{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:45:16Z","timestamp":1793727916603,"version":"4.6.1"},"reference-count":19,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Ventriculoperitoneal shunt (VPS) is widely used in the treatment of hydrocephalus (HC), but it is frequently associated with complications such as migration and obstruction of the distal catheter, which can impact therapeutic success. Inadequate fixation of the catheter is one of the primary causes of these complications. Laparoscopic techniques involving fixation of the catheter at two points have been proposed to reduce the risk of migration and improve outcomes, although the literature still lacks consensus on the ideal technique.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods<\/jats:title>\n<jats:p>An 80-year-old obese female presented with ataxia, headache, urinary incontinence, and papilledema. HC was confirmed by computed tomography. The patient underwent a right VPS using an innovative laparoscopic technique for distal catheter fixation. After the placement of the ventricular catheter and programmable valve, the distal catheter was secured with two 2-0 polypropylene sutures and two loops in the right paracolic gutter.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results<\/jats:title>\n<jats:p>The patient progressed well, with no complications in the immediate postoperative period. The fixation was effective in preventing distal catheter migration and reducing obstruction. The laparoscopic approach was successful.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Laparoscopic fixation of the distal catheter with two sutures and loops is a promising technique to improve VPS outcomes, reducing complications. However, further studies are needed to confirm its long-term efficacy and safety.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_1090_2024","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T08:34:27Z","timestamp":1743755667000},"page":"119","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Distal catheter fixation in ventriculoperitoneal shunt by videolaparoscopy \u2013 Technical note"],"prefix":"10.25259","volume":"16","author":[{"given":"Raissa Piassali","family":"Carvalho","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculdade de Medicina do ABC, Santo Andr\u00e9, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Felipe Pereira","family":"Picazio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculdade de Medicina do ABC, Santo Andr\u00e9, S\u00e3o Paulo, 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