Agrawal Vivek, Aher Rajendra B
Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India.
Asian J Neurosurg. 2018 Oct-Dec;13(4):1071-1073. doi: 10.4103/ajns.AJNS_98_17.
Placement of ventricular catheter (VC) in an optimal position is the most important factor in determining the outcome of shunt surgery. VC obstruction due to shunt tube placement in brain parenchyma, across the septa, tangled in the choroid plexuses and clogging of VC due to brain matter or other debris are common reasons resulting in shunt complete or partial dysfunction. To resolve these hurdles, many technical advancements have been made including navigation, stereotaxy, sonography, and ventriculoscope-guided VC placement.
To report early experience, technique, and result of placing VC with shuntscope.
We are publishing our experience of shuntscope-guided ventriculoperitoneal shunt in 9 cases done from June 2015 to April 2016. Shuntscope is a 1 mm outer diameter semi-rigid scope from Karl Storz with 10000 pixel of magnification. It has a fiber optic lens system with camera and light source attachment away from the scope to make it light weight and easily maneuverable.
In all cases, VC was placed in the ipsilateral frontal horn away from choroid plexuses, septae, or membranes. Septum pellucidum perforation and placement to opposite side of ventricle was identified with shunt scope assistance and corrected.
Although our initial results are encouraging, larger case series would be helpful. Complications and cost due to shunt dysfunction can thus be reduced to a great extent with shuntscope.
将脑室导管（VC）置于最佳位置是决定分流手术效果的最重要因素。由于分流管置于脑实质内、穿过隔膜、缠结在脉络丛中以及因脑组织或其他碎片导致VC堵塞而引起的VC梗阻是导致分流完全或部分功能障碍的常见原因。为了解决这些障碍，已经取得了许多技术进步，包括导航、立体定向、超声检查和脑室镜引导下的VC置入。
报告使用分流镜放置VC的早期经验、技术和结果。
我们正在公布2015年6月至2016年4月期间9例分流镜引导下脑室腹腔分流术的经验。分流镜是卡尔史托斯公司生产的外径为1毫米的半刚性内镜，放大倍数为10000像素。它有一个光纤透镜系统，摄像头和光源附件远离内镜，使其重量轻且易于操作。
在所有病例中，VC均置于同侧额叶角，远离脉络丛、隔膜或膜。在分流镜的辅助下识别并纠正了透明隔穿孔及向脑室对侧的放置。
虽然我们的初步结果令人鼓舞，但更大的病例系列会有所帮助。使用分流镜可在很大程度上降低因分流功能障碍引起的并发症和成本。
