Tanaka J, Kikuchi K, Sasajima H, Koyama K
Department of Surgery, Akita University School of Medicine, Japan.
Surg Laparosc Endosc. 1995 Aug;5(4):263-6.
Two patients previously treated with ventriculoperitoneal shunt for hydrocephalus had the distal catheters disconnected, and they migrated to the free peritoneal cavity. The signs and symptoms of increased intracranial pressure occurred as a result of mechanical failure of the shunt system. Both patients successfully underwent a laparoscopic retrieval of the catheters using endoscopic grasping forceps, and revision of the ventriculoperitoneal shunt by inserting the new catheters into the peritoneal cavity was performed through a small entrance for the laparoscope. Recently, conventional laparotomy has been often replaced by laparoscopic surgery, and general surgeons are well familiar with the laparoscopic procedures. The significant advantage of this procedure is the ability to explore the entire peritoneal cavity for both diagnosis and treatment, and it is by far a less invasive approach than conventional laparotomy. The present report describes the laparoscopic procedure for removal of the migrated catheters and discusses its advantages over conventional laparotomy.
两名先前因脑积水接受脑室腹腔分流术治疗的患者，其分流管远端断开并移入游离腹腔。分流系统机械故障导致颅内压升高的体征和症状出现。两名患者均成功通过腹腔镜使用内镜抓钳取出分流管，并通过腹腔镜的小切口将新的分流管插入腹腔对脑室腹腔分流术进行了修复。近年来，传统剖腹手术常被腹腔镜手术取代，普通外科医生对腹腔镜手术操作十分熟悉。该手术的显著优势在于能够探查整个腹腔以进行诊断和治疗，并且与传统剖腹手术相比，其侵入性要小得多。本报告描述了腹腔镜取出移位分流管的手术过程，并讨论了其相对于传统剖腹手术的优势。
