To the Editor.—The technique for insertion of the LeVeen shunt is well described in the literature.1 The construction of the subcutaneous tunnel for placement of the venous end of the LeVeen shunt requires the passage of the suture that is tied to the venous end of the shunt and then redrawn through the subcutaneous tunnel. This requires a double passage through the subcutaneous space and when performed under local anesthesia necessitates repeated discomfort.
A modification of the aforementioned LeVeen technique was devised that uses a trocar easily constructed from the aluminum insertion trocar of a 28-F Argryl chest tube (Fig 1). This trocar is made by threading the blunt end with standard .625-cm (one-fourth in) thread and rounding the other end (Fig 2). The venous end of the LeVeen shunt tubing is "screwed" onto the threaded tunneler then the tubing is passed from the abdominal wound to the cervical