The utility of combined neuroendoscopic- and laparoscopic-assisted ventriculo- peritoneal shunt as a treatment for patients with communicating hydrocephalus

BACKGROUND: Ventriculo-peritoneal shunt (VPS) is one of the routine methods used to treat communicating hydrocephalus. OBJECTIVE: To sum up the clinical effectiveness of ventriculo-peritoneal shunt (VPS), assisted with neuroendoscopy and laparoscopy, for the treatment of patients with communicating hydrocephalus. METHODS: From January 2010 to 2014, we performed VPS surgery on 209 patients with communicating hydrocephalus, using neuroendoscopy and laparoscopy, which helped to implant the shunt catheter in a suitable position in the ventricles and abdominal cavity, respectively. The subsequent survival following the surgery was analyzed using Kaplan-Meier analysis. RESULTS: A total of 209 patients received 255 VPSs or revisions and all the operations were successfully completed. Open operation or oraniotomy was not needed for any technical complications, while 46 revisions were performed. After the operations, 203 patients with communicating hydrocephalus exhibited improvement of symptoms following surgery. The follow-up period ranged from one month to four years; the shunt surgery efficiencies were 91.0%, 86.7%, 83.9%, and 82.0% in the first, second, third, and fourth years, respectively. CONCLUSION: For ventriculo-peritoneal shunt, laparoscopy and neuroendoscopy can help to implant shunt catheter in a suitable position, in the ventricles or abdominal cavity, respectively. Hence, the combination of the two techniques can reduce the failure rate of VPS, and has an obvious impact on survival following the surgery.