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Hydrocephalus pp 432-437 | Cite as

A New Curved Peritoneal Passer for Shunting Operations — Technical Note

  • Shuzo Sato
  • Naoki Ishihara
  • Kazuta Yunoki
  • Terutoshi Nakamigawa
  • Takayuki Oohira
  • Hideichi Takayama
  • Shigeo Toya

Summary

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.

Keywords

Ventriculoperitoneal shunt Hydrocephalus Abdominal tap 

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References

  1. Dean DE, Keller IB (1972) Cerebrospinal fluid ascites: A complication of a ventriculoperitoneal shunt. J. Neurol Neurosurg Psychiatry 35: 474–476PubMedCrossRefGoogle Scholar
  2. Fernell E, Wendt LV, Serlo W, et al. (1985) Ventriculoatrial or ventriculoperitoneal shunts in the treatment of hydrocephalus in children. Z Kinderchir 40(Suppl)1: 12–14PubMedGoogle Scholar
  3. Golladay ES, Wagner CW (1990) Transthoracic complication after previous abdominal surgery: An alternate approach. South Med J 83: 1029–1032PubMedCrossRefGoogle Scholar
  4. Lgnelze RJ, Kersch WM (1975) Follow-up analysis of ventriculoperitoneal and ventriculoatrial shunts for hydrocephalus. J Neurosurg 42: 679–682CrossRefGoogle Scholar
  5. Little JR, Rhoton AL Jr, Mellinger JF (1972) Ventriculoperitoneal and ventriculoatrial shunt for hydrocephalus in children. Mayo Clin Proc 47: 396–401PubMedGoogle Scholar
  6. Niggemann B, Kauerz U, Petersen V, et al. (1990) Massive ascites formation due to unabsorbed cerebrospinal fluid following abdominal surgery in ventriculoperitoneal shunt. A case report. Klin Padiatr 202: 180–182CrossRefGoogle Scholar
  7. Oi SZ, Shose Y, Asano N, et al. (1987) Intragastric migration of a ventriculoperitoneal shunt catheter. Neurosurgery 21: 255–257PubMedCrossRefGoogle Scholar
  8. Plangger C, Twerdy K, Mohsenipour I, et al. (1987) Hydrocephalus following spontaneous subarachnoid hemorrhage. Neurochirurgia (Stattg) 30: 154–157Google Scholar
  9. Scott M, Wycis HT, Murtagh F, et al. (1955) Observations on ventricular and lumbar subarachnoid shunts in hydrocephalus in infants. J Neurosurg 12: 165–175PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Shuzo Sato
  • Naoki Ishihara
  • Kazuta Yunoki
  • Terutoshi Nakamigawa
    • 1
  • Takayuki Oohira
  • Hideichi Takayama
  • Shigeo Toya
    • 2
  1. 1.Institute of Brain and Blood VesselsMihara Memorial HospitalIsesaki, Gunma. 372Japan
  2. 2.Department of NeurosurgeryKeio University School of MedicineShinjuku-ku, Tokyo, 160Japan

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