Laparoscopic assistance for peritoneal catheter positioning in adults scheduled for ventriculoperitoneal shunting at the Pavlov First Saint Petersburg State Medical University

Objective. To evaluate the efficacy and safety of laparoscopic assistance for peritoneal catheter implantation in adults scheduled for ventriculoperitoneal shunting. Material and methods. A prospective study enrolled 38 patients divided into 2 groups: laparoscopic approach (n=18) and mini-laparotomy (n=20). Surgery time, incision length, pain syndrome and catheter position were assessed. Results. In the main group, surgery time was significantly shorter (40.0 [37.0; 44.0] versus 48.0 [46.0; 50.0] min, p<0.001). The same was true for duration of abdominal stage (10.0 [9.0; 12.0] and 15.0 [14.0; 16.0] min, respectively, p<0.001). The incision length was 15 [14; 16] versus 49 [47; 52] mm (p<0.001). VAS score of pain were lower in the main group (4.5 [4.0; 5.0] versus 5.5 [5.0; 6.0] points; p=0.048). Pain regression was faster (4.0 [3.0; 5.0] versus 7.0 [6.0; 8.0] days; p<0.001). Laparoscopy ensured accurate catheter positioning in all patients. Conclusion. Laparoscopic assistance in ventriculoperitoneal shunting reduces surgery time and invasiveness, ensures accurate catheter positioning and reduces pain. This method is effective in complicated and intact abdominal anamnesis, and improves immediate outcomes.