Laparoscopic management of abdominal complications in ventriculoperitonealshunt surgery

Ventriculoperitoneal (VP) shunts are among the most frequently performed op erations in the management of hydrocephalus. Abdominal complications, thoug h rare, are reported to occur in 5-47%. VP shunt obstruction or malfunction leads to raised intracranial pressure, which requires immediate interventi on. Recently we have used the laparoscope to manage abdominal complications of VP shunt in two patients. The first patient had hydrocephalus secondary to tubercular meningitis. She developed recurrent intraabdominal cerebrosp inal fluid (CSF) pseudocysts, possibly due to subtle peritoneal infection. In the second patient, who developed hydrocephalus following subarachnoid h aemorrhage, the lower end of the shunt was malfunctioning due to retraction into the extraperitoneal tissues. The distal end of the VP shunt was revis ed in both patients with the help of a laparoscopically assisted technique. Thus, a conventional laparotomy, along with its various associated postope rative problems, was avoided without compromising the quality of surgery.