Efficacy of Laparoscopy Guided Ventriculo-Peritoneal Shunt : Analysis of Data in 102 Consecutive Patients

Lee, Sung Ho; Koh, Young Cho; Jang, Sang Keun; Moon, Chang Taek; Cho, Joon; Choe, Woo Jin; Kang, Hyun Seung; Yun, Ik Jin

Abstract

OBJECTIVE
This study compare outcomes in patients with laparoscopic guided ventriculo-peritoneal shunt placement with the nonlaparoscopic approach (conventional mini-laparotomy technique) in patients with hydrocephalus.
METHODS
The study enrolled 102 adult patients who had undergone surgery between August 2005 and May 2008 for the treatment of hydrocephalus at our department. Seventy-six patients (38 men and 38 women) received laparoscopy-assisted distal catheter placement, and 26 patients (14 men and 12 women) received shunt surgery by a conventional mini-laparotomy approach. The median follow-up period of the non-laparoscopic group was 26 months (14-33 months) and laparoscopic group was 12 months (1-30 months). We analyzed age, sex, cause of hydrocephalus, type of shunt valve, operation time, shunt infection rate, and shunt distal catheter malfunction during follow-up.
RESULTS
There was no statistically significant difference in age, sex, cause of hydrocephalus, or type of shunt valve. Shunt infections were observed in 10 cases (13.2%) in the laparoscopic group and in 4 cases (15.4%) in the mini-laparotomy group, which was not statistically significant. Distal shunt malfunction rates were significantly lower in the laparoscopic group (1.3%) compared to the mini-laparotomy group (11.5%, P<0.05). The mean operation time was also shorter in the laparoscopic group (108 min, 45-190 min) than of the mini-laparotomy group (146 min, 75-255 min, P<0.005).
CONCLUSION
Laparoscopic guided placement of the VP shunt in hydrocephalus patients reduces shunt distal catheter malfunction and operation time.