Ventricular Peritoneal Shunting Using Modified Keen’s Point Approach: Technical Report and Cases Series

Background: Ventricular peritoneal shunting (VPS) is a frequent procedure in neurosurgery, unfortunately still burdened with significant rate of complications. The frontal Kocher’s point the most frequently used landmark for ventricular puncture. Keen’s (posterior parietal approach) seems to be valid alternative. We report newly described access lateral ventricle located posterior temporal area and results large series adult patients. Methods: Retrospective analysis 188 cases VPS performed this approach. Results: Mean surgical time was 51.5 +/− 13.1 min (range 25–90 min). Twenty-one patients (11.2%) were subjected revision surgery: eight (4.3%) displacement or malfunction catheter, abdominal issues, three (1.6%) hardware failure, two (1.1%) infection. Optimal catheter placement reached 90.1%. Conclusions: modified approach safe, technically feasible, reproducible, showing some potential advantages such as short time, precision placement, tunneling tract. need similar that reported literature, while malpositioning infections low; hemorrhages around seizures not reported.