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Ventriculoperitoneal shunting

Shunt - ventriculoperitoneal; VP shunt; Shunt revision

Ventriculoperitoneal shunting is surgery to treat excess cerebrospinal fluid (CSF) in the cavities (ventricles) of the brain (hydrocephalus).

Images

Ventricles of the brain
Craniotomy for cerebral shunt

Presentation

Ventriculoperitoneal shunt - series

Description

This procedure is done in the operating room under general anesthesia. It takes about 1 1/2 hours. A tube (catheter) is passed from the cavities of the head to the abdomen to drain the excess cerebrospinal fluid (CSF). A pressure valve and an anti-syphon device ensure that just the right amount of fluid is drained.

The procedure is done as follows:

Why the Procedure Is Performed

This surgery is done when there is too much cerebrospinal fluid (CSF) in the brain and spinal cord. This is called hydrocephalus. It causes higher than normal pressure on the brain. It can cause brain damage.

Children may be born with hydrocephalus. It can occur with other birth defects of the spinal column or brain. Hydrocephalus can also occur in older adults.

Shunt surgery should be done as soon as hydrocephalus is diagnosed. Alternative surgeries may be proposed. Your doctor can tell you more about these options.

Risks

Risks for anesthesia and surgery in general are:

Risks for ventriculoperitoneal shunt placement are:

The shunt may stop working. If this happens, fluid will begin to build up in the brain again. As a child grows, the shunt may need to be repositioned.

Before the Procedure

If the procedure is not an emergency (it is planned surgery):

Ask the provider about limiting eating and drinking before the surgery.

Follow any other instructions about preparing at home. This may include bathing with a special soap.

After the Procedure

The person may need to lie flat for 24 hours the first time a shunt is placed.

How long the hospital stay is depends on the reason the shunt is needed. The health care team will closely monitor the person. IV fluids, antibiotics, and pain medicines will be given if needed.

Follow the provider's instructions about how to take care of the shunt at home. This may include taking medicine to prevent infection of the shunt.

Outlook (Prognosis)

Shunt placement is usually successful in reducing pressure in the brain. But if hydrocephalus is related to other conditions, such as spina bifida, brain tumor, meningitis, encephalitis, or hemorrhage, these conditions could affect the prognosis. How severe hydrocephalus is before surgery also affects the outcome.

Related Information

Hydrocephalus
Surgical wound care - open
Ventriculoperitoneal shunt - discharge

References

Badhiwala JH, Kulkarni AV. Ventricular shunting procedures. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 201.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 88.

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Review Date: 10/6/2019  

Reviewed By: Alireza Minagar, MD, MBA, Professor, Department of Neurology, LSU Health Sciences Center, Shreveport, LA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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