Microlaparoscopic-Assisted Lumboperitoneal Shunt in the Lateral Position for Pseudotumor Cerebri in a Morbidly Obese Adolescent

BACKGROUND: Pseudotumor cerebri or idiopathic intracranial hypertension is a known complication of morbid obesity that often requires neurosurgical intervention for worsening symptoms. Placement of a lumboperitoneal shunt (LPS) is one of the treatment options, but in a morbidly obese patient it can be technically challenging. We describe the use of 3-mm instrumentation for assistance in placing the peritoneal end of the shunt. CASE REPORT: A 16-year-old morbidly obese girl with a diagnosis of pseudotumor cerebri and decreasing visual acuity and contraction of her visual fields underwent lumboperitoneal shunt placement. Due to her body habitus secondary to her morbid obesity a microlaparoscopic-assisted approach was utilized for placement of the peritoneal end of the lumboperitoneal shunt. RESULTS: No operative or postoperative problems occurred, and she was discharged home with resolution of symptoms. Her visual acuity and fields had normalized at 3-month follow-up. CONCLUSION: Microlaparoscopic-assisted lumboperitoneal shunt placement in the lateral position is an efficient and safe method for the treatment of pseudotumor cerebri. It is a minimally invasive, simple, effective tool for placing the peritoneal catheter for LPS.