Minim Invasive Neurosurg 2011; 54(2): 98-99
DOI: 10.1055/s-0031-1275698
Technical Note

© Georg Thieme Verlag KG Stuttgart · New York

Paraumbilical Peritoneal Incision using the Little Finger in Shunt Operations for Hydrocephalus: Technical Note

H. Yamahata1 , K. Hirahara2 , T. Tomosugi2 , K. Tajitsu1 , T. Hirayama1 , Y. Sadamura1 , K. Eguchi3 , H. Tokimura1 , K. Arita1
  • 1Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
  • 2Department of Neurosurgery, Kagoshima City Hospital, Kagoshima, Japan
  • 3Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
Further Information

Publication History

Publication Date:
07 June 2011 (online)

Abstract

Introduction: The shunt operation remains the standard procedure for the treatment of hydrocephalus. We describe a simple minilaparotomy method that involves perforation of the peritoneum with the surgeon's little finger.

Technique: After placing a small paraumbilical incision at the skin and fascia, the little finger is introduced through the incision to perforate the pre-peritoneal fat and peritoneum. The finger should be inserted at a 30–45° angle to the horizontal plane to avoid injuring the underlying viscera and major blood vessels and to put sufficient shear force on the peritoneum. A catheter is inserted into the abdominal cavity after visual confirmation of proper perforation.

Conclusion: As the paraumbilical wound is not noticeable postoperatively due to the presence of the natural umbilical skin fold, this method yields a cosmetically appealing result.

References

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  • 2 Bani A, Telker D, Hassler W. et al . Minimally invasive implantation of the peritoneal catheter in ventriculoperitoneal shunt placement for hydrocephalus: Analysis of data in 151 consecutive adult patients.  J Neurosurg. 2006;  105 869-872
  • 3 Kubo S, Nakata H, Yoshimine T. Peritoneal shunt tube placement performed using an endoscopic threaded imaging port.  J Neurosurg. 2001;  94 677-679
  • 4 Choi SI, Lee KY, Park SJ. et al . Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer.  World J Gastroenterol. 2010;  16 275-278
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Correspondence

H. Yamahata

Department of Neurosurgery

Graduate School of Medical and

Dental Sciences

Kagoshima University

8–35–1 Sakuragaoka

Kagoshim-shi

890–8520 Kagoshima

Japan

Phone: +81/99/275 5375

Fax: +81/99/265 4041

Email: yamahata-nsu@umin.net