211403 Basic research and technical improvement on minimally invasive ventriculoperitoneal shunt

/Ma Banyou(馬班友，Dept Neurosurg，Affil Hosp Nanjing Med Univ，Nanjing 210029)…∥Chin J Neurosurg.-2011，27(4).-444～447

ObjectiveTo explore a new approach for improving therapeutic effects and minimizing complications of ventriculoperitoneal shunt(VPS).MethodsThe length of and lower edge of the greater omentum were measured and analyzed in 28 autopsies(16 adults and 12 children)and laparoscopic surgeries.95 cases of hydrocephalus treated by MIVPS(minimally invasive ventriculoperitoneal shunt)were retrospectively reviewed.The depth and positions of puncture into ventricles were confirmed by CT scanning.And then distal ventriculoperitoneal shunt was navigated into left pelvic area by the assistance of laparoscopy and the special abdominal puncture device.ResultsThe findings of autopsies demonstrated that the percentage of upper and middle abdominal types of greater omentum position was 81.3%in adults.There was no lower abdominal type in children.These cases were followed up from 3 to 45 months.Salmon’s classification rate was 95.7%.Complications were found in 9 cases(9.5%):infection in 3 cases(3.2%)，obstruction in 5 cases(5.3%)，and 1 case of unknown pneumocephalus(1.0%).ConclusionMIVPS is better than previous VPS.It is helpful to reduce complications and should be considered for advanced clinical application.14 refs，3 figs.