gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

ShuntScope: Experience and indications

Meeting Abstract

  • Michael Heckelmann - Abteilung für Neurochirurgie, Krankenhaus Ludmillenstift, Meppen / Ems, Germany
  • Alexandra Huthmann - Abteilung für Neurochirurgie, Krankenhaus Ludmillenstift, Meppen / Ems, Germany
  • Mohamed Salah - Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
  • Joachim Oertel - Neurochirurgische Klinik, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
  • Christoph A. Tschan - Abteilung für Neurochirurgie, Krankenhaus Ludmillenstift, Meppen / Ems, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.21.07

doi: 10.3205/16dgnc369, urn:nbn:de:0183-16dgnc3691

Published: June 8, 2016

© 2016 Heckelmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: With the availability of an endoscope which allows intracatheter visualization, the ShuntScope® (Karl Storz AG, Germany), there is a new valuable tool at hand, which offers a diversity of indications within the field of ventricular shunt treatment. Here we report on our experience and the indications explored during four years of clinical application of the ShuntScope®.

Method: Within the period from January 2012 to November 2015, 67 patients, mean age 35 years (range 0-82 years) underwent an intervention with the ShuntScope. The underlying conditions were: Slit like ventricles (n=38), benign intracranial hypertension (n=11), normal or enlarged ventricles in hydrocephalus (n=26). The indications for using the Shunt Scope were: Initial shunt in challenging narrow anatomy (n=27), shunt revision implanting a new ventricle catheter (n=15), diagnostic work-up for shunt dysfunction (n=8), aqueductal stenting (n=7), Rickham-Reservoir placement (n=5), implanting ventricular catheter in pre-term newborns (third ventricle) (n=4). The semi-rigid ShuntScope® features a fiber optic consisting of 10,000 pixels while the external diameter is very small (1 mm), so that it fits into the inner lumen of a conventional ventricle catheter.

Results: In our experience, the ShuntScope proved to be easy to handle and allowed a fast application of the ventricle catheter. Correction and positioning of the catheter tip is aided by the provided ‘probes eye view’ and the semi-rigid design of the endoscope. This is especially helpful in placement of the catheter tip into the third ventricle in newborns for example. Another application in which the Shunt Scope is extremely helpful, is the diagnostic inspection of the lumen of the catheters in the work-up of ventricle catheter dysfunction. It also provides the option of resolving obstruction. Even though flushing is possible through the ShuntScope® even minor ongoing bleedings might obscure the vision.

Conclusions: The described procedure constitutes the first endoscopic technique to directly control the catheter placement under vision. The indications for the use of the ShuntScope include:

  • placement of ventricle catheters in challenging anatomical conditions
  • aqueductoplasty and placement of the catheter into the third or fourth ventricle
  • inspection and treatment in case of occlusion of the ventricle-catheter
  • in case of planned ventricle catheter removal, the ShuntScope can be used to free the catheter from ingrown plexus.