{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:55:52Z","timestamp":1786125352388,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T00:00:00Z","timestamp":1571270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Ventriculoperitoneal shunting (VPS) is effective for the treatment of normal-pressure hydrocephalus (NPH) and sometimes requires laparoscopic assistance with abdominal insufflation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the association of abdominal insufflation with opening pressure (OP) in NPH patients undergoing VPS implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Between March 2016 and April 2019, 52 consecutive patients who underwent first-time VPS implantation surgery were retrospectively identified by reviewing electronic health records. OP during the large volume lumbar tap test (OP\n                      <jats:sub>LP<\/jats:sub>\n                      ) and VPS implantation surgery (OP\n                      <jats:sub>SURGERY<\/jats:sub>\n                      ) were measured in 29 patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Laparoscopic assistance with abdominal insufflation was used in 20 (69%) cases. There were no differences in patient age (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.589), gender (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.822), body mass index (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.289), weight (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.789), height (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.542), and OP\n                      <jats:sub>LP<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.476) in patients operated with and without laparoscopic assistance. When compared to patients operated without laparoscopic assistance, laparoscopic assistance was associated with a greater rate of OP increase during surgery relative to OP\n                      <jats:sub>LP<\/jats:sub>\n                      (40% vs 100%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.002), a greater increase in OP\n                      <jats:sub>SURGERY<\/jats:sub>\n                      relative to OP\n                      <jats:sub>LP<\/jats:sub>\n                      (\u22120.40\u00a0\u00b1\u00a05.38 vs 10.17\u00a0\u00b1\u00a05.53 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), and a greater proportion of patients with OP\n                      <jats:sub>SURGERY<\/jats:sub>\n                      of \u226525 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O during the VPS surgery (0% vs 78%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Abdominal insufflation is associated with an increase in intracranial pressure with OPs often exceeding 25 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. This should be considered when selecting optimal VPS pressure settings.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz319","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T00:59:21Z","timestamp":1571273961000},"page":"53-56","source":"Crossref","is-referenced-by-count":2,"title":["Abdominal Insufflation Is Associated With Increase of Intracranial Pressure in Patients With Normal Pressure Hydrocephalus"],"prefix":"10.1227","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-6898","authenticated-orcid":false,"given":"Adomas","family":"Bunevicius","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard\u00a0Medical School, Harvard University, Boston, Massachusetts"},{"name":"Harvard Medical\u00a0School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Vernon","sequence":"additional","affiliation":[{"name":"Harvard Medical\u00a0School, Harvard University, Boston, Massachusetts"},{"name":"Department of Surgery,\u00a0Brigham and Women's Hospital, Harvard\u00a0Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Golby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard\u00a0Medical School, Harvard University, Boston, Massachusetts"},{"name":"Harvard Medical\u00a0School, Harvard University, Boston, Massachusetts"},{"name":"Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,7]]},"reference":[{"issue":"5","key":"bib1-20231101","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1212\/CPJ.0b013e3182a78f6b","article-title":"Diagnosis and management of idiopathic normal-pressure hydrocephalus","volume":"3","author":"Williams","year":"2013","journal-title":"Neurol Clin Pract"},{"issue":"3 Suppl","key":"bib2-20231101","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005","journal-title":"Neurosurgery"},{"issue":"1","key":"bib3-20231101","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/ons\/opy232","article-title":"Ventriculoperitoneal shunt complications in the European idiopathic normal pressure hydrocephalus multicenter study","volume":"17","author":"Feletti","year":"2019","journal-title":"Oper Neurosurg"},{"issue":"4","key":"bib4-20231101","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1227\/NEU.0b013e318208f360","article-title":"Morbidity of ventricular cerebrospinal fluid shunt surgery in adults: an 8-year study","volume":"68","author":"Korinek","year":"2011","journal-title":"Neurosurgery"},{"key":"bib5-20231101","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.wneu.2016.10.136","article-title":"The rate of complications after ventriculoperitoneal shunt surgery","volume":"98","author":"Merkler","year":"2017","journal-title":"World Neurosurg"},{"issue":"1","key":"bib6-20231101","doi-asserted-by":"crossref","first-page":"151","DOI":"10.3171\/2011.1.JNS101492","article-title":"Laparoscopic versus open insertion of the peritoneal catheter in ventriculoperitoneal shunt placement: review of 810 consecutive cases","volume":"115","author":"Naftel","year":"2011","journal-title":"J Neurosurg"},{"issue":"3","key":"bib7-20231101","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2016.5.FOCUS1637","article-title":"Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis","volume":"41","author":"He","year":"2016","journal-title":"Neurosurg Focus"},{"issue":"5","key":"bib8-20231101","first-page":"335","article-title":"Adverse hemodynamic effects of intraabdominal pressure\u2014 is it all in the head?","volume":"2","author":"Rosin","year":"2001","journal-title":"Int J Surg Investig"},{"issue":"4","key":"bib9-20231101","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1007\/s004649900367","article-title":"Intracranial pressure. 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