• Benifit of Laparoscopy in ventriculoperitoneal Shunt Placement in hydrocephalus patients
  • narges pazouki,1 saman hakimian,2,*
    1. medical student ,The Univesity of Georgia,school of health sciences and public health, Tblisi , Georgia
    2. M.sc student of Microbiology Islamic Azad university Central Tehran Branch, Iran,Tehran


  • Introduction: Basically the managing patient with hydrocephalus and helping them before irreversible effect on their brain function at the same time reduce compilations after the shunt surgery is making the situation too hard for them. So base on new methods and instrument that is useful for lowering the risks of infections and malfunction shunt. there is lots of article that completely covers the complication with percentage of each of them but this review mostly focused on new methods and protocols . Laparoscopy is one of them in reducing chance of postoperative malposition and obstruction in shunt terminal, and it shows approximately after 1 year in one third of patients, the laparoscopy for distal catheter is doing recently with 3 different method Suture and ligature under laparoscope, Titanium clip fixation under laparoscope and Subcutaneous fixation under laparoscope , the moment shows csf derange from cranial the laparoscope is getting remove, and this methods use in average age range: 9–81 years and the result 93.3% (28/30) succession of subcutaneous fixation, this is better option in comparing with open surgery this method will help faster recovery and low chnce of obstracture because the catheter will place in the suprahepatic space and the fixation will help to not get dislocation and malposition.
  • Methods: And as in open surgery there is some complication in damage to liver, vagina, urinary bladder, gallbladder and bowel, that will not appear in this method. Diaphragmatic CSF Fistula is the other complication that lead to chronic plural effusion was seen in vp shunt is a rare complication, plural effusion can be with or without migration( the correct position of the distal part of the VP shunt) shunt insertion is another common complication in vp shunt receivers, often after 2 to 9 years will appear , with skin rush , pain and irritation that is a result of calcification shunt, that will lead to total shunt removal unfortunately Removal is dangerous. but in this study they offers a method to remove the calcified tissue without removing the shunt to just only relief the pain and help the patient life , other operation can be applying for ETV and whom doesn’t fit with this operation can apply for inserting another VP shunt on the other side in case of intracranial calcification shunts ,mostly the common site was in neck ,the abdomen and chest.
  • Results: in other research among 405 cases shows for seeing more advantage and disadvantage result among them, with 2 to 9 years follow up after the surgery , almost 0 peritoneal catheter misplacement and only in 2 case saw injury of the small bowel that get repair immediately and 2 case umbilical hernia ,was only complications that appear, other good things about this method is short time of surgery and fast recovery with less anesthetic medication because of short operative procedure and direct laparoscopic vision to manage the shunt location intraperitoneally was the key of the operation so the patients will be less under effect of radiology exposures.
  • Conclusion: using the laparoscopy this invasive method for insert the vp shunt in abdomen to facility the operation in this article they did for all patient in Neurosurgical Department of AHEPA Hospital that needs vp shunt with using laparoscopy the result was excellent , facility of recovery after surgery no complication during and after surgery, high safety percentage , Under direct visibility, the surgeon can check that the abdominal component of the VPS locates to the proper place and that CSF flow is adequate. this method definitely is better and old traditional open abdominal operations .the patient was taking orally food without any pain or vomiting , this method with reduce the chance of adhesions and ileus after surgery.
  • Keywords: Vp shunt, ,Complications, Hydrocephalus,Laparoscopic surgery