Ventriculoperitoneal shunting

Definition

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

Alternative Names

Shunt - ventriculoperitoneal; VP shunt; Shunt revision

Description

This procedure is done in the operating room under general anesthesia. It takes about 1 1/2 hours.

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.

Risks

Risks of anesthesia and surgery in general are:

Risks of 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.

References

Hdeib A, Cohen AR. Hydrocephalus in children and adults. In: Ellenbogen RG, Abdulrauf SI, Sekhar LN, eds. Principles of Neurological Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 6.

Meltzer H. Insertion of ventriculoperitoneal shunt. In: Jandial R, McCormick PC, Black PM, eds. Core Techniques in Operative Neurosurgery. Philadelphia, PA: Elsevier Saunders; 2011:chap 52.



Review Date: 1/5/2016
Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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