Armbruster C, Blauensteiner J, Ammerer H P, Kriwanek S
KA Rudolfstiftung, Vienna, Austria.
J Laparoendosc Surg. 1993 Apr;3(2):191-2. doi: 10.1089/lps.1993.3.191.
Laparoscopically-assisted minimally invasive procedures have been applied to a broad spectrum of abdominal interventions. Neurosurgeons performing ventriculoperitoneal shunt operations for hydrocephalus used to place the peritoneal catheter by performing an upper abdominal midline or subcostal incision. In this report, to reduce the patient's inconvenience caused by the laparotomy wound, three consecutive ventriculoperitoneal shunts were implanted, assisted by laparoscopy. By means of three incisions (one 10 mm supraumbilical for the camera and two 5 mm in the right hypochondric region for instrumentation) the peritoneal catheter was placed next to the epiploic foramen. After subcutaneous pull-through of the catheter to the right supraclavicular region, the operation was continued by the neurosurgeon. The postoperative course was uneventful in all cases. The patients were dismissed 3-7 days after surgery. Short time follow-up (212, 202, and 169 days after surgery) showed no complications and perfect function of the ventriculoperitoneal shunts.
腹腔镜辅助的微创手术已应用于广泛的腹部干预。过去，神经外科医生在为脑积水患者进行脑室腹腔分流手术时，通过上腹部中线或肋下切口来放置腹腔导管。在本报告中，为减少剖腹手术伤口给患者带来的不便，在腹腔镜辅助下连续进行了三例脑室腹腔分流术。通过三个切口（一个位于脐上10毫米用于放置摄像头，两个位于右季肋区5毫米用于器械操作）将腹腔导管放置在网膜孔旁。在将导管经皮下拉至右锁骨上区域后，由神经外科医生继续完成手术。所有病例术后过程均顺利。患者在术后3 - 7天出院。短期随访（术后212天、202天和169天）显示无并发症，脑室腹腔分流功能良好。
