I performed a lumbo-peritoneal shunt. Actually, I only deployed a periotenial catheter. I was an assistant surgeon. A chief surgeon, neurosurgical resident, deployed a lumbar catheter. He had asked another doctor to assist, but the doctor had to provide important informed consent then, so I was asked instead.
A lumbo-peritoneal shunt improves symptoms of hydrocephalus. It is not a prophylactic surgery, such as endovascular therapy for unruptured cerebral aneurysms. If you have a cerebral aneurysm and feel anxiety for the rupture, would your symptom be resolved by treatment? I mean, is anxiety a symptom of a cerebral aneurysm? Well, it is not the case I want to talk about today.
I made a 3.5 cm left-sided transverse paraumbilical skin incision, and separated the underlying fat tissues with muscle retractors to expose the superficial fascia of the rectus abdominis muscles. I cut and pulled it up with silk threads on both sides. I separated rectus andominis muscles to expose the deep fascia. I pulled up and cut it. I exposed the thin peritoneum. I incised it carefully and saw vivid yellow greater omentum through the small window to confirm to reach the peritoneal cavity. I got relaxed as I was sure I was a right place. I inserted the catheter into the peritoneal cavity. I closed the peritoneal opening by means of a purse-string suture. The resident continued the abdominal part of the surgery as he finished the lumbar part. I watched him suturing the skin very carefully behind him, feeling it took too much time.
WILLPOWER MELTDOWN SOMETIMES 