Laparoscopic Surgery in Patients with VP Shunt

Laparoscopic surgery can be safely performed in patients with VP shunt with some precautions mentioned in the literature. In our short experience, we prepare for research work for our cases. But until that is published, I want to say the most important issue in this subject is to avoid iatrogenic injury to the tube intraperitoneally and most importantly subcutaneously during port insertion, you should palpate the tract of the tube especially, during the epigastric port insertion during laparoscopic cholecystectomy. I can summarize what’s written in the literature here:

Laparoscopic surgery appears to be generally safe in patients with a ventriculoperitoneal (VP) shunt, though certain precautions should be taken:

Laparoscopic procedures in VP shunt patients have been reported with good outcomes, with a low risk of shunt-related complications like infection or retrograde failure.

The main concern is the potential for increased intracranial pressure (ICP) during the pneumoperitoneum, but this has not been shown to be clinically significant in most cases. Routine ICP monitoring may not be necessary.

Precautions include: having a neurosurgical consult prior to surgery, careful trocar placement to avoid the shunt path, and keeping the pneumoperitoneum pressure low (e.g. below 16 mmHg).

Laparoscopic surgery can be safely performed in VP shunt patients with appropriate anesthetic monitoring and precautions, though the operative time may need to be limited.

In summary, laparoscopic surgery appears to be a viable option for VP shunt patients, but should be done cautiously by an experienced surgeon and with appropriate perioperative management.