Revision of ventriculo-peritoneal shunt under laparoscopic guidance in patients with hydrocephalus

Ventriculo-peritoneal (V-P) shunt is a common treatment for hydrocephalus. However, shunt insufficiency due to obstruction, dislocation, and detachmen t of the peritoneal tube is frequently encountered. We designed a new techn ique in which the peritoneal tube is inserted into a target site of the abd ominal cavity under laparoscopic guidance. We operated on 9 patients with h ydrocephalus using this technique. Shunt insufficiency of the peritoneal tu be had been observed in all patients, and 7 patients had undergone repeated revision of the peritoneal tube before this procedure. Our laparoscopic-as sisted method ensured tube insertion into the appropriate site, and minimiz ed the abdominal wound and postoperative adhesions. This method also made i t possible to differentiate abdominal pain induced by shunt failure from pa in caused by other diseases, including appendicitis;In conclusion, we consi der this new technique for V-P shunt performed under laparoscopic guidance to be very useful.