What is ventriculoperitoneal (VP) shunt surgery in children?
Ventriculoperitoneal shunts (VP shunts) help control the pressure in the brain. Certain conditions, such as brain tumors or fluid buildup in the brain (hydrocephalus), can cause the brain to swell. When this happens, the brain may not be able to work well. VP shunts help lower the pressure by draining extra fluid out of the brain and into the belly. This extra fluid is absorbed by the body.
How is ventriculoperitoneal (VP) shunt surgery done?
To do the surgery, the doctor makes a few small cuts above your ear. These cuts are called incisions. Then the doctor drills a small hole in the side of your skull. The hole lets the doctor put a thin tube into the part of the brain that’s filled with fluid. This tube is called a catheter.
Then the doctor makes another incision in your belly. A second catheter goes into this incision. It is gently pushed under the skin and up to your chest and neck. Next, the doctor uses a valve to attach the two catheters on the side or back of your head. Then the doctor closes up the incisions with stitches or staples. Both catheters and the valve are completely under your skin.
After your child's ventriculoperitoneal (VP) shunt surgery: When to call
Call 911 anytime you think your child may need emergency care. For example, call if:
- Your child passes out (loses consciousness).
- Your child has severe trouble breathing.
- Your child has sudden chest pain and shortness of breath or coughs up blood.
- Your child has a severe headache.
- It is difficult for your child to think, move, speak, or see.
- Your child's body is jerking or shaking.
- Your child falls and hits their head.
- Your child is confused, does not know where they are, or is extremely sleepy or hard to wake up.
Call your doctor now or seek immediate medical care if:
- You feel new bumps on your child's head 3 to 5 days after surgery, or the bumps get bigger after 2 weeks.
- Your child has signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
- Your child has a headache and throws up.
- Your child has a fever with a stiff neck or a severe headache.
- Your child has new or worse headaches.
- Your child is very tired or cranky.
- Your child sleeps more than they are awake.
- Your child has a fever.
- Your child's incision comes open.
- Your child has any vision changes.
- Your child's pain does not get better after your child takes pain medicine.
Watch closely for changes in your child's health, and be sure to contact your doctor if your child has any problems.
How do you prepare for your child's ventriculoperitoneal (VP) shunt surgery?
Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.
Preparing for surgery
- Talk to your child about the surgery. Tell your child that the surgery will help get rid of extra fluid in your child's brain. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
- Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
- Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.
The day before surgery
- A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
- Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.
How can you care for yourself after ventriculoperitoneal (VP) shunt surgery?
Activity
- Rest when you feel tired. Getting enough sleep will help you recover.
- Do not touch the valve on your head.
- It is okay for you to lie on the side of your head with the shunt.
- Do not do any activity that may cause you to hit your head.
- You will probably be able to return to work in less than 1 week.
- After your doctor says it is okay to remove the bandages, you can shower. Afterward, be sure to pat the incision areas dry.
- Do not swim or bathe until your stitches or staples are removed.
- Check with your doctor about when it is safe to travel by plane.
Diet
- The tube in your belly will not affect how you digest food. You can eat as usual. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Medicines
- Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
- If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
- Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
- If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
- If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
Incision care
- If you have strips of tape on the incisions the doctor made, leave the tape on until it falls off.
- Wash your incision areas daily with warm, soapy water, and gently pat them dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the areas with a gauze bandage if they weep or rub against clothing. Change the bandages every day.
- Keep the areas clean and dry.
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