Ventriculoportal Shunt,a New Transomphalic Extraperitoneal Surgical Technique in Treatment of Hydrocephalus

Abstract

Aim. The aim of this article was to report a new transomphalic extraperitoneal surgical technique for treatment of hydrocephalus, called ventriculoportal shunt. Materials and Methods. We performed ventriculoportal shunt on an experimental animal (pig). The particularity of ventriculoportal shunt consists in the fact that the distal end of the catheter is inserted transomphalic extraperitoneally in the portal system through reopened umbilical vein. We present technical details regarding this new surgical technique. Results and Discussion. The animal had favorable outcome, without any postoperative early or late morbidity. We discuss indications, contraindications, possible complications in humans and advantages of ventriculoportal shunt compared with ventriculocardiac and ventriculoperitoneal drainages and possibilities to avoid complications specific to classic shunt procedures. Conclusions. Ventriculoportal shunt is a new surgical technique for treatment of hydrocephalus. The distal end of the catheter introduced into reopened umbilical vein, drains cerebrospinal fluid into the portal system. Ventriculoportal shunt is safe and easy to perform. With ventriculoportal shunt specific complications of ventriculoperitoneal or ventriculocardiac drainages can be potentially avoided. Ventriculoportal shunt combines advantages of vascular shunt with those of having an immunological barrier for cerebrospinal fluid before entering the systemic circulation. Theoretically, indications for surgery are extended, and ventriculoportal shunt can be performed in patients former contraindicated for ventriculoperitoneal shunt. Further research is needed and this surgical technique must be performed on human subjects with hydrocephalus.