ArticleLangenbeck's archives of surgery2026
Minimally invasive abdominal catheter placement in ventriculoperitoneal shunt patients is associated with lower abdominal catheter complications: a single center experience.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeVentriculoperitoneal (VP) shunt placement represents one of the modalities for hydrocephalus (HC) requiring cerebrospinal fluid (CSF) flow diversion and is considered a procedure with a high complication rate. Reducing VP-shunt procedure time and optimizing abdominal catheter placement could help surgical VP-shunt complication rates.
methodsA 7-year, single-center retrospective analysis was performed on adult patients who underwent minimally invasive (MI) trocar-guided direct peritoneal puncture (through the outer and inner fascia) for abdominal catheter insertion during VP-shunt implantation. This was compared with a reference cohort undergoing standard trocar insertion after dissection to the inner fascia in 2018 pertaining to surgical procedure time and method related complication rates (abdominal catheter migration and surgical site or wound infection). A matched-pair analysis was used to confirm the observations made.
resultsBetween 2015 and 2022, 25 adult patients (average age: 57 years) underwent VP-shunt insertion with MI abdominal catheter placement and showed a significantly shorter average procedure time (35.1 min ± 16.3) compared to 59.2 ± 16.2 min in the reference cohort (n = 103) undergoing standard insertion (p < 0.001). The rate of abdominal catheter migration or shunt infections in the MI group was 0%, while the standard insertion cohort showed rates of 16% and 8% respectively (p < 0.001). No cases of bowel injury were reported in any of the cohorts. A matched-cohort analysis of 25 MI and 25 ‘standard trocar method’ patients showed a significantly reduced surgical procedure time in the MI group (35.1 vs. 75.1 min, p < 0.001). In addition, a higher rate of abdominal catheter migration (0% vs. 8%, p < 0.001) and infection rate (0% vs. 8%, p < 0.001) in the standard cohort was observed.
conclusionUsing a direct MI trocar-based direct peritoneal puncture was associated with a reduced surgical duration and subsequently reduced abdominal catheter migration and shunt infection rate compared to a standard insertion cohort. These findings highlight an alternative approach that could help reduce VP-shunt complications in adult patients.
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