Laparoscopy-assisted placement of a ventriculobiliary shunt: a technical note.


Department of Neurosurgery, Hospital Universitario y Politécnico La Fe, Valencia, Spain. [Email]


OBJECTIVE : Hydrocephalus is a common condition in pediatric neurosurgeon's clinical practice. Peritoneal and atrial shunting is the treatment of choice in the immense majority of patients. Sometimes, there are complex cases that may need innovative solutions in order to implant the distal catheter of the shunt: in these situations, the gallbladder is a well-described option and it can be safely used.
METHODS : We report the case of a 4-month-old baby with a wide optic-chiasmal hypothalamic glioma generating hydrocephalus with high protein values in CSF. Ventriculobiliary shunting was decided, and the distal catheter was directed by the assistance of laparoscopic surgery.
RESULTS : The outcome was satisfactory.
CONCLUSIONS : As far as we know, laparoscopic placement of a distal catheter in the gallbladder has not been described in the literature; herein, we describe the tenets and the technical tips of this approach.