscopy in ventriculoperitoneal surgery.