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VP Shunt Laparoscopy Concern — FRCA Final MCQ

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HardNeuroanaesthesiaVP Shunt Laparoscopy ConcernFRCA Final

A patient with raised ICP and a ventriculoperitoneal shunt requires emergency laparoscopic appendicectomy. What is the primary concern with pneumoperitoneum?

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Correct answer: C — Shunt malfunction from increased abdominal pressure

Pneumoperitoneum (12-15 mmHg) increases intra-abdominal pressure which may impair VP shunt drainage (distal catheter in peritoneum) and raise ICP. Considerations: low insufflation pressure, monitor ICP if possible, gasless laparoscopy as alternative. Neurosurgical consultation regarding shunt management.

Reference: SBNS – 2023 – Anaesthesia in patients with CSF shunts