Clinical application of a laparoscope in ventri-peritoneal shunting.

A new laparoscopic method was used for percutaneous placement of the peritoneal end of cerebrospinal fluid shunts in patients with obstructive or normal-pressure hydrocephalus. The peritoneal ends of shunts were placed and fixed upward between the liver and the diaphragm by a two-trocar method under direct laparoscopic vision. Meanwhile, patients with postoperative obstruction at the peritoneal end of shunts underwent laparoscopic exploring and adjusting. One obstruction case at the peritoneal pipe end occurred on the third postoperative day, two obstructed by the first month and the other obstructed by the sixth month after the operation. All operations were completed successfully, and all obstructions were adjusted successfully under the laparoscope. All patients were followed up from 6 to 38 months and remained unobstructed. Compared with the traditional open-abdominal method, this method has fewer traumas, quicker recovery and a lower ratio of pipe end obstruction. Besides, it is convenient to adjust obstructed peritoneal ends of shunts.