Ventriculoperitoneal shunting.

Sir,

The report on “ventriculoperitoneal shunting” is very interesting.[1] Nigim et al. noted that “laparoscopic ventriculoperitoneal shunting (LVPS)-placement results compare similarly to open ventriculoperitoneal shunting (OVPS) placement in most aspects.”[1] In fact, LVPS-placement is a new alternative that is considered minimally invasive. In Chinese experience, it is reported that “this method has fewer traumas, quicker recovery and a lower ratio of pipe end obstruction.”[2] Similar finding is also reported from USA.[3] Nevertheless, there are also some considerations on this technique. First, the technique required experience neurosurgeon and good case selection. According to recent reports by Bani et al., the important complication of LVPS-placement over OVPS placement is shunt infection.[4] Hence, the case with risk of infection should not be considered to use this technique.