Abstract
The relationship between the intra-abdominal pressure (IAP) and intracranial pressure (ICP) has been suspected for more than 100 years and was subsequently confirmed by numerous studies in both animals and humans which demonstrate the link and the positive correlation between IAP and ICP. There are mounting concerns that the pneumoperitoneum created during laparoscopic surgery to create space for instrument placement and to allow safe tissue dissection may result in an increase in the ICP secondary to the increase in the IAP which may result in serious consequences in patients with Ventriculoperitoneal (VP) shunts. There is uncertainty about the safety of laparoscopic surgery in VP shunt patients. The aim of this article is to review the literature to answer the question [Is laparoscopic surgery safe in VP shunt patients with and without intraoperative monitoring of ICP]?
Highlights
The first attempt of rerouting cerebrospinal (CSF) from the ventricles to the peritoneal cavity (VP shunt) was performed in 1905, the procedure of VP shunt was abandoned for more than the 30 years [1]
There is an increased survival of patients with VP shunts due to the advances in the techniques of cerebral shunts and improved medical therapies
A similar study conducted by Halverson et al [35] by insufflating carbon dioxide at 1.5 l/min in the abdomen of nine 30-35-kg domestic pigs while recording the intracranial pressure (ICP), lumbar spinal pressure (LP), central venous pressure (CVP), and some others vital parameters
Summary
The first attempt of rerouting cerebrospinal (CSF) from the ventricles to the peritoneal cavity (VP shunt) was performed in 1905, the procedure of VP shunt was abandoned for more than the 30 years [1]. Surgeons resisted and ignored laparoscopy and didn’t attempt to test its suitability for surgical applications since 1901, when Georg Kelling performed the first diagnostic laparoscopy on the peritoneal cavity of a dog using a cystoscope [3]. It was until the late eighties of the last century when the advent of computer chip-based television cameras resulted in its revival [4]. Laparoscopic surgery became the standard treatment of much surgical pathology. Patients with hydrocephalus are living longer and may present with unrelated medical or surgical problems
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