A modified surgical technique for ventriculoperitoneal shunt placement using a non-burr hole valve in a pediatric population.

PURPOSE: This study evaluated a modified anchoring technique using a straight connector in non-burr hole valve shunt systems to reduce catheter migration in children under 3 years of age.

METHODS

We retrospectively reviewed records of 48 children (< 3 years) who received frontal ventriculoperitoneal (VP) shunt placement using a non-burr hole valve system between January 2017 and July 2022.

RESULTS

Catheter migration occurred in 18 of 48 patients. Migration was significantly higher with the right-angle adaptor (61.5%) than with the straight connector (9.1%; p = 0.0002). Younger age at surgery was associated with migration (4.5 vs. 10.1 months, p = 0.0048). Univariate analysis showed younger age and use of the straight connector were associated with reduced migration risk.

CONCLUSIONS

In this small retrospective study, anchoring the straight connector was associated with fewer catheter migration events, but the difference was not statistically significant after adjustment for age. These findings should be interpreted as exploratory, highlighting a potential technical consideration rather than a proven benefit. Further prospective studies with larger and age-stratified cohorts are needed to determine whether this modification contributes meaningfully to reducing shunt migration.