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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Cerebral Shunt Placement)

Definition

A ventriculoperitoneal (VP) shunt placement is surgery to insert a plastic tube to drain excess fluid from the brain and into the abdomen where it can be absorbed.

Reasons for Procedure

The shunt is placed to treat hydrocephalus. This is a buildup of cerebrospinal fluid (CSF) in spaces in the brain called ventricles. Too much of this fluid puts pressure on the brain.

The Brain
IMAGE
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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Blockage of the shunt
  • Damage to normal brain tissue
  • The need for additional surgery

Things that may raise the risk of problems are:

  • Smoking
  • Drinking alcohol
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Specialists you may need to see
  • Tests that will need to be done before surgery

Anesthesia

You will be given general anesthesia . You will be asleep.

Description of the Procedure

The hair over the area will be shaved. A small incision will be made in the scalp. It may be just past the hairline, on back of the head, or behind the ear. A small hole is then made in the skull. A tube is passed through the hole into a ventricle. A valve is placed on the tube to manage the flow of fluid. A small incision may be made behind the ear to help pass the tube. Another tube is attached to the other side of the valve and is guided under the skin of the skull until it reaches the abdomen. A small incision will also be made in the abdomen to help guide the tube into the correct place. The incisions will be closed with staples or stiches. A bandage will be placed over the areas.

How Long Will It Take?

About 2 hours

Will It Hurt?

Pain and headaches are common in the first 1 to 2 weeks. Medicine and home care can help.

Average Hospital Stay

You will be in the hospital for 2 to 7 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Do a CT scan to make sure the shunt is in the right place
  • Give you pain medicine.
  • Ask questions to check brain function
  • Encourage you to begin walking
  • Teach you how to care for the shunt valve

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

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

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions
At Home

It will take a few weeks for the incisions to fully heal. Physical activity will be limited for 4 to 6 weeks. You may need to ask for help with daily activities and delay your return to work.

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge from an incision
  • Pain that you cannot control with medicine
  • Nausea and vomiting
  • Lightheadedness and fainting
  • A valve that is blocked
  • Severe headache
  • Changes in vision
  • Problems speaking
  • Confusion
  • Memory loss

If you think you have an emergency, call for medical services right away.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://www.familydoctor.org 

Hydrocephalus Association  http://www.hydroassoc.org 

CANADIAN RESOURCES

Canadian Neurological Sciences Federation  http://www.cnsfederation.org 

Spina Bifida and Hydrocephalus Association of Canada  http://sbhac.ca 

References

About your ventriculoperitoneal (VP) shunt surgery. Memorial Sloan Kettering Cancer Center website. Available at: https://www.mskcc.org/cancer-care/patient-education/about-your-ventriculoperitoneal-vp-shunt-surgery. Accessed September 28, 2021.

Hydrocephalus in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hydrocephalus-in-adults. Accessed September 28, 2021.

Ventriculo-peritoneal shunt. University of Rochester Medical Center website. Available at: https://www.urmc.rochester.edu/neurosurgery/for-patients/treatments/ventriculoperitoneal-shunt.aspx. Accessed September 28, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 07/2021
  • Update Date: 09/28/2021