Shunt - ventriculoperitoneal; VP shunt; Shunt revision
Ventriculoperitoneal shunt is surgery that is done to relieve pressure inside the skull (intracranial pressure). This pressure is caused by too much cerebrospinal fluid (CSF) on the brain (hydrocephalus). The fluid is drawn off (shunted) from the ventricles in the brain into the abdominal (peritoneal) cavity. In rare cases the fluid is shunted into the pleural space in the chest (the thin covering of the lungs).
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. An incision or cut in the shape of a horseshoe is made behind the ear. Another small incision is made in your 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 tunneled under the skin from behind the ear, down the neck and chest, and most of the time into the abdominal cavity. Sometimes this catheter goes to the heart. Sometimes, the doctor makes a small cut in the neck to help thread 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 in the head, fluid is directed to the valve and then drains from inside the head down to the belly or the heart.
The valves in newer shunts can be programmed to drain more or less fluid from the brain.
Etilogical categories of neurological disease. In: Goetz CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 28.
Kinsman SL, Johnston MV. Congential anomalies of the central nervous system. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 592.