caa a22 4500 475781082 CHVBK 20180406123644.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s004640020017 doi (NATIONALLICENCE)springer-10.1007/s004640020017 Minilaparoscopically assisted placement of ventriculoperitoneal shunts [Elektronische Daten] [J. S. Roth, A. E. Park, R. Gewirtz] Background: Ventriculoperitoneal (VP) shunting remains the preferred treatment for hydrocephalus. Laparoscopic techniques to aid in the placement of the peritoneal portion of the catheter have been reported previously. We describe a minilaparoscopic VP shunt (MLVPS) insertion technique that facilitates directed placement of the peritoneal portion of the catheter in most patients, including those with obese abdomens previously subjected to surgery. In this study we review our experience with MLVPS placement. Methods: All cases of MLVPS insertions at the University of Kentucky Medical Center and Lexington VA Hospital performed between February 1998 and March 1999 were reviewed retrospectively. A total of 27 patients (13 males and 14 females) ranging in age from 4 to 81 years (mean, 41 years) underwent VP shunting. The MLVPS insertion was performed via a 2-mm laparoscope and a separate 2-mm incision for catheter insertion using a venous introducer kit. In patients who had prior abdominal surgery, a 5-mm direct-view trocar was used. Results: The MLVPS procedure was successful in 27 patients (100%). The mean number of prior shunts was 2 (range, 0-28). Of the 27 patients, 16 (59%) had undergone previous abdominal surgery. The mean operative time was 76 min (range, 19-155 min). There were no intra- or postoperative complications, and no mortalities. The follow-up period extended from 1 to 12 months. Conclusions: Findings show MLVPS placement to be safe and feasible. It allows accurate, directed placement of the VP shunt with a 2-mm laparoscope and a second 2-mm incision for shunt insertion. The procedure is associated with reduced trauma to the abdominal wall and minimal postoperative ileus. Long-term follow-up assessment of shunt function is planned. Springer-Verlag New York Inc., 2000 Key words: Hydrocephalus — Laparoscopy — Ventriculoperitoneal shunt — Minilaparoscopy nationallicence Roth J. S. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut Park A. E. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut Gewirtz R. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut Surgical Endoscopy Springer-Verlag 14/5(2000-05-01), 461-463 0930-2794 14:5<461 2000 14 464 https://doi.org/10.1007/s004640020017 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020017 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Roth J. S. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut NATIONALLICENCE 700 1- Park A. E. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut NATIONALLICENCE 700 1- Gewirtz R. Department of Surgery, University of Kentucky Chandler Medical Center, 800 Rose Street, Lexington, KY 40536-0298, USA, US aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/5(2000-05-01), 461-463 0930-2794 14:5<461 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer