Listed below is the step by step procedure of VP shunt surgery:
A hollow tube placed in the brain by surgical method is known as a shunt. It is occasionally placed in the spine and helps in draining cerebrospinal fluid. This fluid is then redirected to other areas in the body where re-absorption is possible. Ventriculoperitoneal shunt (VP Shunt) is a surgery for treatment of excess cerebrospinal fluid (CSF) in the brain.
In case of planned VP shunt procedure, patients need to inform surgeon about medications they are taking along with the supplements. Any medication suggested by the surgeon, needs to be taken with a small sip of water.
In case of planned VP shunt procedure, patients need to inform surgeon about medications they are taking along with the supplements. Any medication suggested by the surgeon, needs to be taken with a small sip of water.
Eating and drinking restrictions are provided to the patients. Patients need to follow these restrictions strictly. Failing to do so can result in cancellation of surgery. Patient medication record needs to be kept handy to avoid complications during surgery. Patient needs to inform the surgeon about any known allergies of medications, anesthesia as well as latex. This helps in reducing possibility of complications during and after shunt process.
Before the start of surgery, patients need to maintain cleanliness. All instructions given by surgeon need to be followed. Close relatives or friends of the patient are advised to accompany the patient prior to and after the surgery. This helps in reducing anxiety in the patients. Jewelery and contact lenses along with other valuables need to be kept away before start of the surgery.
Ventriculoperitoneal shunting or VP Shunt is carried out in an operation theater using general anesthesia. It usually continues for 1 to 1 ½ hrs.
The process of VP shunt has following steps.
Post procedure, patient will be monitored for 24 hours.
In general, two to four days of hospitalization is required. It is very essential to attend follow up appointments. It helps in relieving the symptoms of hydrocephalus and also ensures proper working of the shunt. Additionally, physical and occupational therapy along with rehabilitation is recommended to the patients after VP shunt. This helps in early recovery.
Post surgery, there can be tenderness in the neck and abdomen of the patient. Headache can be experienced by the patients after few weeks of surgery. Patients feel tired, but there will not be much pain. Movements of fluid around the scalp can be felt by the patients; which is common. As the scalp gets healed, these feelings will not last.
In cases where tenderness near stitches and staples is experienced, surgeon can remove them after 5-10 days post surgery. There will not be limitation on the activities of the patients as such because of shunt. In some patients, surgeon needs to adjust the shunt valve for drainage of right amount of fluid.
When shunt is not working properly, signs such as infection can be seen. If shunt is not working properly because of infection or stops working, it needs to be replaced. A properly working shunt can be left in place for many years.
Risks associated with ventriculoperitoneal shunt placement are listed below.
A. The success rate of ventriculoperitoneal shunting varies from patient to patient. It has been reported in medical literature that 50% cases fail after ventriculoperitoneal shunting. Surgical revision is required in most of the cases. Endoscopic third ventriculosotomy (ETV) is used as an alternative to it and has shown good success rate. Though it is the case, ETV can be used in selected patients only.
A. Upon underdraining, CSF gets accumulated on the brain and can make recurrence of hydrocephalus. In case of over-draining using VP shunt, CSF gets drained from the ventricles at high speed than it gets formed. Patients need to inform the surgeon about any unusual symptoms they are suffering from. This helps in early treatment and working of VP shunt is also monitored.
A. It is not easy to confirm the exact life span of VP shunts. Some medical practitioners predict that after 6 years, approximately half of the VP shunts need to be checked or replaced.
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