The Evaluation of Outcome between Trocar Insertion Versus Laparotomy in Lower End Insertion in Ventriculoperitoneal Shunt: A longitudinal study of 100 patients

BACKGROUND: Hydrocephalus is a condition of abnormal dilation of the ventricular system within the cranium. Hydrocephalus is a common brain condition that is treated with neurosurgery. The diversion of cerebrospinal fluid to relieve hydrocephalus may be accomplished via a number of different methods. The most commonly used method is the ventriculoperitoneal shunt (VPS). OBJECTIVE: To compare the outcome and complications between trocar and nini laparotomy in the lower end insertion in the ventriculoperitoneal shunt. PATIENTS AND METHODS: A longitudinal study of 100 patients with hydrocephalus who attended the Dr. Saad Al-Witry Teaching Hospital in Baghdad from October 2018 to April 2021 was done with clearance from the institutional review board. RESULTS: This study was done on 100 patients with hydrocephalus, 50 of them with implementation of trocar, and the other 50 patients underwent mini laparotomy. (64%) were in age groups of 18 years, the mean age was (14. 2 ± 11) years; (42%) of patients were females, while (68%) were males, female to male ratio was (14.2+11) years old. The mean of hospital stay of the mini laparotomy was 5 days, while the mean of hospital stays of trocar insertion of the lower end catheterization during VP shunt surgery 3 days. Complications during the mini laparotomy occur in 12 patients about 48%. While complications during trocar insertion occur in 4 patients only about 8%. CONCLUSION: In a subset of patients, the lower end catheter of the VP shunt with trocar insertion technique is a simple, fast, economical and effective method. Patients who are operated by this method generally experience rapid postoperative recoveries, less post-operative complications and less hospital stay compared to the patients with mini laparotomy.