Peritoneal Shunt for Hydrocephalus Utilizing the Fimbria of the Fallopian Tube for Entrance to the Peritoneal Cavity

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Though recognized by the ancients, hydrocephalus, as noted by Dorothy Russell,19 remained an anatomical enigma until the time of Vesalius20 who gave the first accurate description of an autopsied case. It remains a partial etiological enigma until the present time. However, a great deal of knowledge has accumulated concerning its origin through the efforts of numerous workers from Magendie through Dandy. The saga of the treatment of hydrocephalus has been well documented in numerous reviews.1,4,8,12 On the whole, treatment has been directed toward either reducing the quantity of cerebrospinal

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Figures

  • View in gallery

    Showing exposure of fallopian tube and ovary through a McBurney incision. Ligatures are placed on either side of point of incision (dotted line) into fallopian tube.

  • View in gallery

    Probe introduced through fimbria as guide for polyethylene tube to be inserted into salpinx. (Inset) Tube being anchored by suture.

  • View in gallery

    Proximal end of polyethylene tube is pulled through paraspinal muscles for subsequent implantation into lumbar subarachnoid space.

  • View in gallery

    Through a partial hemilaminectomy the tube is inserted into lumbar theca and anchored by a transfixion suture to the dura mater.

  • View in gallery

    (Left) For ventriculosalpingostomy, after fixing the distal end of the catheter in salpinx, the proximal end is carried subcutaneously up to the occipital area. Tubing is telescoped in anticipation of body growth. (Right) Rostral end of tube inserted into lateral ventricle through a burr hole. (Insets) Details of making lateral openings into tube and bending and sealing it over a small heating iron.

References

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