Laparoscopic surgery in a Patient with a Ventriculoperitoneal Shunt: Management and care of peritoneal catheter of shunt

Ventriculoperitoneal Shunt (V.P. Shunt) surgery is common surgery routinely performed for Hydrocephalous. Patient survival is increasing day by day due to new techniques and better facilities in hospitals. Patients with VP shunt, in the long run, may suffer, from abdominal pathologies like cholecystitis, ovarian cysts, ectopic pregnancy, etc. which require Laparoscopic intervention as a procedure of choice With the advances in surgeries of cerebral shunts and the increased life span associated with them, has made the incidence of patients with VP shunts presenting with an indication for laparoscopy higher.(1,2) A few questions arise to avoid complications associated with VP Shunt.(3) Whether the pneumoperitoneum created during a laparoscopy procedure will cause retrograde diffusion of gases into the ventricles causing increased intracranial pressure and associated complications? There is still controversy regarding the safety of performing laparoscopic surgery in patients with VP shunt and potentially decreased cerebral compliance. This retrospective study is based on observations made with 12 patients operated on in the last five years. Initially, laparoscopic surgeons used to clamp or exteriorize of peritoneal VP Shunt catheter. But currently, there is no evidence to suggest that clamping of the catheter or exteriorization is necessary. So Laparoscopic procedures are not contraindicated in patients with VP Shunt only a cautious approach is required.