Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus
Abstract Ventriculoperitoneal shunt (VPS) placement is the standard procedure in the management of hydrocephalus. The introduction of laparoscopy allows better visualization during the operation and a more reliable placement of the peritoneal terminal of the catheter, which significantly decreases p...
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Nature Portfolio
2023-04-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-33566-5 |
| _version_ | 1797841075726974976 |
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| author | Qian Ding Jinchao Wang Haitao Fan Wanli Jiang Hua Guo Hongsheng Ji Tao Song Shangchen Xu Bin Liu |
| author_facet | Qian Ding Jinchao Wang Haitao Fan Wanli Jiang Hua Guo Hongsheng Ji Tao Song Shangchen Xu Bin Liu |
| author_sort | Qian Ding |
| collection | DOAJ |
| description | Abstract Ventriculoperitoneal shunt (VPS) placement is the standard procedure in the management of hydrocephalus. The introduction of laparoscopy allows better visualization during the operation and a more reliable placement of the peritoneal terminal of the catheter, which significantly decreases postoperative obstruction and malposition rates. However, the fixation methods of the peritoneal terminal of the catheter have not been previously discussed. The indications, techniques, and complications were compared between conventional VPS and laparoscopy-guided VPS. Furthermore, same analyses were performed within the laparoscopy-guided VPS group subdivided by three different techniques of the fixation of the peritoneal terminal of catheter, including suture and ligature, titanium clip fixation, and subcutaneous fixation. A total of 137 patients with hydrocephalus who received VPS treatment was retrospectively studied, 85 of which were laparoscopy-guided, and 52 were not. The distal ends of the catheters were all placed in the suprahepatic space. At least one year (mean 28.6 months) follow-up was given postoperatively. The average duration of the whole operation was 45 min for suture and ligature, 40 min for titanium clip fixation, and 30 min for the subcutaneous fixation, respectively. Six patients (4.4%) had obstructive of the ventricular catheter in total. The success rates for the laparoscopy-assisted VPS procedure and the conventional VPS procedure were 87.1% (74/85) and 80.8% (42/52), respectively. Within subgroups of the laparoscopy-assisted VPS divided by fixation methods, the procedures were successful in 85.2% (23/27) of suture and ligation, 82.1% (23/28) of titanium clip fixation, and 93.3% (28/30) of subcutaneous fixation, respectively. Two patients had dislocated shunt tube in peritoneal end in laparoscopy group, all in the titanium clip fixation subgroups. The laparoscopy-assisted VPS insertion is an ideal shunt method for its effectiveness and lesser complication rate after operation. The subcutaneous fixation method of the peritoneal terminal of catheter might be the optimal fixation technique. |
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| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T16:25:10Z |
| publishDate | 2023-04-01 |
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| series | Scientific Reports |
| spelling | doaj.art-669dbdcce3384ffa92bf62ee724bfb772023-04-23T11:14:01ZengNature PortfolioScientific Reports2045-23222023-04-011311710.1038/s41598-023-33566-5Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalusQian Ding0Jinchao Wang1Haitao Fan2Wanli Jiang3Hua Guo4Hongsheng Ji5Tao Song6Shangchen Xu7Bin Liu8Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityFirst School of Clinical Medicine, Shandong University of Traditional Chinese MedicineDepartment of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityAbstract Ventriculoperitoneal shunt (VPS) placement is the standard procedure in the management of hydrocephalus. The introduction of laparoscopy allows better visualization during the operation and a more reliable placement of the peritoneal terminal of the catheter, which significantly decreases postoperative obstruction and malposition rates. However, the fixation methods of the peritoneal terminal of the catheter have not been previously discussed. The indications, techniques, and complications were compared between conventional VPS and laparoscopy-guided VPS. Furthermore, same analyses were performed within the laparoscopy-guided VPS group subdivided by three different techniques of the fixation of the peritoneal terminal of catheter, including suture and ligature, titanium clip fixation, and subcutaneous fixation. A total of 137 patients with hydrocephalus who received VPS treatment was retrospectively studied, 85 of which were laparoscopy-guided, and 52 were not. The distal ends of the catheters were all placed in the suprahepatic space. At least one year (mean 28.6 months) follow-up was given postoperatively. The average duration of the whole operation was 45 min for suture and ligature, 40 min for titanium clip fixation, and 30 min for the subcutaneous fixation, respectively. Six patients (4.4%) had obstructive of the ventricular catheter in total. The success rates for the laparoscopy-assisted VPS procedure and the conventional VPS procedure were 87.1% (74/85) and 80.8% (42/52), respectively. Within subgroups of the laparoscopy-assisted VPS divided by fixation methods, the procedures were successful in 85.2% (23/27) of suture and ligation, 82.1% (23/28) of titanium clip fixation, and 93.3% (28/30) of subcutaneous fixation, respectively. Two patients had dislocated shunt tube in peritoneal end in laparoscopy group, all in the titanium clip fixation subgroups. The laparoscopy-assisted VPS insertion is an ideal shunt method for its effectiveness and lesser complication rate after operation. The subcutaneous fixation method of the peritoneal terminal of catheter might be the optimal fixation technique.https://doi.org/10.1038/s41598-023-33566-5 |
| spellingShingle | Qian Ding Jinchao Wang Haitao Fan Wanli Jiang Hua Guo Hongsheng Ji Tao Song Shangchen Xu Bin Liu Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus Scientific Reports |
| title | Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus |
| title_full | Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus |
| title_fullStr | Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus |
| title_full_unstemmed | Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus |
| title_short | Introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy-assisted ventriculoperitoneal shunt for hydrocephalus |
| title_sort | introduction and comparision of three different fixation methods in the suprahepatic space in laparoscopy assisted ventriculoperitoneal shunt for hydrocephalus |
| url | https://doi.org/10.1038/s41598-023-33566-5 |
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