**Abstract**

Hydrocephalus is an abnormal accumulation of excess cerebrospinal fluid (CSF) in the brain causing increased intracranial pressure, which can arise from a variety of causes, including congenital, acquired, or idiopathic pathologies. Ventriculoperitoneal (VP) shunting is most commonly used to treat hydrocephalic patients, relieving the increased intracranial pressure by draining excess CSF from the ventricles to the peritoneal cavity. VP shunts are primarily completed using either an open or a more minimally invasive neuronavigated laparoscopic-assisted surgical technique. There is a high level of surgical complications, shunt failures and revision rates following VP shunting. It is suggested that different surgical techniques are associated with varying degrees of patient outcomes, surgical complications, and revision rates, with the less invasive laparoscopic-assisted approach producing improved results. We present our results on 14 consecutive hydrocephalic patients, analyzed retrospectively between 2017 and 2019, investigating the benefits offered by the neuronavigated laparoscopic-assisted insertion of VP shunts. Additionally, we explain our workflow and procedural technique. By investigating these differences, changes can be implemented in current routine procedures to ameliorate patient safety, surgical complications, and revision rates.

**Keywords:** hydrocephalus, ventriculoperitoneal shunt, laparoscopy, neuronavigation, complications, shunt failure, revision rates
