Copyright Philippe Schucht.
Laparoscopic VP shunt placement. A 5-mm optic trocar is inserted next to the navel after a sufficient pneumoperitoneum has been established. A peel-away needle is used to puncture the peritoneum. The distal shunt, which has been subcutaneously tunneled from the head toward the abdomen, is inserted through the needle and placed into the peritoneal cavity under direct laparoscopic vision.