Our experience of ventriculoperitoneal shunting with joining of posterior horns of lateral ventricles at patients semi-sitting position suffered from mass lesions of chiasmatic regions

Abstract

The bilateral ventriculoperitoneal shunting should be done in some cases of non-operable tumors of chiasmatic region, occupying the III ventricle and causing the occlusion of both Monro foramens (craniopharyngiomas, gliomas, pituitary adenomas, meningiomas and others). The drainage of posterior horns of both lateral ventricles is seems to be the logic and correct solution to solve this problem. The main advantage of such operation is the possibility to perform the tumor removal in future via different approaches (pterional, subfrontal, transcallosal) because of absent of shunting system components in front of the coronal suture. The expectancy of correct placement of ventricular catheter into posterior horn of lateral ventricle varies from 42 till 89%. This article presents our first experience (5 clinical cases) of ventriculoperitoneal shunting with joining of posterior horns of lateral ventricles, during which the semi-sitting position of patient was used for facilitating the puncture of posterior horns of lateral ventricles. The authors haven’t found such operations in literature. This described semi-sitting position of patient facilitates the unmistakable placement of catheter into posterior horn of lateral ventricle and don’t embarrass the «peritoneal» step of operation.