Laparoscopic Treatment of Ventriculoperitoneal Shunt Complication Caused by Distal Catheter Isolation Inside the Falciform Ligament.

Abstract

A ventriculoperitoneal shunt is a widely recognized treatment that we use to treat hydrocephalus. In one's lifetime, there is a high possibility of being diagnosed with shunt dysfunction. Occasionally, complications caused by the distal catheter located in the intra-abdominal cavity may occur. In this case, after undergoing shunt surgery, the patient's distal catheter had not moved and was fixed in 1 place. Therefore, we used abdominal computed tomography and discovered the presence of a pseudocyst where the distal catheter was located. Through laparoscopic-assisted surgery performed by the department of general surgery, we discovered that the distal catheter entered into the falciform ligament and caused it to expand, creating a cyst. The fascia of the falciform ligament was dissected using a harmonic scalpel. Cerebrospinal fluid and the distal catheter were noted. Afterwards, the distal catheter was placed into the peritoneal cavity. After surgery, the patient was discharged without any complications. Although this is an unusual circumstance, there have been reports of some cases in which the ventriculoperitoneal shunt distal catheter entered the falciform ligament. Therefore, one must pay close attention during the operation. In addition, when treatment is necessary, laparoscopic-assisted surgery might serve as an effective diagnostic and therapeutic modality.