Outcomes of ventriculoperitoneal shunt placement with or without laparoscopic assistance: An analysis of the national inpatient sample

Monica Maloney; Kevin Zhao; Patrick Hilden; Amber L Turner; Aziz M Merchant; Pankaj K Agarwalla

doi:10.1016/j.wnsx.2023.100266

Outcomes of ventriculoperitoneal shunt placement with or without laparoscopic assistance: An analysis of the national inpatient sample

World Neurosurg X. 2023 Dec 9:21:100266. doi: 10.1016/j.wnsx.2023.100266. eCollection 2024 Jan.

Authors

Monica Maloney¹, Kevin Zhao², Patrick Hilden³, Amber L Turner⁴, Aziz M Merchant⁵, Pankaj K Agarwalla²

Affiliations

¹ Department of Surgery, University of Connecticut School of Medicine, Farmington, CT, USA.
² Department of Neurosurgery, Rutgers New Jersey Medical School, USA.
³ Department of Biostatistics, Cooperman Barnabas Medical Center, Livingston, NJ, USA.
⁴ Department of Surgery, Cooperman Barnabas Medical Center, Livingston, NJ, USA.
⁵ Department of Surgery, Hackensack Meridian Health JFK University Medical Center, Edison, NJ, USA.

Abstract

Background: Ventriculoperitoneal shunt (VPS) can be placed solely by a neurosurgeon often via an open-laparotomy approach, or laparoscopically as a collaborative effort between a neurosurgeon and a general surgeon. Prior studies have shown conflicting results when examining outcomes regarding infection, revision rate, hospital charges, length of stay, and mortality between the open mini-laparotomy and the laparoscopic approaches.

Objective: The current study uses the National Inpatient Sample (NIS) to compare outcomes of open mini-laparotomy vs. laparoscopic collaborative approach in VPS placement.

Methods: We performed a retrospective database study of the NIS from October 2015-December 2017 utilizing International Classification of Diseases, 10th Revision coding to identify all cases of VPS placement. All analyses accounted for the sampling design of the NIS.

Results: A total of 6580 cases (4969 with open mini-laparotomy approach and 1611 with laparoscopic collaborative approach) met inclusion criteria. Hospital charges, infection rates, and revision rates were similar between approaches. There were no significant differences in length of stay, mortality, or complication rates between the two approaches.

Conclusion: The collaborative, laparoscopic approach to VPS placement has similar outcomes and is non-inferior to the traditional open mini-laparotomy approach.

Keywords: General surgery; Laparoscopic; Length of stay; Mini-laparotomy; National impatient sample (NIS); Neurosurgery; Ventriculoperitoneal shunt (VPS).