Skip to main content
SpringerLink
Log in

Transcranial Doppler monitoring of middle cerebral flow velocity in a patient with a ventriculoperitoneal shunt undergoing laparoscopy

  • Brief Report
  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

Laparoscopic surgery is possibly associated with a risk of intracranial pressure (ICP) increase due to pneumoperitoneum in patients with ventriculoperitoneal shunts (VPS). Invasive techniques for shunt pressure monitoring are not routinely used because of the possible complications. Transcranial Doppler (TCD) is a non-invasive, safe method which gives accurate information about blood-flow velocities in basal cerebral arteries and indirectly about the ICP. Moreover it is inexpensive and simple in use. We report the use of TCD for middle cerebral flow velocity monitoring in a patient with a VPS who underwent laparoscopic surgery. In the case we present, during 60 min of pneumoperitoneum, TCD showed a sustained, but not clinically significant increase of the Pulsatility Index, with a recorded maximum change of 31 %. We consider that the use of TCD may increase the safety of laparoscopic procedures in patients with preexisting VPS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Uzzo RG, Bilsky M, Mininberg DT, Poppas DP. Laparoscopic surgery in children with ventriculoperitoneal shunts: effect of pneumoperitoneum on intracranial pressure- preliminary experience. Urology. 1997;49:753–7.

    Article  PubMed  CAS  Google Scholar 

  2. Jackman SV, Weingart JD, Kinsman SL, Docimo SG. Laparoscopic surgery in patients with ventriculoperitoneal shunts: safety and monitoring. J Urol. 2000;164:1352–4.

    Article  PubMed  CAS  Google Scholar 

  3. Rosenthal RJ, Hiatt JR, Phillips EH, Hewitt W, Demetriou AA, Grode M. Intracranial pressure. Effects of pneumoperitoneum in a large-animal model. Surg Endosc. 1997;11:376–80.

    Article  PubMed  CAS  Google Scholar 

  4. Rosin D, Brasesco O, Varela J, et al. Low-pressure laparoscopy may ameliorate intracranial hypertension and renal hypoperfusion. J Laparoendosc Adv Surg Technol A. 2002;12:15–9.

    Article  Google Scholar 

  5. Fujii Y, Tanaka H, Tsuruoka S, Toyooka H, Amaha K. Middle cerebral arterial blood flow velocity increases during laparoscopic cholecystectomy. Anesth Analg. 1994;78:80–3.

    Article  PubMed  CAS  Google Scholar 

  6. Baskin JJ, Vishteh AG, Wesche DE, Rekate HL, Carrion CA. Ventriculoperitoneal shunt failure as a complication of laparoscopic surgery. JSLS. 1998;2:177–80.

    PubMed  CAS  Google Scholar 

  7. Neale ML, Falk GL. In vitro assessment of back pressure on ventriculoperitoneal shunt valves. Is laparoscopy safe? Surg Endosc. 1999;13:512–5.

    Article  PubMed  CAS  Google Scholar 

  8. Al-Mufarrej F, Nolan C, Sookhai S, Broe P. Laparoscopic procedure in adults with ventriculoperitoneal shunts. Surg Laparosc Endosc Percutan Tech. 2005;15:28–9.

    Article  PubMed  Google Scholar 

  9. Collure DWD, Bumpers HL, Luchette FA, Weaver WL, Hoover EL. Laparoscopic cholecystectomy in patients with ventriculoperitoneal (VP) shunts. Surg Endosc. 1995;9:409–10.

    Article  PubMed  CAS  Google Scholar 

  10. Nadvi SS, Du Trevou MD, Van Dellen JR, Gouws E. The use of transcranial Doppler ultrasonography as a method of assessing intracranial pressure in hydrocephalic children. Br J Neurosurg. 1994;8:573–7.

    Article  PubMed  CAS  Google Scholar 

  11. Ravaoherisoa J, Meyer P, Afriat R, et al. Laparoscopic surgery in a patient with ventriculoperitoneal shunt: monitoring of shunt function with transcranial Doppler. Br J Anaesth. 2004;92:434–7.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, 76 Vassilissis. Sophias Ave., 11528, Athens, Greece

    C. Staikou, A. Tsaroucha, A. Mani & A. Fassoulaki

Authors
  1. C. Staikou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Tsaroucha
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Mani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Fassoulaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Staikou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Staikou, C., Tsaroucha, A., Mani, A. et al. Transcranial Doppler monitoring of middle cerebral flow velocity in a patient with a ventriculoperitoneal shunt undergoing laparoscopy. J Clin Monit Comput 26, 487–489 (2012). https://doi.org/10.1007/s10877-012-9380-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10877-012-9380-y

Keywords

Search

Navigation