Gasless laparoscopy in patients with prior ventriculoperitoneal shunt: yet another option!

Authors

  • Dheeraj Kapoor Govt. Medical College and Hospital, Chandigarh
  • Lalit Kumar Gupta Ivy Hospital, Sector 71, Mohali, Punjab
  • Ashwani Kumar Dalal Govt. Medical College and Hospital, Chandigarh
  • Kamlesh Kumari Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh

DOI:

https://doi.org/10.3329/bjms.v14i4.20544

Keywords:

ventriculoperitoneal shunt, laparoscopy, pneumoperitoneum, intracranial pressure, cerebrospinal fluid, insufflation

Abstract

Anaesthetic management of patients with ventriculoperitoneal shunt (VPS) undergoing laparoscopic surgeries remains controversial for its safety concerns. At present, no standardized protocol exists for managing these patients during perioperative period. The prime concerns are the rise in intracranial pressure (ICP) and shunt dysfunction due to carbon dioxide insufflation. Anaesthetic considerations in these patients should focus primarily on the intrinsic characteristics and functioning of the VP shunt, the insufflation pressures for pneumoperitoneum creation and techniques to monitor the function of shunt. Gasless laparoscopy may be an option by warding off the complications associated with pneumoperitoneum. In our institution, surgeon improvises the laparoscopic technique to create a gasless condition. We discuss the anaesthetic concerns and considerations in this subset of patients for laparoscopy surgeries.

Bangladesh Journal of Medical Science Vol.14(4) 2015 p.420-421

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Author Biographies

Dheeraj Kapoor, Govt. Medical College and Hospital, Chandigarh

Assistant Professor, Department of Anaesthesia and Intensive Care

Lalit Kumar Gupta, Ivy Hospital, Sector 71, Mohali, Punjab

Consultant, Department of Anaesthesia and Intensive Care

Ashwani Kumar Dalal, Govt. Medical College and Hospital, Chandigarh

Assistant Professor, Department of Surgery

Kamlesh Kumari, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh

Senior Resident, Department of Anaesthesia and Intensive Care

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Published

2015-12-11

How to Cite

Kapoor, D., Gupta, L. K., Dalal, A. K., & Kumari, K. (2015). Gasless laparoscopy in patients with prior ventriculoperitoneal shunt: yet another option!. Bangladesh Journal of Medical Science, 14(4), 420–421. https://doi.org/10.3329/bjms.v14i4.20544

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Section

Brief Communications