Background: Peritoneal complications following cerebrospinal fluid (CSF) diversion by ventriculo-peritoneal (VP) shunts are commonly encountered. In this study, the role of laparoscopy in the management of peritoneal segment complications of VP shunts was evaluated. We hypothesize that it has multiple advantages over open surgery, including enhanced ability to visualize the catheter's situation and address the problem, in addition to decreased morbidity and rapid recovery. Methods: This retrospective study reviewed 11 patients with abdominal domain complications, secondary to VP shunts for CSF diversion, who were all laparoscopically operated upon at a tertiary paediatric surgical referral unit. Results: The peritoneal segment complications encountered were shunt fracture or disconnection and intra-peritoneal catheter migration in 27.3% (3/11); abdominal pseudo-cysts in 18.2% (2/11); CSF ascites in 18.2% (2/11); scrotal position of the tip in 9% (1/11); and abdominal sepsis in 27.3% (3/11). The role of laparoscopy was (a) retrieval of the migrated or disconnected shunt (11/11 – all cases); (b) evacuation, debridement, lavage and drainage for pseudo-cysts, abscesses or peritonitis (5/11 – 45.5%); and (c) repositioning of the peritoneal segment tip and assessment of its function (6/11– 54.5%), either primarily (immediate) or secondarily (delayed). Conversion to laparotomy was needed in 2 cases (2/11 – 18.2%). Conclusion: Abdominal complication following CSF shunts can be successfully, advantageously and safely managed laparoscopically, achieving salvage of the shunt system in more than half the cases or assisting with externalisation.

Key words: Laparoscopy, Hydrocephalus, Benign Intracranial Hypertension, Pseudotumor Cerebri, CSF Shunts, Abdominal Pseudocysts and CSF Ascites.