A ventriculoperitoneal shunt, or a VP shunt, is a medical device installed to relieve pressure on the brain and is recommended for people suffering from hydrocephalus. This condition is brought about by excessive cerebrospinal fluid (CSF) that leads to the rapid widening of the spaces in the brain (ventricles) causing undue pressure. If left untreated, this can ultimately lead to brain damage.
The CSF is a very important component of the nervous system as it creates a cushion for the brain tissue and provides means for the delivery of nutrients into the brain. It flows between the spine and the cranium to ensure there is sufficient intracranial blood volume. The CSF is continuously produced as it flows through the ventricles, nourishing the surface of the brain and spinal cord. It then exits into the base of the brain and gets reabsorbed into the bloodstream. However, due to abnormalities, the flow and balance of the CSF may be disrupted leading to its accumulation.
Ventriculoperitoneal shunt is the main treatment for hydrocephalus, which affects about 1 in every 500 children. It can either be congenital or acquired, and its most apparent indication is the abnormal increase in head circumference. In children, symptoms can be accompanied by downward deviation of the eyes and seizures. In adults, symptoms of hydrocephalus include headaches, nausea and vomiting, swollen optic nerve, blurred or double vision, irritability, lethargy, and changes in cognition or memory. The cause of this condition is yet to be fully understood.
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A VP shunt surgery is performed on patients with hydrocephalus. It is often immediately performed as soon as the condition is diagnosed to prevent serious complications.
To confirm hydrocephalus, certain tests such as ultrasound, magnetic resonance imaging (MRI) scan or computed tomography (CT) scan, are usually performed to rule out other conditions. Once confirmed, ventriculoperitoneal shunt is performed at the soonest possible time.
With surgery, excess CSF is drained out of the brain to restore normal volume. However, it is important to note that the procedure does not reverse brain damage if it has already occurred. Its main goal is to prevent any further damage that may otherwise occur if treatment is not immediately provided.
How is the Procedure Performed for Ventriculoperitoneal Shunt?
VP shunting is performed under general anaesthesia and it usually takes about an hour or two to finish. In general, the shunt serves as a drainage system that consists of a long tube equipped with a valve. This procedure is performed in the following order:
First, the hair in a pre-determined area of the head is shaved, which is usually at the top or back or behind the ear. The surgeon then makes incisions in strategic areas of the brain to accommodate a catheter that will be later placed in the ventricle. The surgeon also makes another surgical cut in the stomach area.
A hole is drilled in the skull, through which a thin tube (catheter) is inserted into a brain ventricle. Another catheter is positioned under the skin behind the ear and is inserted further into the neck and chest, right down to the belly area.
A fluid pump (valve) is then placed under the skin behind the area and is connected to both catheters. This is designed in such a way that when extra pressure builds up in the brain due to excess CSF, the valve automatically opens and excess fluid is drained through the catheter into the chest area. The shunt is implanted permanently and has to be monitored on a regular basis.
New surgical technology now allows this procedure to be done using an endoscope or through a computer-guided method.
After surgery, recovery usually takes about three to four days, with most patients able to leave the hospital within a week. During hospitalisation, patients are regularly monitored to ensure normal heart rate and blood pressure. Preventive antibiotics are also administered to avoid the development of infection.
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Ventriculoperitoneal shunt surgery is a very safe procedure with high success rates. However, just like any surgical procedure, there may be risks and complications involved. Surgical risks may include infection and excessive bleeding. Adverse reactions to anaesthesia such as blood pressure level changes and breathing difficulties are also some possible complications.
Complications that are specific to VP shunting are very rare but can be serious. These include:
It is also very important to watch out for symptoms such as fever, abdominal pain, headache, and abnormal spikes in heart rate and blood pressure, which may indicate shunt malfunction.
What is Ventriculoperitoneal Shunt? Overview, Benefits, and Expected Results
Ventriculoperitoneal (VP) shunting is a common neurosurgical procedure used to treat hydrocephalus, which is a neurological condition caused by the accumulation of excess cerebrospinal fluid (CSF) in the ventricles of the brain. This procedure involves the insertion of a long, flexible tube, known as a shunt, into the brain to divert the buildup of CSF away from the ventricles and into another part of the body, such as the abdominal cavity or the right atrium of the heart.
The main goal of VP shunt surgery is to reduce intracranial pressure caused by the excess accumulation of CSF, relieving pressure on the brain and improving brain function. The procedure can also be used to treat certain complications of hydrocephalus, such as impaired vision, seizures, and loss of motor control.
Overview of VP Shunt Surgery
VP shunt surgery is performed under general anesthesia and typically takes one to two hours. During the procedure, a long, thin tube is inserted through a small hole in the skull and into a ventricle of the brain. The tip of the tube is then connected to a one-way valve, which is placed in a different part of the body such as the abdominal cavity or the right atrium of the heart. This allows the excess CSF to be diverted away from the brain and absorbed by the other part of the body.
During the VP shunt procedure, the neurosurgeon will typically place a small reservoir on the outside of the skull, connected to the shunt tube, that can be used to regulate the amount of CSF being diverted away from the brain. The procedure is reversible and the shunt can be removed at any time.
Benefits of VP Shunt Surgery
VP shunt surgery is one of the most commonly used surgical treatments for hydrocephalus and can provide a number of benefits, such as:
Expected Results From VP Shunt Surgery
VP shunt surgery can be an effective treatment for hydrocephalus and can significantly reduce pressure in the brain. However, the success of the procedure will vary depending on individual circumstances. Some individuals may not experience any noticeable improvement following surgery, while others may experience significant relief from their symptoms. It is important to also be aware that the shunt can become blocked or infected, and may require additional medical attention.
Risks of VP Shunt Surgery
VP shunt surgery carries a risk of potential complications, including:
It is important to speak to your doctor about potential risks and complications before deciding to undergo VP shunt surgery.
Recovery From VP Shunt Surgery
VP shunt surgery is typically safe and complications are rare. Recovery times vary and depend on the individual’s overall health and the extent of the surgery. However, most individuals can expect to be fully recovered within one to two weeks. During this time, individuals should avoid strenuous activity and head trauma. It is also important to closely monitor the shunt’s operation and note any signs of infection or blockage.
VP shunt surgery is a common treatment for hydrocephalus and can help to reduce intracranial pressure and alleviate symptoms of the condition. However, as with any procedure, it is important to discuss potential risks and benefits with your doctor before deciding to undergo surgery. With proper care and attention, VP shunt surgery can be an effective treatment for hydrocephalus and help to improve quality of life.