THE USE OF LAPAROSCOPY IN THE DIAGNOSIS AND TREATMENT OF ABDOMINAL COMPLICATIONS OF VENTRICULO-PERITONEAL SHUNTS IN CHILDREN

Ventriculo-peritoneal shunts (VPS) are the most frequent operative pro cedures used to treat hydrocephalic children. Abdominal complications of VPS are now a rare event; however, their frequency varies from 5% t o 47% according to reports. Anything that causes an obstruction or imp ediment of the VP derivation system will lead to intracranial hyperten sion, which requires immediate surgery. From 1985 to 1995 at the Divis ion of Pediatric Surgery of the Federico II University of Naples, ten laparoscopies were performed in ten children with VPS complications. C erebrospinal fluid pseudocysts were found in four infants. There was o ne case of abdominal wall perforation by the tip of the catheter at th e umbilical level, two bowel obstructions, and one catheter was lost i n the abdominal cavity. Finally, two children had malfunctioning of th e peritoneal limb of the catheter. The laparoscopic technique was cura tive in all ten cases, thus avoiding a conventional laparotomy and the consequent risk of adhesions, which could cause further complications .