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Ventriculopleural shunt: thoracoscopic placement of the distal catheter

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Abstract

Ventriculopleural shunting is usually reserved for patients with limited options for shunt revisions. We report the case of a 16-year-old boy with posthemorrhagic hydrocephalus who required numerous shunt procedures. At the age of 6 years, a ventriculopleural shunt was inserted by an intercostal thoracotomy, and 4 years later replacement of the distal catheter was necessary. Recently, he presented again with a shunt malfunction due to migration of the pleural catheter. We describe a technique for performing the placement of the distal catheter under direct thoracoscopic vision by a peel-off needle into the unscarred thoracic cavity despite two previous pleural procedures. The postoperative course was uneventful. Thoracoscopic assistance in ventriculopleural shunt placement appears to be a safe and effective technique, offering several advantages over the open procedure: it is less invasive, allows a precise positioning of the thoracic catheter under visual control, and confirms appropriate function.

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Acknowledgements

We thank Abhaya Kulkarni for his help in reviewing the manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Karl-Franzens University, Auenbruggerplatz 29, A-8036 Graz, Austria

    S. Kurschel & H. G. Eder

  2. Department of Pediatric Surgery, Karl-Franzens University, Auenbruggerplatz 29, A-8036 Graz, Austria

    J. Schleef

Authors
  1. S. Kurschel
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  2. H. G. Eder
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  3. J. Schleef
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Correspondence to S. Kurschel.

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Kurschel, S., Eder, H. & Schleef, J. Ventriculopleural shunt: thoracoscopic placement of the distal catheter . Surg Endosc 17, 1850 (2003). https://doi.org/10.1007/s00464-003-4225-x

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  • DOI: https://doi.org/10.1007/s00464-003-4225-x

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