Ventriculoperitoneal Shunt Placement For Hydrocephalus In Children

What you should know

Ventriculoperitoneal Shunt Placement For Hydrocephalus In Children (Precare) Care Guide

  • A ventriculoperitoneal (VP) shunt is needed to treat hydrocephalus . Hydrocephalus is the build up of too much fluid in the brain. This fluid is called cerebrospinal fluid (CSF). The CSF is made in a part of the brain called the ventricles . If there is too much CSF in the ventricles they will become larger than normal. This can put extra pressure on the brain. The VP shunt will drain the extra CSF out of the ventricles. It will also decrease the pressure on the brain. The shunt surgery is done by a neurosurgeon . Ask your child's caregiver for the CareNotes™ handout about hydrocephalus for more information.

  • Most children with hydrocephalus need to have a VP shunt for the rest of their lives. It may need to be replaced or revised (fixed) if it is not working properly. If a shunt was put in a baby, it may need to be replaced when the child is older. This is done because the tubing needs to be longer in an older child. Many shunts that are put in now are longer. This means the shunt will not need to be replaced as the child grows.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

There are always risks with surgery. Your child may bleed more than usual or get an infection (in-fek-shun). Brain damage or other problems may happen if your child's hydrocephalus is not treated. Call your child's caregiver if you have questions about your child's surgery or medicines.

Getting Ready

The Week Before Surgery:

  • Tell your child's caregiver about any medicines your child is taking or if he had a recent illness. Ask your child's caregiver about any medications your child should or should not take before the surgery.

  • Your child may need blood tests before the procedure. Talk to your child's caregiver about these or other tests he may need. Write down the date, time and location for each test.

  • Children who have a VP shunt surgery do not usually need a blood transfusion. A caregiver will tell you if your child may need a transfusion. If your child does need a blood transfusion, you or a family member may be able to donate. If you or a family member has the same blood type as your child, you may be able to donate. This is called directed blood donation. Talk to a caregiver for more information on directed blood donation.

The Night Before Surgery:

  • Your child should get a good night sleep the night before surgery.

  • Ask caregivers about directions for eating and drinking.

The Day Of Surgery:

  • Write down the date, time, and location of your child's surgery.

  • Ask your child's caregiver before giving your child any medicine the day of surgery. Bring a list of your child's medicines or the pill bottles with you to the hospital.

  • If your child is staying in the hospital after surgery, bring some of your child's belongings with you. These may include pajamas, toothbrush, hairbrush, and slippers, special blanket or toy.

  • Your child's caregiver will tell you what your child can and cannot wear the day of the surgery.

  • An anesthesiologist may talk to you before your child's surgery. This is the caregiver that gives the medicine to make your child sleepy during surgery.

  • Informed Consent: You have the right to understand your child's health problem. You should understand what tests, treatments, or procedures may be done to treat your child's problem. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form. If you are unable to give your consent, someone who has permission can sign this form for your child. A consent form is a legal paper that gives a caregiver permission to do certain tests, treatments, or procedures. This form should tell you exactly what will be done to your child. Your child's caregiver should explain what the risks and benefits of each treatment are before you sign the form. Before giving your consent, make sure all your questions have been answered. This way you will understand what may happen to your child.

Treatment

What Will Happen:

  • You will be asked to help your child change into a hospital gown. General anesthesia will be used to keep your child completely asleep during the surgery. After your child is asleep, a small area of hair on your child's head may need to be cut or shaved. Your child's head will then be cleaned with a special soap. Your child's neck, chest, and abdomen will be cleaned with special soap too. These areas are cleaned because the shunt starts in the head and runs under the skin to the abdomen. This soap may make your child's skin yellow, but it is cleaned off later. All of this soap and cleaning is used to prevent infection.

  • Sheets will be put over your child while leaving an opening only where the surgery will be done. These sheets are used to keep the surgery area clean. Two small incisions (cuts) are made. One will be in your child's head and the other in the abdomen. The surgeon will place the top part of the shunt into the ventricle. The shunt tubing will then be tunneled under the skin from the head to the abdomen.

  • Sometimes teenagers or tall children will need a small third incision. This incision is made near the collarbone to get the shunt down to the abdomen. Your child's incisions will usually be closed with staples or stitches (thread). Bandages may then be put over the incisions.

After Surgery:

Your child will be taken to the recovery room until he wakes up and is comfortable. You may be able to visit your child in the recovery room after caregivers get him settled. Your child will then be taken to his room in the hospital. Your child may be sleepy and have some pain after surgery. Your child should not get out of bed until caregivers say it is OK. You should leave any bandages on your child until a caregiver takes them off.

Waiting Room:

This room is where you and your family can wait until your child is ready for visitors after surgery. Your child's caregiver can then find you to let you know how the surgery went. If you or your family leave the hospital, leave a phone number where you can be reached.

Contact a caregiver if

  • Your child cannot make it to the surgery appointment on time.

  • You or your child have questions or concerns about the surgery or your child's care.

  • Your child has a fever.

  • The problem for which your child is having the surgery gets worse.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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