Your Health

Ventriculoperitoneal Shunt Placement

(Cerebral Shunt Placement)

Definition

A ventriculoperitoneal (VP) shunt placement is surgery to insert a draining device from inside the skull to the abdomen. It allows excess fluid to drain from the brain into the abdomen. The fluid can be reabsorbed in the abdomen.

Reasons for Procedure

The interior of the brain has four spaces called ventricles. The ventricles hold a fluid that bathes and cushions the brain and spinal cord. Certain health conditions and injuries can cause an excess amount of this fluid, called hydrocephalus. Excess fluid creates too much pressure and can lead to brain damage.
VP shunt placement is done to treat hydrocephalus. Half of the ventriculoperitoneal shunts that are placed can successfully drain the excess fluid.
Brain
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Possible Complications

Problems from the procedure do occur, but all procedures have some risk. Your doctor will review potential problems, like:
  • Blockage of the shunt
  • Infection
  • Excess bleeding
  • Blood clots
  • Damage to normal brain tissue
  • Adverse reaction to anesthesia
  • Soreness in throat
  • Nausea and vomiting
  • The need for additional surgery
Smoking may increase your risk of complications.
Talk to your doctor about these risks before the procedure.

What to Expect

Prior to Procedure

The doctor may do the following:
  • Physical exam and medical history
  • Blood tests
Talk to your doctor about your medications. You may be asked to stop taking some medications up to two weeks before the procedure such as:
  • Anti-inflammatory medications such as ibuprofen and naproxen
  • Blood thinners
  • Anti-platelet medications
Before the procedure, you should:
  • Arrange for a ride home from the hospital.
  • Arrange for help at home, as you recover.
  • Eat a light meal the night before your surgery. Do not eat or drink anything after midnight unless told otherwise by your doctor.
  • Talk to your doctor if you take any medications, herbs, or supplements.

Anesthesia

General anesthesia will be used. You will be asleep during surgery.

Description of the Procedure

The hair over the area will be shaved. A small incision will be made in the scalp. It may be just past the hairline, on back of the head, or behind the ear. A small hole is then made in the skull. A tube is passed through the hole into a ventricle. A valve is placed on the tube to manage the flow of fluid. A small incision may be made behind the ear to help pass the tube. Another tube is attached to the other side of the valve and is guided under the skin of the skull until it reaches the abdomen. A small incision will also be made in the abdomen to help guide the tube into the correct place in the abdomen. Once the tube is in place, the incisions are closed.

Immediately After Procedure

After the operation, you will be taken to the recovery room for observation.

How Long Will It Take?

About 2 hours

How Much Will It Hurt?

Anesthesia prevents pain during surgery. As you recover, you may have some pain. Your doctor will give you pain medication.

Average Hospital Stay

This is done in a hospital. The usual length of stay is 2-7 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At Home

When you return home, take these steps:
When you return home, take these steps:
  • Avoid pushing, pulling, and lifting anything heavy for four weeks.
  • Do not participate in sports or exercise until your doctor says it is okay.
  • Do not drive for two weeks.
  • Be sure to follow your doctor’s instructions.

Call Your Doctor

Call your doctor if any of these occur:
  • Evidence of valve blockage as described by your doctor
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Signs of infection, including fever and chills
  • Pain that you cannot control with the medications that you have been given
  • Nausea and vomiting
  • Lightheadedness and fainting
  • Severe headache
  • Changes in vision
  • Confusion
  • Memory loss
  • Difficulty speaking
  • Clear fluid draining from the incision site
If you have an emergency, call for medical help right away.

RESOURCES

Hydrocephalus Association http://www.hydroassoc.org

University of Rochester Medical Center http://www.urmc.rochester.edu

CANADIAN RESOURCES

Canadian Neurological Sciences Federation http://www.cnsfederation.org

Spina Bifida & Hydrocephalus Canada http://www.sbhac.ca

References

Complications of hydrocephalus. Hydrocephalus Association website. Available at: http://www.hydroassoc.org/hydrocephalus-education-and-support/learning-about-hydrocephalus/life-threatening-complications-of-hydrocephalus. Accessed December 23, 2013.

Shunt systems. Hydrocephalus Association website. Available at: http://www.hydroassoc.org/hydrocephalus-education-and-support/learning-about-hydrocephalus/shunts. Accessed December 23, 2013.

Ventriculoperitoneal shunt. NeuroSurgery PA website. Available at: http://www.neurosurgerypa.com/procedures/Ventriculoperitoneal%5FShunt.html. Accessed December 23, 2013.

Ventriculo-peritoneal shunt. University of Rochester Medical Center website. Available at: http://www.urmc.rochester.edu/neurosurgery/for-patients/treatments/ventriculoperitoneal-shunt.aspx. Accessed December 23, 2013.

Ventriculoperitoneal VP shunt placement. Holy Cross Hospital website. Available at: http://www.holycrosshealth.org/ventriculoperitoneal-vp-shunt-placement. Accessed December 23, 2013.

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