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064. Mechanical shunt catheter damage is impacted by surgical instrument, catheter type, and surgical technique

Authors: Wilson Fisher

Introduction:
Despite the ubiquity of ventriculoperitoneal shunt (VPS) procedures, advances in VPS technology, and evolving treatment methods, VPS is still frequently associated with complications. There are no current studies in the literature that analyze how physical surgical manipulation affects the mechanical integrity of the shunt components.Methods: Investigators conducted failure testing of a total of 85 rifampin-coated catheters and 85 barium-impregnated catheters using five different surgical instruments and two different surgical techniques. In technique A, the distal end of the catheter was pushed from a proximal position onto the inlet connector. In technique B, the catheter was pulled over the inlet connector with the surgical instrument. Each catheter was assessed for failure after 10 consecutive assembly/disassembly repetitions. 100-repetition-failure tests were also conducted for 10 catheters. Catheters were assessed for failure, defined by tearing or leakage, and how many repetitions to failure.
Results:
There was a significant difference when comparing the overall failure rate of the different instruments (p =
Conclusion:
This study is the first of its kind to give an objective measure of physical manipulation leading to shunt failure and provides a profile of how common surgical instruments damage shunt catheters. Finally, this study highlights the importance of technique and instrument type in shunt assembly.