This surgery is performed when the following diagnosis are made.
- Hydrocephalus
- Normal Pressure Hydrocephalus
- Idiopathic Intracranial Hypertension
This procedure is performed to divert CSF from inside the skull into the abdominal cavity by the means of a shunt. A shunt usually consists of two catheters with a one-way valve between the two ends
A half-moon cut is made in the scalp and a small hole is drilled into the skull beneath the cut. A small tube (catheter) is placed into the brain to drain the fluid. This is done using Neuronavigational tools to guide the position of the catheter in the ventricle.
Another cut is made in the abdomen. A second catheter is tunnelled under the skin, from behind the ear, down the neck and chest, and ending in the abdominal cavity.
The catheter from the abdomen and the catheter in the brain are then connected by a valve. This valve controls the flow of fluid from the brain to the abdominal cavity. The valve is set a desired pressure setting which can be adjusted later if required through a magnet placed over the valve on the skin.
The valve will be sutured to stop it from moving. The abdominal wound will be closed with sutures while the cranial wound will be stapled
Anaesthesia
The procedure is done under general anaesthesia.
Risks of Insertion of Ventriculo-Peritoneal Shunt
There are some risks/complications with this procedure/treatment/investigation.
Common risks include:
- Infection. This may need antibiotics and further treatment.
- IV cannula. This may cause minor pain, bruising and/or infection at the injection site. This may require treatment with antibiotics.
- Bleeding. If bleeding occurs further surgery may be required. Bleeding is more common if you have been taking blood thinning drugs such as Warfarin, Aspirin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin)
- Small areas of the lung may collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
- Increase risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
Uncommon risks include:
- A heart attack because of the stain on the heart or a stroke.
- A heart attack because of the stain on the heart or a stroke.
- Clots in the leg (deep vein thrombosis or DVT) with pain and swelling. Rarely part of this clot may break off and go into the lungs.
- The shunt may go into an unexpected position. This may require further surgery to re-position the shunt.
- The shunt may become infected. This may require removal of the shunt.
- The shunt may block, become disconnected or malfunction. This may require further surgery.
- Abnormal sensations from the valve. This may be temporary or permanent.
Rare risks include:
- Stroke or stroke like complications can occur which can cause weakness in the face, arms and legs. This could be temporary or permanent.
- Epilepsy which may require medication. This condition may be temporary or permanent.
- Injury to the liver, bowel, and intra-abdominal due to the tunnelling process. This may require further surgery and an increase in hospital stay.
- Death is rare due to this procedure.
