Microlaparoscopic-Assisted Lumboperitoneal Shunt in the Lateral Position for Pseudotumor Cerebri in a Morbidly Obese Adolescent

Author： Kumar Nirupama Bierbrauer Karin S. Grewal Harsh

Publisher： Society of Laparoendoscopic Surgeons

ISSN： 1086-8089

Source： JSLS, Journal of the Society of Laparoendoscopic Surgeons, Vol.10, Iss.2, 2006-04, pp. : 267-269

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Abstract

Background: Pseudotumor cerebri or idiopathic intracranial hypertension is a known complication of morbid obesity that often requires neurosurgical intervention for worsening symptoms. Placement of a lumboperitoneal shunt (LPS) is one of the treatment options, but in a morbidly obese patient it can be technically challenging. We describe the use of 3-mm instrumentation for assistance in placing the peritoneal end of the shunt.Case Report: A 16-year-old morbidly obese girl with a diagnosis of pseudotumor cerebri and decreasing visual acuity and contraction of her visual fields underwent lumboperitoneal shunt placement. Due to her body habitus secondary to her morbid obesity a microlaparoscopic-assisted approach was utilized for placement of the peritoneal end of the lumboperitoneal shunt.Results: No operative or postoperative problems occurred, and she was discharged home with resolution of symptoms. Her visual acuity and fields had normalized at 3-month follow-up.Conclusion: Microlaparoscopic-assisted lumboperitoneal shunt placement in the lateral position is an efficient and safe method for the treatment of pseudotumor cerebri. It is a minimally invasive, simple, effective tool for placing the peritoneal catheter for LPS.