The one-step edge-to-edge technique in ventriculoperitoneal shunt

Br J Neurosurg. 2023 Oct;37(5):1066-1068. doi: 10.1080/02688697.2020.1854684. Epub 2020 Dec 7.

Abstract

Background: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Ventriculoperitoneal shunt; catheter; hydrocephalus; tunneling.

MeSH terms

  • Adult
  • Catheters / adverse effects
  • Female
  • Humans
  • Hydrocephalus* / etiology
  • Hydrocephalus* / surgery
  • Hydrocephalus, Normal Pressure* / surgery
  • Male
  • Middle Aged
  • Prostheses and Implants / adverse effects
  • Retrospective Studies
  • Subarachnoid Hemorrhage* / surgery
  • Ventriculoperitoneal Shunt / adverse effects