Ventriculoperitoneal shunt

Definition

Ventriculoperitoneal shunt is surgery that is done to relieve pressure inside the skull (intracranial pressure). This pressure is caused by too much cerebrospinal fluid (CSF) on the brain (hydrocephalus). The fluid is drawn off (shunted) from the ventricles in the brain into the abdominal (peritoneal) cavity. In rare cases the fluid is shunted into the pleural space in the chest (the thin covering of the lungs).

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 child's hair behind the ear is shaved off. An incision or cut in the shape of a horseshoe is made behind the ear. Another small incision is made in your child's belly.

A small hole is drilled in the skull. A small thin tube called a catheter is passed into a ventricle of the brain.

Another catheter is tunneled under the skin from behind the ear, down the neck and chest, and most of the time into the abdominal cavity. Sometimes this catheter goes to the heart. Sometimes, the doctor makes a small cut in the neck to help thread the catheter.

A valve (fluid pump) is placed underneath the skin behind the ear. The valve is attached to both catheters. When extra pressure builds in the head, fluid is directed to the valve and then drains from inside the head down to the belly or the heart.

The valves in newer shunts can be programmed to drain more or less fluid from the brain.

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

Risks for any surgery are:

• Bleeding
• Infection

Possible risks of ventriculoperitoneal shunt placement are:

• Blood clot or bleeding in the brain
• Brain swelling
• The shunt may stop working and fluid will begin to build up in the brain again
• The shunt may become infected
• Infection in the brain
• Damage to brain tissue