[Laparoscopic retrieval of a dislocated ventriculoperitoneal shunt catheter: report of three cases and a review of the literature].

Described are 3 cases of a disconnected ventriculoperitoneal shunting system that was successfully retrieved by using a laparoscopic procedure, with a review of the literature. All patients had symptoms of increased intracranial pressure. Roentgenograms showed disconnection of a ventriculoperitoneal shunt catheter at the connecting device and its migration into the peritoneal cavity. A laparoscope was introduced into the peritoneal cavity using the double puncture procedure and the catheter was extracted in less than 15 minutes. The use of a laparoscope enabled exploration of the entire space of the cavity without any large laparotomy incision. Furthermore, the laparoscopic procedure also easily enabled introduction of a replaceable ventriculoperitoneal shunt catheter into the appropriate portion in the cavity and confirmed the CSF flow into the cavity. Because catheters which have migrated into the cavity might cause an acute abdomen, it is important that they should be removed as soon as possible. It should be kept in mind, during the procedures of extracting catheters, that the inner absorptive surface of the peritoneal cavity must be preserved as much as possible. In this regard, laparoscopic retrieval of disconnected shunt catheters is a promising method.