ĐÁNH GIÁ HIỆU QUẢ CỦA KỸ THUẬT “FALCIFORM TECHNIQUE” QUA NỘI SOI Ổ BỤNG SỬA CHỮA TẮC ĐẦU XA DẪN LƯU SAU PHẪU THUẬT DẪN LƯU NÃO THẤT - Ổ BỤNG

Abstract

Purpose: To evaluate the effectiveness of “falciform technique” via laparoscopy in  repairing of distal catheter obstruction following ventriculoperitoneal shunt. Materials and methods: A retrospective study of 19 distal obstruction patients following ventriculoperitoneal shunt, underwent laparoscopic repair at 108 Military Central Hospital from December 2015 to January 2021. All of these were done using the ‘‘falciform technique,’’ with the fixation of the distal catheter to the falciform ligament in supra-hepatic space performed laparoscopically. Results: In total, 19 distal obstruction patients following ventriculoperitoneal shunt patients, the most common cause of hydrocephalus was meningoencephalitis (36.8%); followed by subarachnoid/ventricular hemorrhage (31.6%). The mean time from previous  ventriculoperitoneal shunt placement to obstruction was 9.5 ± 4.9 months. The most common cause of distal catheter obstruction is due to the adhesiolysis of greater omentum (47.4%), foreign bodies (31.6%). The average surgical time was 32.1±14.7 minutes. Median follow-up was 14.3 ± 8.7 months. Except for 2 patients died during the follow-up period (1 due to pneumonia, 1 due to exhaustion), none of the patients (0%) was found to have distal obstruction at the end of the study period at the most recent follow-up. Conclusion: Laparoscopy with the application of falciform technique is a safe and highly effective method in repairing distal catheter obstruction following ventriculoperitoneal shunt.