Safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt.

Abstract

This study retrospectively investigated the safety of laparoscopic colorectal surgery in patients with ventriculoperitoneal shunt (VPS) based on the experiences within our department. A total of 866 patients underwent laparoscopic colorectal surgery for colorectal cancer, ulcerative colitis, Crohn's disease, and acute appendicitis at Osaka University during the study period. Laparoscopic colorectal surgery cases were collected from the Osaka University database. Among them, four (0.5%) had VPS when they underwent surgery. In these four cases, we consulted a neurosurgeon and checked the route of the VPS catheter to determine whether it had a unidirectional valve to prevent backflow and whether it was working normally. We retrospectively investigated the clinical characteristics of these four cases. All cases were safely treated, with the pneumoperitoneum pressure set at 10 mmHg under routine anesthetic monitoring and without any manipulations such as clamping or externalization of the VPS catheter. The four patients were discharged without any VPS-related complications such as increased intracranial pressure, shunt failure, or infection. Our study suggests that laparoscopic colorectal surgeries in patients with VPS without any manipulations may be safe. Future studies should aim to better standardize the perioperative management of VPS during laparoscopic colorectal surgery.