Ventriculoperitoneal shunting

Alternative Names: Shunt - ventriculoperitoneal; VP shunt; Shunt revision

Ventriculoperitoneal shunting is surgery to relieve increased pressure inside the skull due to excess cerebrospinal fluid (CSF) on the brain (hydrocephalus).

This article primarily discusses shunt placement in children.

See also: Intracranial pressure

Description of Procedure

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. A surgical cut in the shape of a horseshoe (U-shape) is made behind the ear. Another small surgical cut is made in the 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 placed under the skin behind the ear and moved down the neck and chest, and usually into the abdominal (peritoneal) cavity. Sometimes, it goes to the chest area. The doctor may make a small cut in the neck to help position 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 up around the brain, the valve opens, and excess fluid drains out of it into the belly or chest area. This helps decrease intracranial pressure.

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

Risks of Ventriculoperitoneal shunting

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing
• Changes in blood pressure or breathing rate

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
• Seizures

Ventricles of the brain	Craniotomy for cerebral shunt	Ventriculoperitoneal shunt - series

Review Date: 11/22/2010
Reviewed By: Kevin Sheth, MD, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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