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A Simplified Technique for Performing the Ventriculo-Peritoneal Shunt

1967; American Association of Neurological Surgeons; Volume: 26; Issue: 3 Linguagem: Inglês

10.3171/jns.1967.26.3.0357

1933-0693

Anthony J. Raimondi, Satoshi Matsumoto,

Fetal and Pediatric Neurological Disorders

W E HAVE found tha t the use of the Pudenz -Heye r valve with a ventr iculo-peri toneal shunt provides the mos t favorable me thod of t r e a t m e n t for congenital and acquired hydrocephalus. The simple ventr iculo-peri toneal shunt was prone to early malfunct ion because of the insinuation of omen tum into the distal end of the tubing. For this reason, ventr iculo-caval and ventriculo-atrial shunts have been generally adopted. The Pudenz -Heye r shunt ing device has a leaf valve a t the distal end of the tubular system. This va lve remains closed a t all t imes except when fluid is passing outward, thus prevent ing o m e n t u m f rom gaining access to the tubula r system. Consequently, we chose to per form ventriculo-peri toneal shunts when confronted with the problem of a child who a l ready had one internal and two external jugular veins thrombosed from previous ventr iculo-venous shunts. Our resuits in these cases p roved so favorable tha t we ul t imately made it our practice to use this method as a m a t t e r of routine. Although the technique of establishing a ventI iculo-peri toneal shunt is relatively simple in an adult , the appl ica t ion to a newborn or premature child is more complicated. The problems of general anesthesia in the newborn add to the difficulties. We are report ing our simplified technique for performing the ventriculo-peri toneal shunt under local anesthesia. Our experience includes 67 procedures performed on 6~ newborn children and 5 adults , for either congenital or acquired hydrocephalus of either the communica t ing or the obstruct ive varieties.