Abstract
For the purpose of preventing obstruction of the peritoneal catheter following ventriculoperitoneal (V-P) shunt, we have devised a method of making additional slits in the peritoneal catheter of an Ames-Dow-Corning set, extending 10 to 15 cm from the tip. Results of clinical application of this method were analyzed in comparison with other V-P shunting methods. In 31 children cases of hydrocephalus, 42 V-P shunt operations were performed, using the Ames-Dow-Corning set with additional slits, and postoperative shunt impairments were observed 19 times (45 %), where four times (10 %) were abdominal catheter obstruction. In 14 children cases, 20 V-P shunt operations were performed, using the Pudenz single lumen shunt set, and postoperative shunt impairments were observed 19 times (95 %), of which 9 times (45 %) were abdominal catheter obstruction. In 17 children cases, 28 V-P shunt operations were performed, using the Mishler double lumen shunt set, and postoperative shunt impairments were observed 21 times (75 %), of which 13 times (46 %) were abdominal catheter obstruction. Thus it has been evidenced that application of the method of additional slit formation in the peritoneal catheter is useful to reduce incidences of postoperative abdominal catheter impairment and in promoting duration of shunt patency.
In several cases in which V-P shunt had been done with the Ames-Dow-Corning set having additional slits, changes in intraventricular pressure accompanying alterations in posture were examined. Marked negativity in intraventricular pressure during maintenance of an erect posture, which indicated existence of a siphon effect, was noted, and counteracting measures were referred to.
