Minimally invasive surgery in pediatric patients with ventriculo-peritoneal shunts]

The use of laparoscopy in patients with ventriculo-peritoneal shunts has been controversial. There is concern about the risk malfunction or infection of the shunt as well as about the possibility of adhesions that could make the surgical procedures too difficult to be undertaken by minimally invasive surgery. We present our results in pediatric patients with ventriculoperitoneal shunts that have undergone laparoscopic procedures in our department. We have performed 16 surgical procedures. The most frequent indication was fundoplication. During surgery there were no complications or intracranial hypertension episodes. Two of the procedures were considered by the surgeons more difficult and longer than usual. None of them required conversion to open technique. One shunt had to be replaced after surgery because of infection. According to our experience minimally invasive surgery is feasible and safe in pediatric patients with ventriculo-peritoneal shunts.