Laparoscopy-Assisted Abdominal Shunt Revisions in Children with Hydrocephalus

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Abstract
Background and Purpose: After placement of ventriculoperitoneal shunts in children with hydrocephalus, revisions are often necessary. We investigated the efficacy of a video-assisted laparoscopic technique for abdominal shunt revisions. Patients and Methods: Among 1894 patients requiring revisions of shunts from 1960 to 1998, 31 seen between June 1996 and December 1998 were treated laparoscopically. Results: Laparoscopy enabled inspection of the abdominal cavity, assessment of the peritoneum, identification of pseudocyts, and localization of the peripheral end of the catheter. Additionally, riskless implantation of a new extended catheter was possible using the Seldinger technique. Completely dislocated catheters could be removed. Conclusion: The laparoscopic method provides simple handling, excellent intra-abdominal views, short operation time, and, especially in obese patients, good cosmetic results. The hospitalization time also can be reduced.