Neurosurgery: Ventriculoperitoneal (VP) Shunt

Basics

• Shunt Used to Drain Excess CSF from Hydrocephalus into the Peritoneum
• Shunts Can Also Be Directed to Atrium or Pleura
• Contraindications:
  • Absolute: Meningitis or Infection at Entry Site
  • Relative: Coagulopathy, Blood or High Protein in CSF

Procedure

• Neurosurgeon Places the Ventricular Portion
• Abdominal Site is Chosen Free of Adhesions (Laparoscopic Approach Often Preferred)
  • Right Upper Quadrant (Most Common) or Midline
• Using a Tunneler the Catheter is Passed Subcutaneously from the Abdomen to the Postauricular Region to Connect to the Ventricular Portion
• Abdominal Portion is Then Inserted into the Peritoneal & Appropriately Positioned

Complications

• Most Occur in the First Year After Placement
• Shunt/CNS Infection – Requires Shunt Removal
• Mechanical Obstruction – May Require Shunt Revision (10-20%)