Paraumbilical Peritoneal Incision using the Little Finger in Shunt Operations for Hydrocephalus: Technical Note

Abstract

Introduction: The shunt operation remains the standard procedure for the treatment of hydrocephalus. We describe a simple minilaparotomy method that involves perforation of the peritoneum with the surgeon's little finger.

Technique: After placing a small paraumbilical incision at the skin and fascia, the little finger is introduced through the incision to perforate the pre-peritoneal fat and peritoneum. The finger should be inserted at a 30–45° angle to the horizontal plane to avoid injuring the underlying viscera and major blood vessels and to put sufficient shear force on the peritoneum. A catheter is inserted into the abdominal cavity after visual confirmation of proper perforation.

Conclusion: As the paraumbilical wound is not noticeable postoperatively due to the presence of the natural umbilical skin fold, this method yields a cosmetically appealing result.

Key words

hydrocephalus - ventriculoperitoneal shunt - lumboperitoneal shunt - peritoneum - skin incision

References

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