ABSTRACT
The use of laparoscopic guidance for abdominal puncture and introduction of ventriculoperitoneal shunt peritoneal catheters using a peritoneal split trocar is proposed. The technique permits location of the catheter in the right parietocolic space or its relocation if trapped within the omentum. Cerebrospinal fluid flow is certified. Since the submission of the paper 6 selected cases have been operated upon without complications.
Subject(s)
Catheterization/methods , Hydrocephalus/surgery , Laparoscopy , Ventriculoperitoneal Shunt , Abdomen/surgery , Female , Humans , Hydrocephalus/physiopathology , Male , PuncturesABSTRACT
Twenty-eight cases of intracranial arachnoidal cysts diagnosed during the period 1978-1990 are analyzed. All cases were investigated with computed tomography (CT), 5 with magnetic resonance imaging (MRI) and 5 with ultrasonography (US). Seventeen were located in the middle cranial fossa, 3 in the quadrigeminal cistern, 2 were parasagittal, 3 suprasellar and 3 were located in the posterior fossa. Twenty-three of the 28 patients were treated surgically, craniotomy with fenestrations was used in 3 cases. Different varieties of shunts were inserted in 8 cases and in the last 15 patients the only surgical treatment was the insertion of cysto-peritoneal (CP) drainage (without a valve) with excellent results. MRI and/or CT follow-up revealed disappearance of the cyst in 13 out of 22 cases and 7 experienced a marked reduction. In 2 patients the cyst showed little change. There were no cases of infection and no deaths.
Subject(s)
Arachnoid Cysts/surgery , Cerebrospinal Fluid Shunts , Adolescent , Adult , Arachnoid Cysts/diagnosis , Child , Child, Preschool , Echoencephalography , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Male , Middle Aged , Neurologic Examination , Peritoneum , Postoperative Complications/diagnosis , Tomography, X-Ray ComputedABSTRACT
A simple method for the replacement of a peritoneal catheter is described. The old catheter is disconnected from the valve and exteriorized from the peritoneal cavity, using a straight connector. The new catheter is anchored to the cranial or peritoneal end of the old catheter. A gentle traction allows the new catheter to follow the previous subcutaneous tunnel.
