Orange County Neurosurgery

Ventriculoperitoneal Shunting Procedures

Ventriculoperitoneal shunting procedures are very common surgical procedures done to treat hydrocephalus or the buildup of cerebrospinal fluid in the brain. The cerebrospinal fluid buildup in hydrocephalus patients puts pressure on the brain, and if left untreated, can cause major damage to the brain and spine, and impair the patient’s neurological functions.

A ventriculostomy catheter is only a temporary solution and is recommended for cases of acute hydrocephalus and cerebrospinal fluid buildup caused by head trauma and injury to the brain. Surgically inserting ventriculoperitoneal shunts, however, provide a longer lasting solution for most cases of hydrocephalus.

The Benefits of Ventriculoperitoneal Shunts

When a patient has an excess amount of cerebrospinal fluid, many complications can arise depending on which part of the brain experiences the most pressure. Mobility and speech are often affected by this condition, and the longer one waits to get treated, the harder it is to regain full neurological functions.

Shunting procedures allow the cerebrospinal fluid to drain from the brain, relieving the pressure that is causing the pain and neurological damage. In many cases, patients who have had ventriculoperitoneal shunts inserted within the ventricles of their brain experienced immediate relief from the pain and other symptoms. For others, it takes a little bit longer before they start feeling the effects of the shunts.

These shunts are built to stay inside a patient’s body for life, making it a great long term treatment solution that only requires regular monitoring after the shunt is put in place.

How Shunting Procedures Are Done

A patient who is about to receive a ventriculoperitoneal shunt is prepped shortly before surgery. During this time, the hair behind one ear is shaved off. The patient is then given general anesthesia and is brought to the operating room. Inserting a shunt involves making a U-shaped incision in the area at the back of the ear and another one in the abdominal area. Once the incisions are made, the neurosurgeon will then proceed to drill a small hole in the skull using a special surgical drill.

The catheter is passed through the hole and is then inserted into one of the ventricles in the brain. Once that is in place, the surgeon will then insert another catheter underneath the flap of skin made by the U-shaped incision behind the ear. This second catheter is then gently and carefully guided down to the abdomen (peritoneal cavity), passing through the neck and chest areas. In cases where there is difficulty in getting the catheter to the desired position, it’s possible that the surgeon will make a 3rd incision somewhere in the neck area to help with positioning the catheter properly.

When both catheters are securely in place, the surgeon will then proceed to attach a valve connecting both catheters. This valve is positioned underneath the skin flap behind the ear and is secured in place when the incision is closed. The purpose of the valve is to regulate the drainage of cerebrospinal fluid.

When there is excess fluid, the valve opens up and lets the fluid drain from one catheter to the other, relieving the pressure on the brain. Before closing up the incisions, the surgeon will test the shunt by letting it drain the cerebrospinal fluid and making any necessary adjustments before closing up the incisions.

If you have any questions about ventriculoperitoneal shunting procedures, call us and schedule an appointment with one of our highly-skilled and well-trained doctors.

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