VP Shunt Surgery in Indore

What is vp shunt surgery?

The brain makes a clear fluid called CSF (cerebrospinal fluid) that flows through spaces inside the brain called ventricles. Normally, this fluid is absorbed into the blood. In hydrocephalus, the fluid builds up, the ventricles become larger, and the pressure inside the head can rise.

A ventriculoperitoneal (VP) shunt is a soft, thin tube with a valve. One end sits in a ventricle in the brain. The tube runs under the skin behind the ear, down the neck and chest, and its other end is placed in the peritoneal cavity (the space inside the tummy). The valve controls how much fluid drains.

A shunt is usually meant to stay for life. Some patients, especially those whose fluid flow is blocked inside the brain, may be suitable for ETV (endoscopic third ventriculostomy) instead. In ETV, a small opening is made inside the brain with an endoscope so the fluid can flow without a tube. Your surgeon will decide which is suitable after studying your scans.

Who may need it

Babies and children with hydrocephalus present at birth or developing later, for example with a rapidly growing head size.

Adults with hydrocephalus caused by a brain tumour, bleeding in the brain, infection such as meningitis, or a head injury.

Older adults with normal pressure hydrocephalus, which can cause difficulty walking, memory problems and loss of bladder control. Tests such as a lumbar tap (removing some fluid from the lower back) are often done first to see if a shunt is likely to help.

People whose hydrocephalus is causing headache, vomiting, drowsiness or vision problems.

Not everyone with large ventricles needs a shunt. Some patients only need a temporary drain or treatment of the underlying cause.

Surgery is one option, not the only one. It is decided after an examination and a careful look at your scans, and non-surgical treatment is discussed first where it is suitable.

How it is done

1
You are given general anaesthesia and are fully asleep. A small area of hair is shaved.
2
A small cut is made on the head, and a tiny hole is made in the skull. The upper end of the tube is gently placed into a ventricle.
3
The valve is placed under the skin of the head, usually behind the ear.
4
The lower part of the tube is passed under the skin, down the neck and chest, to the tummy, using a long, thin tool.
5
A small cut is made in the tummy and the lower end of the tube is placed inside the peritoneal cavity.
6
The system is checked to make sure fluid is flowing, and the cuts are closed. The whole shunt lies under the skin and is not seen from outside, though a small bump may be felt behind the ear.

Possible risks

Every operation carries some risk. Your surgeon will explain which of these apply to you.

Shunt blockage. This is the most common problem and can happen months or years later. It usually needs another operation to repair or replace part of the shunt.

Shunt infection, which usually needs the shunt to be removed, treatment with antibiotics, and a new shunt later.

Over-drainage, where too much fluid drains, which can cause headache on standing or a collection of fluid or blood over the brain.

Under-drainage, where too little fluid drains and symptoms of hydrocephalus come back.

Bleeding in the brain, or seizures (fits).

Problems in the tummy, such as the tube moving, a collection of fluid, or rarely injury to the bowel. Anaesthesia also carries its own risks.

Preparing for surgery

Bring all CT or MRI scans and previous reports. In babies, the head size records are also useful.

Blood tests and a check-up with the anaesthetist are usually needed. If there has been a recent infection, the CSF may need to be tested first.

Tell the doctor about all medicines. If you or your child take blood thinners, stop them only when and as your doctor advises.

Follow the fasting instructions given by the hospital. For babies, the team will tell you when to stop feeds.

If you travel from a nearby district, arrange for family support, as at least one person should stay with the patient.

Recovery

Most patients stay in hospital for about 2 to 5 days after a planned shunt operation. Mild headache and tummy discomfort are common for a few days. Children usually return to normal play within a few weeks, as advised by the surgeon.

Learn the warning signs of shunt problems: headache, vomiting, unusual sleepiness, confusion, fits, or blurred vision. In babies, look for a swollen or bulging soft spot on the head, eyes looking downwards, poor feeding or unusual crying. Fever, redness or swelling along the tube can mean infection. If you notice any of these, contact your neurosurgeon or go to the nearest emergency at once.

Keep a copy of the operation details and the type of valve. Some valves are adjustable with a magnet, so tell the staff about the shunt before any MRI scan, as the setting may need to be checked afterwards. Regular follow-up visits are important, especially for growing children.

Questions patients ask

Is a VP shunt permanent?

In most cases, yes. The shunt is meant to stay for life. Parts of it may need to be repaired or replaced if it gets blocked or infected, or sometimes as a child grows.

Is ETV better than a shunt?

Neither is better for everyone. ETV avoids a tube, but it works only in certain types of hydrocephalus, mainly where the fluid is blocked inside the brain. The surgeon decides based on the cause, the scans and the patient's age.

Can my child live a normal life with a shunt?

Many children with shunts go to school, play and grow up normally. Parents need to know the warning signs of shunt blockage and keep regular follow-up visits.

How long does the operation take?

A planned shunt operation usually takes about an hour or two. The hospital stay is often a few days.

What should I do if I think the shunt is blocked?

Do not wait. Severe headache, vomiting, drowsiness or fits can mean the shunt is not working. Go to the nearest emergency and inform your neurosurgeon.

Disclaimer: This information is for general awareness and is not a substitute for a medical consultation. Read moreSource: Content on this website was prepared with the help of AI tools (AI-assisted) and is medically reviewed by Dr. Kshitiz Nigam, MBBS, MS, MCh (Neurosurgery), Reg. No. MP-33282.