Ventriculoperitoneal shunting is surgery to treat excess cerebrospinal fluid (CSF) in the brain (hydrocephalus).
This procedure is done in the operating room under general anesthesia. It takes about 1 1/2 hours.
The procedure is done as follows:
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 of anesthesia 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.
If the procedure is not an emergency (it is planned surgery):
Ask your doctor or nurse about eating and drinking before the surgery. The general guidelines are:
Follow any other instructions about preparing at home. This may include bathing with a special soap.
Children need to lie flat for 24 hours the first time a shunt placed. After that, your child will be helped to sit up.
Children and adults stay in the hospital for 2 to 4 days. The health care team will closely monitor the patient. IV fluids, antibiotics, and pain medicines will be given if needed.
Follow your health care provider's instructions about how to take care of the shunt at home. This may include taking medicine to prevent infection of the shunt.
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.
Shunt - ventriculoperitoneal; VP shunt; Shunt revision
Kinsman SL, Johnston MV. Congential anomalies of the central nervous system. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 585.11.
Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 59.
Updated by: Joseph V. Campellone, M.D., Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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