Minimally invasive insertion of thecoperitoneal shunts using ventriculoscope

Abstract

Background: Thecoperitoneal shunt insertion is an effective widely used procedure for treatment of idiopathic intracranial hypertension. Laparoscopic insertion of the peritoneal end minimizes extraperitoneal insertion, shunt migration, and shunt obstruction. However, this needs availability of laparoscopy sets and experienced laparoscopic surgeon. The aim of this study is to evaluate feasibility, safety and effectiveness of minimally invasive thecoperitoneal shunt insertion using ventriculoscope. Methods: Prospective study of 15 patients with IIH operated for minimally invasive thecoperitoneal shunt insertion using ventriculoscope. Operative time, intraoperative and post-operative complication, and clinical outcome were recorded. Results: All patients were females with mean age 27.2 years. The mean body mass index was 44.4. Headache and papilledema were present in all cases with mean CSF manometry 41.7 cm. Mean operative time was 48.9 min. Clinical improvement was achieved in all patients except one patient who developed shunt infection and meningitis. Conclusion: Minimally invasive thecoperitoneal shunt insertion using ventriculoscope is easy and safe. It minimizes complication of shunt obstruction, migration and extraperitoneal insertion in obese patients.