Ventriculoperitoneal Shunt—Child

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

Definition

A ventriculoperitoneal shunt is a tube that is placed under the skin. It runs from the brain to the belly. The tube allows extra fluid to drain from the brain into the belly. It is placed during a surgery.

Reasons for Procedure    TOP

This shunt is used to treat excess fluid in the brain. It is a condition called hydrocephalus. Excess fluid causes increased pressure in the head. This pressure can damage sensitive brain tissues. The shunt reduce pressure on the brain by draining the extra fluid.

Hydrocephalus

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Possible Complications    TOP

Problems from the procedure are rare. However, 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

Your child will have had several tests before surgery. The doctor will use these tests to plan for the surgery.

Let your doctor know about any medicine your child is taking. Some medicine will need to be stopped before the procedure.

Do not let your child eat or drink before the surgery. Your child’s doctor will give you instructions about not eating 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 belly. A small hole is made in the skull. The tube is passed through the hole into your child’s skull. Then, the catheter is passed under the skin down to the belly. This end of the tube is pulled into the belly. The incisions are closed. A dressing is applied to each area.

Immediately After Procedure    TOP

After the surgery, your child will be taken to the recovery room. They will be watched closely as they wake up.

How Long Will It Take?    TOP

1-1½ hours

How Much Will It Hurt?    TOP

Anesthesia prevents pain during surgery. The incision sites will be uncomfortable. Your child will be given medicine 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 care team 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 occur:

  • 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 27, 2017.
NINDS Hydrocephalus information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Hydrocephalus-Information-Page. Accessed December 27, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 8/20/2018

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