Introduction of a self-holding retractor for optimized abdominal visualization in ventriculoperitoneal shunt surgery: first experiences at a single center.
- Krauss P Department of Neurosurgery, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland. ph.krauss@gmx.de.
- Oertel MF Department of Neurosurgery, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
- Stieglitz LH Department of Neurosurgery, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
- 2019-01-13
Published in:
- Acta neurochirurgica. - 2019
Hydrocephalus
Surgical technique
Ventriculoperitoneal shunt
Wound retractor
Adult
Aged
Catheters
Female
Humans
Hydrocephalus
Male
Middle Aged
Postoperative Complications
Ventriculoperitoneal Shunt
English
OBJECTIVE
Ventriculoperitoneal shunt implantation is a common procedure in general neurosurgery. The patient population is often fragile, ranging from elderly to pediatric patients, and avoidance of perioperative complication is of utmost importance. Abdominal catheter dislocation has been found to be a common cause for early shunt dysfunction and needs to be avoided by optimal visualization of the abdominal catheter insertion zone. Here, we introduce a self-holding wound retractor system Alexis® and demonstrate its use for abdominal shunt surgery in a series of patients.
METHODS
We explain the use of the Alexis® self-holding wound retractor during open ventriculoperitoneal shunt surgery in a series of 16 patients operated at our institution.
RESULTS
The self-holding retractor consists of two polymer rings connected by a polymer membrane. The deep ring is easily placed on the internal fascia of the straight muscle and circular retraction is achieved by twisting the upper ring. Free hand working can then be performed by a single surgeon with good abdominal exposure. No case of abdominal dislocation or infection occurred in our series, although no properly powered statistical analysis can be performed regarding the sample size.
CONCLUSION
We demonstrate the Alexis® Wound Retractor, which is an easy tool for optimal visualization of the abdominal catheter insertion zone. We believe it can facilitate surgical practice of shunt surgery, especially in obese patients.
Ventriculoperitoneal shunt implantation is a common procedure in general neurosurgery. The patient population is often fragile, ranging from elderly to pediatric patients, and avoidance of perioperative complication is of utmost importance. Abdominal catheter dislocation has been found to be a common cause for early shunt dysfunction and needs to be avoided by optimal visualization of the abdominal catheter insertion zone. Here, we introduce a self-holding wound retractor system Alexis® and demonstrate its use for abdominal shunt surgery in a series of patients.
METHODS
We explain the use of the Alexis® self-holding wound retractor during open ventriculoperitoneal shunt surgery in a series of 16 patients operated at our institution.
RESULTS
The self-holding retractor consists of two polymer rings connected by a polymer membrane. The deep ring is easily placed on the internal fascia of the straight muscle and circular retraction is achieved by twisting the upper ring. Free hand working can then be performed by a single surgeon with good abdominal exposure. No case of abdominal dislocation or infection occurred in our series, although no properly powered statistical analysis can be performed regarding the sample size.
CONCLUSION
We demonstrate the Alexis® Wound Retractor, which is an easy tool for optimal visualization of the abdominal catheter insertion zone. We believe it can facilitate surgical practice of shunt surgery, especially in obese patients.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1007/s00701-018-03794-0
- PMID 30635726
- Persistent URL
- https://sonar.ch/global/documents/298700
Statistics
Document views: 31
File downloads:
- Full-text: 0