Ventriculoperitoneal Shunt: Procedure, Recovery, and Risks

A ventriculoperitoneal shunt is a device that is used to relieve pressure on the brain that is caused by the accumulation of tube fluid. VP shunting is primarily a procedure used to treat a condition called hydrocephalus. This condition occurs when excess cerebrospinal fluid gets collected in the brain ventricles. The fluid mainly acts as a delivery system for the nutrients required by the brain.

 However, when this normal flow is disturbed, this accumulation of fluid can prove to be very harmful as it exerts pressure on brain tissues. To treat this condition, a VP shunt is placed inside one of the ventricles to stop the fluid from accumulating. In this blog, we will look more into the procedure of placing a VP shunt, recovery after the surgery, and the risks associated with it.

 Symptoms of Hydrocephalus

 The common symptoms of hydrocephalus include:

●       Larger head size

●       Seizures

●       Headaches

●       Excessive sleepiness

●       Poor appetite

●       Memory loss

●       Poor control and coordination

●       Impaired vision

 Hydrocephalus can be detected using ultrasound, CT scans, and MRI scans. Testing shows if areas of the brain contain more fluid than normal.

 VP Shunt Procedure

VP shunt is placed by the doctors under general anesthesia. Normally the entire procedure takes about 90 minutes. The whole procedure of placing the VP shunt is as follows:

●       The surgery begins by making a tiny incision behind the ear. The surgeon also makes a small hole in the skull using a drill.

●       The surgeon will then insert a catheter into one of the ventricles of the brain and the other catheter is passed down into the abdominal cavity.

●       A one-way valve is placed along the catheter under the skin. This valve helps to regulate the flow of fluid from the brain to the abdominal cavity.

●       The two catheters are connected and a small tunnel is created under the skin to allow the fluid to flow from the brain to the abdominal cavity.

●       The abdominal end of the catheter is placed within the peritoneal cavity, which is a space within the abdomen.

●       The incisions are then closed and the entire area is bandaged.

 Recovery after the surgery

 There are several things you need to know about the recovery process after ventriculoperitoneal (VP) shunt surgery. The recovery period looks like this:

●       Stay in the hospital: After surgery, patients stay in the hospital for a few days for close monitoring. During this time, the healthcare team will monitor the patient's vital signs, monitor how the shunt is working, and manage pain.

●       Incision Care: Making sure the incision sites are clean is crucial to a quick recovery. Patients are given instructions on keeping the incision clean and dry.

●       Pain Management: During surgery, patients may experience some discomfort or pain at the incision sites. To manage the discomfort, pain medications will be prescribed. Be sure to take the medication as directed and tell your doctor if your pain gets worse.

●       Physical Activity and Restriction: Patients will get guidelines on physical activity and restrictions during recovery. Keep these instructions in mind to prevent straining the surgical site and make sure it heals properly. In the beginning, the doctor may restrict activities, but slowly, patients can resume normal activities.

●       Monitoring and follow-up appointments: Patients are scheduled for regular follow-up appointments to check on the shunt and make any necessary adjustments. A CT scan or X-ray may be used to evaluate a shunt's positioning and effectiveness.

 Risks associated with the surgery

A VP shunt surgery is considered to be a safe surgery, but here are some potential risks associated with it:

●       Infection: There is a slight risk of infection at the incision site. The symptoms of infection include headache, fever, swelling, or redness at the incision site.

●       Malfunction of shunt: In rare cases, the shunt system can malfunction or become blocked leading to the accumulation of CSF in the brain again. This can lead to intracranial pressure and may then cause headaches, nausea, or vomiting.

●       Overdrainage and Underdrainage: Overdrainage is the excessive drainage of CSF. it occurs when the shunt allows too much fluid to drain from the brain leading to improper absorption of CSF. Underdrainage is a condition when the shunt is unable to drain the excess fluid from the brain resulting in its accumulation. These things happen due to shunt malfunction after the surgery.

●       Shunt Failure: Shunt failure is a condition when the shunt system stops working properly. It can be due to infection, mechanical malfunction, or breakage. It then requires a surgical intervention to treat the damaged shunt.

●       Surgical Complications: As with other surgeries, in VP shunt surgery there are also several complications involved like bleeding, blood clots, and damage to surrounding tissues.