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Ventriculoperitoneal Shunt—Child

Pronounced: Ven-tric-cue-lo-perit-toe-neal shunt

Definition

A ventriculoperitoneal shunt operation is surgery to insert a drainage tube (catheter) into the brain. The tube runs into the abdominal cavity. This tube is used to move extra fluid in the brain to the abdomen where it can be absorbed. The entire tube is under the skin and not visible.

Reasons for Procedure    TOP

This type of shunt is used to treat hydrocephalus, an condition that results in excess fluid in the brain. Excess fluid can cause increased pressure. This pressure can damage sensitive brain tissues. The shunt drains the excess fluid and reduces pressure on the brain.

Hydrocephalus

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Copyright © Nucleus Medical Media, Inc.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review potential problems, like:

  • Shunt failure
  • Brain swelling
  • Blood clot or bleeding in the brain
  • Infection in the shunt or brain
  • Damage to brain tissue
  • Reaction to the anesthesia

What to Expect    TOP

Prior to Procedure

At your child’s doctor appointment before the surgery, the doctor may:

  • Do a neurological exam—This is to find out how your child’s nerves work. It involves evaluating mental status, as well as motor and sensory abilities.
  • Order MRI or CT scans of the brain—Images of your child’s body will help the doctor plan the surgery.
  • Answer any question that you have
  • Talk to your doctor about your child's medications. Your child may be asked to stop taking some medications up to 2 weeks before the procedure.
  • Instruct your child to not eat or drink before the surgery—Your child’s doctor will give you instructions about fasting based on your child’s age. Fasting may range from 6-12 hours before surgery.

Anesthesia

General anesthesia will be used. It will block any pain and keep your child asleep during the surgery. It is given through an IV in the hand or arm.

Description of the Procedure    TOP

A breathing tube will be placed to help your child breathe during surgery. The scalp and abdomen are cleaned with antiseptic. Small incisions will be made in the scalp and abdomen. A small hole is made in the skull. A catheter is passed through the hole into your child’s brain. Then, the catheter is tunneled under the skin down to the abdomen. This end of the catheter is put into the abdominal cavity. The incisions are closed and a dressing is applied to each area.

Immediately After Procedure    TOP

After the surgery, your child will be taken to the recovery room for observation.

How Long Will It Take?    TOP

1-1½ hours

How Much Will It Hurt?    TOP

Anesthesia prevents pain during surgery. Your child will be given medication to manage pain after the procedure.

Average Hospital Stay    TOP

Your child may be in the hospital for 3-7 days. Your child may stay longer if complications arise.

Post-procedure Care    TOP

At the Hospital
  • Your child may need to lay flat for up to 24 hours after surgery.
  • Your child’s heart rate, blood pressure, breathing rate, and brain status will be monitored closely.
  • Your child will receive nutrition through an IV until he or she is ready to eat and drink.
  • The shunt will be checked to make sure it is working.
  • Antibiotics may be given. Pain medication will be given as needed.
Preventing Infection

During your child's stay, the hospital staff will also take steps to reduce the chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your child's incisions covered

There are also steps you can take to reduce your child's chance of infection, such as:

  • Washing both you and your child's hands often, and reminding visitors and healthcare providers to do the same
  • Reminding your child's healthcare providers to wear gloves or masks
  • Not allowing others to touch your child's incision
At Home

When your child is at home, do the following for a smooth recovery:

  • Go to physical therapy appointments as directed.
  • Keep track of your child's growth. Longer shunts may be needed as your child develops.
  • Be sure to follow your child's doctor's instructions.

Call Your Child’s Doctor    TOP

After your child leaves the hospital, contact the doctor if any of the following occurs:

  • Symptoms that went away return
  • Stiff neck
  • Headache
  • Irritability
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, a lot of bleeding, or any discharge from the incision site
  • Vomiting—may be a sign of the shunt not working
  • Pain that is not controlled with the medications your child has been given
  • Vision problems
  • Being very sleepy
  • Confusion
  • Developmental delays
  • Not eating or drinking enough

Call for emergency medical services right away for:

  • Fast breathing or trouble breathing
  • Blue or gray skin color
  • Not waking up or not interacting
  • Not wanting to be held
  • Seizures

If you think your child has an emergency, call for emergency medical services right away.

RESOURCES:

Hydrocephalus Association
http://www.hydroassoc.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Paediatric Society
http://www.cps.ca
Spina Bifida and Hydrocephalus Canada
http://www.sbhac.ca

References:

About normal pressure hydrocephalus. National Hydrocephalus Association website. Available at:
...(Click grey area to select URL)
Accessed December 9, 2014.
NINDS Hydrocephalus information page. National Institute of Neurological Disorders and Stroke website. Available at:
...(Click grey area to select URL)
Updated April 16, 2014. Accessed December 9, 2014.
Last reviewed December 2014 by Kari Kassir, MD
Last Updated: 1/23/2014