Microlaparoscopic-Assisted Lumboperitoneal Shunt in the Lateral Position for Pseudotumor Cerebri in a Morbidly Obese Adolescent

BACKGROUND Pseudotumor cerebri or idiopathic intracranial hypertension is a known complication of morbid obesity that often requires neurosurgical intervention for worsening symptoms. Placement of a lumboperitoneal shunt (LPS) is one of the treatment options, but in a morbidly obese patient it can be technically challenging. We describe the use of 3-mm instrumentation for assistance in placing the peritoneal end of the shunt. CASE REPORT A 16-year-old morbidly obese girl with a diagnosis of pseudotumor cerebri and decreasing visual acuity and contraction of her visual fields underwent lumboperitoneal shunt placement. Due to her body habitus secondary to her morbid obesity a microlaparoscopic-assisted approach was utilized for placement of the peritoneal end of the lumboperitoneal shunt. RESULTS No operative or postoperative problems occurred, and she was discharged home with resolution of symptoms. Her visual acuity and fields had normalized at 3-month follow-up. CONCLUSION Microlaparoscopic-assisted lumboperitoneal shunt placement in the lateral position is an efficient and safe method for the treatment of pseudotumor cerebri. It is a minimally invasive, simple, effective tool for placing the peritoneal catheter for LPS.