Department of Neurosurgery, Cannizzaro Hospital, Trauma Center, Gamma Knife Center, Catania, Italy.
Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi", Catania, Italy.
Br J Neurosurg. 2023 Oct;37(5):1066-1068. doi: 10.1080/02688697.2020.1854684. Epub 2020 Dec 7.
Subcutaneous tunneling of the distal catheter is a potentially risky part of ventriculoperitoneal shunt (VPS) insertion. We describe our institutional experience with a simple trick to improve functional and aesthetic results in VPS by reducing the distal catheter tunneling to a single passage.
The one-step edge-to-edge technique has been performed in our institution over 14 years in 46 patients with a mean age of 63. 27 were female (58.7%). 7 patients suffered from post-traumatic hydrocephalus, 6 from normal pressure hydrocephalus, 15 from obstructive hydrocephalus and 18 from hydrocephalus secondary to subarachnoid hemorrhage. Operative blood loss varied from 20 to 40 cc.
No complication related to the modified tunneling technique were described except a transitory peripheral VII nerve palsy (2.2%). The absence of middle skin incision is appreciated by the patient, especially in young females that not presented scars at the level of the neckline.
Our technique is the first report of one step tunneling in adults. It reduces distal catheter tunneling time in VPS simplifying the procedure to a single step and using a simple reproducible trick.
脑室-腹腔分流术（VPS）中，远端导管的皮下隧道是一个潜在的风险部位。我们介绍了一种简单的技巧，通过将远端导管的隧道减少到一个单一的通道，来改善 VPS 的功能和美观效果，从而减少风险。
在我们机构中，这种一步式边缘对边缘技术已经应用了 14 年，共 46 例患者，平均年龄为 63.27 岁，其中 27 例为女性（58.7%）。7 例患者为创伤后脑积水，6 例为正常压力性脑积水，15 例为阻塞性脑积水，18 例为蛛网膜下腔出血后继发脑积水。手术失血量从 20 到 40cc 不等。
除了 2.2%的短暂性周围 VII 神经麻痹外，没有与改良隧道技术相关的并发症。这种改良技术减少了远端导管隧道的时间，将 VPS 手术简化为一个单一的步骤，并使用了一种简单、可重复的技巧。
我们的技术是成人一步式隧道的首例报告。它减少了 VPS 中远端导管隧道的时间，将手术简化为一个单一的步骤，并使用了一种简单、可重复的技巧。
