Laparoscopically assisted ventriculoperitoneal shunt placement in infants with previous multiple abdominal operations.
Eur J Pediatr Surg
; 19(3): 168-70, 2009 Jun.
Article
in En
| MEDLINE
| ID: mdl-19499491
ABSTRACT
BACKGROUND:
The insertion of a ventriculoperitoneal shunt (VPS) is the treatment of choice in patients with hydrocephalus. However, VPS placement may be difficult in patients with extensive adhesions following prior abdominal interventions. Laparoscopic placement of the abdominal part of the VPS allows controlled adhesiolysis in combination with an optimal shunt placement in patients with a body weight above 5 kg. We investigated the feasibility and safety of laparoscopic VPS placement in young infants who had undergone abdominal operations. PATIENTS ANDMETHODS:
In our institution, 6 children with prior laparotomies (range 2-9; median 3) received a VPS catheter between 2004 and 2008. The median age was 9 months (range 2 months-4 years) and the median body weight was 4.5 kg (3.5-8.2 kg). All procedures were laparoscopically assisted and performed simultaneously by an interdisciplinary neurosurgical and a pediatric surgical team.RESULTS:
Median operating time was 63 min (35-100 min). In all cases, correct placement of the shunt with sufficient drainage was achieved. Enteral feeding was started on the day of operation in all patients. Median follow-up was 10 months (range 2 months-3 years). There were no complications except in one patient, who developed shunt dysfunction 4 weeks postoperatively and underwent a laparoscopic shunt revision.CONCLUSION:
In our series laparoscopically assisted VPS insertion in low-weight children who had undergone repeated prior abdominal surgery was feasible and had a low complication rate. We recommend laparoscopically assisted VPS insertion in small infants to avoid the complications of alternative techniques, such as open techniques or ventriculoatrial shunt.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Adhesions
/
Ventriculoperitoneal Shunt
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Language:
En
Journal:
Eur J Pediatr Surg
Journal subject:
PEDIATRIA
Year:
2009
Document type:
Article
Affiliation country:
Germany