Peritoneocystic Shunting for Ascites

Abstract

The study was designed to determine if a prototype pump could be successfully implanted in the abdomen and effectively remove excess fluid without causing complications for a 1-month period. The procedure was performed on four swine under general anesthesia. A standard two-valve Denver shunt was implanted under the skin with the efferent limb implanted in the urinary bladder. The effectiveness of the pump was verified in vivo by pumping normal saline irrigated into the abdomen. The incision was closed and the animals were observed for any problems. After 1 month, a repeat test of the pump was performed. After this second test, the animals were euthanized and examined for complications of the device. All four swine survived the procedure and the 1-month follow-up. Pump function at the end of the 1-month interval was maintained in three of the four animals. None of the swine developed calculi. There were no consistent pathologic findings, although all four swine showed evidence of reactive inflammation at the insertion site of the efferent limb into the bladder. Preliminary data suggests that a subcutaneously implanted peritoneocystic shunt may be an option for the treatment of tense ascites.