Laparoscopy-guided insertion of peritoneal catheters in ventriculoperitoneal shunt procedures: analysis of 39 children.

Ventriculoperitoneal shunting is the mainstay in the treatment of hydrocephalus in childhood. Repeated shunt revision and previous laparotomy may complicate the implantation of the distal catheter. We describe our experience with laparoscopic insertion of peritoneal catheters in 21 male and 18 female children with an age range from 3 months to 18 years, operated between 2002 and 2004. Fourteen patients (36%) had laparotomy due to previous shunt operations and 5 patients (13%) due to other reasons. Laparoscopy was carried out concurrently with the cranial part of the procedure. In all cases, successful insertion of the peritoneal catheter was carried out with visual documentation of the patency of the distal catheter. There were no procedure-related complications. We recommend this minimally invasive procedure for all children with a body weight >5 kg, especially in cases of repeated shunt operations with intraperitoneal adhesions.