Laparoscopic Resection of Endometriosis in a Patient with a Ventriculoperitoneal Shunt Using the LapDisc

Iris Kerin Orbuch, Orbuch IK, Atkin R, R.P. Atkin, Russell Atkin, Gilad Filmar, Filmar G, Singer T, T. Singer, Tomer Singer, Michael Y. Divon, Divon MY
Journal of Minimally Invasive Gynecology · 2010 · vol. 17(1) , pp. 107–109 · doi:10.1016/j.jmig.2009.09.014 · PMID:20129342 · W2109723099
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This case report describes the successful laparoscopic resection of endometriosis in a patient with a ventriculoperitoneal shunt using the LapDisc device.

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Abstract

The surgical approach in a patient with a ventriculoperitoneal shunt in need of abdominal surgery remains controversial. The risk of increased intracranial pressure with pneumoperitoneum in laparoscopy is still unresolved. We used the LapDisc (Ethicon, Inc., Somerville, New Jersey) to access the shunt and temporarily seal it, which enabled us to perform laparoscopic resection of endometriosis without subjecting the shunt to high intraabdominal pressure. The benefits of this approach are the ability to perform laparoscopy, less skin-to-shunt contact minimizing infection, and elimination of possible increased intracranial pressure secondary to pneumoperitoneum. With the progress made in the management of hydrocephalus, patients with ventriculoperitoneal (VP) shunts enjoy a longer lifespan. Therefore, the gynecologic laparoscopic surgeon can expect to treat a patient with a VP shunt in place.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopes Laparoscopy Peritoneal Diseases Ventriculoperitoneal Shunt Adult Endometriosis Female Humans Laparoscopy Peritoneal Diseases Treatment Outcome

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