What is ventriculoperitoneal shunt surgery?

Ventriculoperitoneal (VP) shunt surgery drains extra fluid out of the brain. The extra fluid moves into the belly and is absorbed by the body. This helps control the pressure in the brain so the brain can work as it should.

Some health problems can cause swelling and pressure in the brain. These include brain tumours and hydrocephalus, which is extra fluid in the brain.

To do the surgery, the doctor makes a few small cuts above your child's ear. These cuts are called incisions. Then the doctor drills a small hole in the side of the 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 child's belly. A second catheter goes into this incision. It is gently pushed under the skin and up to your child's chest and neck. Next, the doctor uses a valve to attach the two catheters on the side or back of your child's head. Then the doctor closes up the incisions with stitches or staples. Both catheters and the valve are completely under the skin.

Your child will be asleep during the surgery. It usually takes about 2 hours. But your child will probably need to be in the hospital for 2 to 7 days.

The shunt will not limit your child's activities. There will be a lump on your child's head where the valve is. But it may not show after your child's hair grows back.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

What happens before surgery?

Surgery can be stressful both for your child and for 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

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctors ALL the medicines, including natural health products, such as vitamins, supplements, and herbal remedies your child takes. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines your child should take or stop before surgery.
• Talk to your child about the surgery. Tell your child that the surgery will help get rid of extra fluid in his or her 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 operating area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. He or she may need more of your time right after the surgery, both for care and for comfort.

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.

What happens on the day of surgery?

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be cancelled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery centre

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by an anesthesia provider. Your child will be asleep during the surgery.
• The surgery usually takes about 2 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.

Going home

• Expect your child to be sleepy. Encourage extra rest the first day. Most children can be more active on the day after surgery.
• Follow your doctor's instructions about when your child can do vigorous exercise. This includes sports, running, and physical education.
• When you leave the hospital, you will get more information about how to take care of your child at home.
• The doctor or nurse will tell you when your child can start normal activities again.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare your child for the surgery.
• Your child becomes ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about your child having the surgery.