Single-Incision laparoscopic surgery (SILS) for ventriculoperitoneal shunt placement.

Abstract

BACKGROUND:

Single-incision laparoscopic surgery (SILS) may facilitate safer shunt placement and lower distal obstruction rate than is seen in conventional surgery.

OBJECTIVE:

We reviewed our 2-year experience in SILS for ventriculoperitoneal shunt placement to evaluate its usefulness and safety.Materials and Methods In this retrospective study, we enrolled patients older than 18 years with dilated ventricle and syndromes of hydrocephalus. A total of 31 patients underwent 31 primary ventriculoperitoneal shunt placement surgery and two underwent revision surgery. All the procedures were performed by the SILS technique.

RESULTS:

The entire duration of ventriculoperitoneal shunt implantation ranged from 45 to 80 minutes, with mean operation time of 65 ± 15.3 minutes. No major laparoscopy-related complications were noted. Shunt infection, peritonitis, and distal catheter malfunction occurred in one case (3.2%), proximal malfunction in one case (3.2%), and subcutaneous emphysema occurred in two cases (6.4%). The emphysema resolved within 2 days. Cosmetic results were "very good to good" in 17 patients (54.8%) and "satisfactory" in 14 patients (45.2%). The abdominal scars in most cases were nearly invisible.

CONCLUSION:

SILS is a safe and effective technique for ventriculoperitoneal shunt placement and can be accomplished with no higher risk of shunt infection and distal malfunction. Without an additional port, SILS allows good visualization of the peritoneal cavity to avoid major intra-abdominal complications. Only one 6-mm incision at the umbilicus area is required and is almost invisible after wound healing.

• Authors: Wei-Chen Hong, Peng-Sheng Lai, Yin-Hsuan Chien, Yong-Kwang Tu, Jui-Chang Tsai
• Journal: Journal of neurological surgery. Part A, Central European neurosurgery (J Neurol Surg A Cent Eur Neurosurg) Vol. 74 Issue 6 Pg. 351-6 (Nov 2013) ISSN: 2193-6323 [Electronic] Germany
• PMID: 23444132 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Abdominal Cavity (surgery)
• Aged
• Data Interpretation, Statistical
• Female
• Humans
• Hydrocephalus (etiology, surgery)
• Laparoscopy (adverse effects, methods)
• Male
• Middle Aged
• Neurosurgical Procedures (adverse effects, methods)
• Peritoneal Cavity (anatomy & histology)
• Postoperative Complications (epidemiology, therapy)
• Reoperation (statistics & numerical data)
• Retrospective Studies
• Treatment Outcome
• Umbilicus (anatomy & histology, surgery)
• Ventriculoperitoneal Shunt (adverse effects)
• Wound Healing