Ventriculoperitoneal or VP Shunt is a medical device which relieves pressure on brain caused due to accumulation of fluid. VP Shunt in fact is a surgical procedure which primarily treats a medical condition called hydrocephalus. Hydrocephalus occurs when excess cerebrospinal fluid (CSF) collects within the brain’s ventricles. CSF is basically meant to cushion the brain & protect it from injury inside the skull. This cerebrospinal fluid also acts as a delivery system for nutrients which the brain requires & also for taking away waste products which are generated in brain. CSF normally flows through ventricles to the base of brain. This fluid also bathes the spinal cord & brain before it is reabsorbed into blood. However, when the normal flow of CSF is disrupted, subsequent buildup of fluid can create harmful pressure on brain tissue & eventually damage brain. As a treatment for this condition, surgeons place VP shunts inside ventricles of brain so as to divert fluid away from brain & restore effective flow & absorption of CSF.
Although, hydrocephalus is more likely to occur among babies & older adults, people of any age can develop this condition & therefore require VP shunt surgery. It is also estimated that 1 – 2 of every 1,000 babies are born with hydrocephalus. Excessive CSF can build up around the brain for a number of reasons including some of the following.
Of these, blockages are the most common reason for hydrocephalus. Moreover, tumors, cysts, or inflammation can also impede normal flow of CSF in brain & create accumulation which is unsafe.
Imaging tests can effectively confirm diagnosis of hydrocephalus. CT scans, Ultrasound & MRI scans can allow doctors to view tissues & cavities within the brain. These imaging tests will also show if areas of brain are containing more fluid than what is normal.
Surgeons will typically perform placement of VP shunt while patients are under general anesthesia. They will be asleep while undergoing surgery & will not feel any pain. The entire VP shunt surgical procedure will last for about 90 minutes. Prospective patients should speak to the surgeons during initial consultation & find out details about preoperative drink & food restrictions. Adults & older children must generally fast for about 8 hours before undergoing surgery. Toddlers & infants will only need to stop eating baby-formula & other solid foods at least 6 hours prior to undergoing surgery. They can however drink water until 4 hours prior to the scheduled time of VP shunt surgery. Nevertheless, these instructions would need to be reviewed with the surgeon in all cases of hydrocephalus.
Surgical team will shave area behind patient’s ear in preparation for VP shunt surgery. This is basically the area where catheter will be placed. These catheters are usually thin & flexible tubes which are used to drain excessive fluid. Surgeons will then make tiny incision behind the ear so as to drill a small hole in skull. They will subsequently thread one catheter into brain through this opening while the other catheter will go behind ears & will be subcutaneous or reside under the skin. This catheter tube will then travel down to patient’s chest & abdomen & will allow excessive CSF to drain inside the abdominal cavity where it will eventually be absorbed. Surgeons during the VP shunt procedure also attach a tiny pump to both catheters & place them under skin behind the ear. This pump is designed to automatically activate so as to remove fluid when pressure inside the skull increases. It is possible to even program this pump which is also called a valve, to activate every time CSF in brain reaches a certain volume.
Recovery from VP shunt surgery will take about 3 – 4 days of time. Most patients leave the hospital within about 7 days following the VP shunt operation. The hospital staff will frequently monitor blood pressure & heart rate of VP shunt patients after operation & doctors will administer preventive antibiotics to keep away from infection. Surgeons will however make sure that the VP shunt is properly working before discharging patients from the hospital.
Placement of VP shunt is an extremely safe procedure. Complications may however occur during or after the surgical procedure like they do with all types of surgery. Common risks associated with most surgical interventions include infection & excessive bleeding. VP shunt patients may also experience adverse reactions to anesthesia which include changes in levels of blood pressure, changes in heart rate or difficulty in breathing. Rare risks which are specifically associated with VP shunt surgery & listed below can be serious & potentially life-threatening if they were left untreated.
Headache, fatigue, fever, abdominal pain & spike in blood pressure levels indicate infection or malfunction of VP shunt. Hydrocephalus patients should immediately notify surgeons if these signs & symptoms are found to develop. Infection is one of the most common problems found within the first few weeks following VP shunt placement.
Malfunctions within VP shunt systems can lead to serious complications like over-draining or under-draining of accumulated cerebrospinal fluid. Over-draining usually occurs when cerebrospinal fluid drains from ventricles at a faster pace than it is being produced. This condition may eventually cause ventricles to collapse & may subsequently lead to headaches or hemorrhage inside brain. Under-draining of the VP shunt system will invariably allow cerebrospinal fluid to accumulate inside brain & cause hydrocephalus symptoms to return. VP shunt patients should in such conditions seek immediate medical attention in case they experience symptoms which indicate that the VP shunt system is not functioning properly.
VP shunt surgery is a successful procedure which can effectively reduce pressure in brain for most people. VP shunt systems are also likely to require replacement after several years, especially among smaller children. Average life-span of VP shunt system in infants is about 2 years. However, adults & children above 2 years of age may not need any VP shunt replacement for about 8 years or even more. But then again, VP shunt systems will require frequent monitoring & follow-up care.
Many doctors & surgeons in India today have earlier trained & experienced in the western developed countries like UK, Canada & United States. They are therefore well versed in handling latest technologies & aware of emerging trends. Healthcare infrastructure in this country is also well established with numerous internationally accredited hospital facilities & multinational healthcare giants in the fray. IndianMedTrip is a leading South Asian medical tourism company which has tie-ups with all reputed medical facilities in the country. They are therefore in the best position to provide affordable medical solutions including VP shunt surgery for hydrocephalus patients coming from all parts of the world. Seamless services offered by IndianMedTrip begin from the first telephonic conversation & go on to assisting obtaining medical visa, warm reception at the airport on arrival, convenient travel & comfortable accommodation, scheduled treatment & surgical appointments, cozy recuperative vacation, follow-up checks & a successful farewell for international patients.