Insertion of Ventriculoperitoneal Shunt
What is a Ventriculoperitoneal Shunt?
A ventriculoperitoneal (VP) shunt is a medical device used to treat a brain condition called hydrocephalus.
How Does a Ventriculoperitoneal Shunt Work?
A VP shunt is comprised of two small, thin tubes called catheters and a control valve. One end of the upstream catheter (short catheter) is placed in the ventricles. The other end of the downstream catheter (long catheter) is placed in the peritoneal cavity. Both catheters are connected to a valve that controls the flow of CSF. The valve opens when the pressure in the brain gets too high, passing excess fluid from the short catheter to the long catheter. This enables drainage of excess fluid from the brain into the peritoneal cavity, the space in the abdomen where the digestive organs are located. The CSF diverted to the peritoneal space is reabsorbed into the bloodstream.
There are several types of valves, and your surgeon will decide on the appropriate one for you. Programmable valves are valves where the pressure setting can be altered using a magnetic devise.
How is Ventriculoperitoneal Shunt Surgery performed?
Under general anaesthesia, the surgeon makes a small incision on the scalp and creates a burr hole in the skull to access a lateral ventricle. A catheter is gently guided into the ventricle, then connected to a valve placed beneath the skin, usually behind the ear. A second catheter is tunnelled subcutaneously down the neck and chest wall to the abdomen, where it enters the peritoneal cavity through a small incision. Once connected, the system allows controlled drainage of fluid, relieving intracranial pressure. The incisions are closed, and the shunt function is checked before the patient is awakened.
How should I prepare for VP Shunt surgery?
- Discuss the procedure, risks, benefits, and expected outcomes with your surgical team.
- Sign consent form.
- Attend all preoperative appointments and imaging studies.
- Inform your doctor about medications, allergies, and medical conditions.
- Stop certain medications, such as blood thinners, supplements, and fish oil.
- Follow fasting instructions carefully.
- Arrange transportation and support for recovery.
What can I expect after surgery?
After VP shunt surgery, patients are monitored on the ward for complications such as swelling, bleeding, or neurological changes. Doctors assess speech, movement, memory, and overall brain function. Pain medications may be prescribed. Imaging scans are performed the next day to evaluate positioning of the shunt. Recovery time varies, and rehabilitation may be needed for some patients. Generally, hospital stay is around 2-5 days.
What are the benefits of VP shunt Surgery?
- Relieve symptoms related to hydrocephalus
What are the Risks and Complications of VP shunt Surgery?
- Bleed in the brain from insertion of catheter
- Malposition of catheters
- Overdrainage by shunt causing new low pressure symptoms
- Infection of shunt
- Blockage of shunt
What can I expect when I am discharged from hospital
- You may experience pain (including headache), inflammation, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed.
- Keep the surgical site clean. Instructions on surgical site care and bathing will be provided.
- Refrain from smoking and alcohol until your first follow up visit as it can negatively affect the healing process.
- Refrain from lifting anything heavier than 5 Kg and other strenuous activities until the first follow-up visit. These activities may include housework, yard work, gardening, mowing, etc.
- Gentle exercise and regular walking are recommended to improve strength and endurance from 2 weeks after surgery.
- Refrain from driving until you are fully fit and receive your surgeon’s clearance.
- Most patients can return to their normal daily routines in 4-6 weeks after surgery.
- You will require close follow-up in the first 4-6 weeks after surgery to ensure the shunt is working as it should and that the valve is at an appropriate setting.
