Tormenti Matthew J, Adamo Matthew A, Prince Jose M, Kane Timothy D, Spinks Theodore J
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Neurosurg Pediatr. 2011 Oct;8(4):390-3. doi: 10.3171/2011.7.PEDS115.
Ventriculoperitoneal (VP) shunt placement is the most common surgical treatment for hydrocephalus. Laparoscopic techniques to aid in the placement of the peritoneal portion have been reported previously. Laparoscopic shunt placement has been associated with decreased operating time, less blood loss, and shorter hospital stays. The authors describe a single-incision laparoscopic shunt (SILS) insertion technique that facilitates directed placement of the peritoneal portion of the catheter in children. A total of 6 pediatric patients underwent the SILS procedure between December 2008 and March 2009. This cohort included 5 girls and 1 boy; the average age was 6 years (range 1 day-16 years). One patient had previously undergone a VP shunt placement, but all other patients were undergoing the initial creation of their shunt. The most common pathological condition encountered was posttraumatic hydrocephalus (2 patients). All patients underwent successful placement of the peritoneal catheters. All catheters were seen to have CSF flowing freely within the peritoneal space. The authors' recent experience shows that SILS placement is safe and feasible in children. It allows accurate, directed placement of the VP shunt with a single, almost invisible, umbilical incision. The shunt tubing is remote from this incision.
脑室腹腔（VP）分流术是治疗脑积水最常用的外科手术方法。此前已有报道采用腹腔镜技术辅助放置腹腔段分流管。腹腔镜分流术具有手术时间缩短、失血减少和住院时间缩短的优点。作者描述了一种单切口腹腔镜分流（SILS）置入技术，该技术有助于在儿童中定向放置导管的腹腔段。2008年12月至2009年3月期间，共有6例儿科患者接受了SILS手术。该队列包括5名女孩和1名男孩；平均年龄为6岁（范围1天至16岁）。1例患者此前曾接受过VP分流术，但所有其他患者均为初次行分流术。最常见的病理情况是创伤后脑积水（2例患者）。所有患者的腹腔导管均成功置入。所有导管在腹腔内均可见脑脊液自由流动。作者最近的经验表明，SILS置入术在儿童中是安全可行的。它允许通过一个几乎不可见的脐部切口准确、定向地放置VP分流管。分流管远离该切口。
