A New Curved Peritoneal Passer for Shunting Operations — Technical Note
Various operations have been reported for hydrocephalus. Even if these operations consist of minor surgery, general anesthesia or laparotomy is required. To avoiding this complicated type of procedure, we developed a peritoneal and a long subcutaneous passer. This paper indicates the usefulness of these passers for VP shunt operations.
Local anesthesia was performed at the right occipital, right hypochondrium, and the route of the shunt tube. After ventricular tapping at the right occipital, a 4 mm skin incision was made at the right hypochondrium. A ventricular tube was passed through subcutaneously from head to abdomen without any additional incision, using a long curved subcutaneal passer. An abdominal tap was performed using a peritoneal passer with double lumen. The inner part of the peritoneal passer was pulled out and, after making sure that the tip of the passer was in the upper lateral surface of the liver, a peritoneal tube was inserted to the peritoneal cavity in a manner similar to the Seldinger method. As the outer part of peritoneal passer has a side slit, the passer could be removed easily.
The peritoneal passer was used in 124 cases and when it was used, the average operation time was 10–15 min. CSF shunt was performed under local anesthesia or neuroleptanalgesia (NLA). Because the operation time was decreased, the rates of infection and other complications were minimal.
KeywordsVentriculoperitoneal shunt Hydrocephalus Abdominal tap
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