West Virginia University School of Medicine, Morgantown, WV, United States.
West Virginia University School of Medicine, Morgantown, WV, United States.
J Pediatr Surg. 2021 Jul;56(7):1246-1250. doi: 10.1016/j.jpedsurg.2021.02.056. Epub 2021 Feb 26.
Ventriculoperitoneal (VP) shunts in pediatric patients are an important aspect of management for patients with hydrocephalus and are fraught with complications. Surgical revision rates for VP shunts in the pediatric population are currently high, which necessitates innovation in operative techniques for placing VP shunts in attempt to decrease complication risks. Here we describe a novel approach for placement of VP shunts that we hypothesize can reduce potential morbidity among pediatric patients. By utilizing the falciform ligament of the liver and the suprahepatic recess to suspend and maintain the shunt, outcomes may portend fewer iatrogenic intra-abdominal injuries, enhanced ease of shunt removal, provide a large surface area for absorption of drained cerebrospinal fluid, and result in fewer adhesions secondary to device placement. We are referring to the operative technique as the "SupraHepatic IntraFalciform Tubing" (SHIFT) technique. In summary, the SHIFT shunt is fashioned by creating a window through the falciform ligament, inserting the shunt, and placing tubing in the suprahepatic recess.
儿童患者的脑室腹腔（VP）分流术是脑积水患者管理的重要方面，但存在诸多并发症。目前，儿科人群中 VP 分流术的手术修正率很高，这需要创新的手术技术来放置 VP 分流术，以降低并发症风险。在这里，我们描述了一种放置 VP 分流术的新方法，我们假设这种方法可以降低儿科患者的潜在发病率。通过利用肝镰状韧带和肝上间隙来悬挂和维持分流管，可能会减少医源性的腹腔内损伤，更容易移除分流管，为引流的脑脊液提供更大的吸收表面积，并减少由于设备放置而导致的粘连。我们将该手术技术称为“肝上镰状韧带内管”（SHIFT）技术。总之，通过在肝镰状韧带上创建一个窗口、插入分流管并将管置于肝上间隙来制作 SHIFT 分流管。
