Hydrocephalus Shunt Procedures

Shunt surgery is a relatively short and uncomp>licated procedure that varies slightly depending upon two factors : -

* The neurosurgeon's preference on where to place the upper shunt catheter
* The decided location of the lower shunt catheter to permit draining of the excess cerebrospinal fluid (CSF)



When it is time for your surgery, you will be brought into the operating room. There, you will be hooked up to an intravenous (IV) line as well as to one or more devices to monitor you during and after surgery. These devices include : -

* Electrocardiogram (EKG -which monitors your heart rate.
* Automatic blood pressure (BP) cuff-monitors your blood pressure.
* Pulse oximeter-measures the amount of oxygen in your blood.


The surgical procedure to implant a VP (ventricular peritoneal) shunt usually requires less than an hour in the operating room.
After the patient is placed under general anesthesia, their scalp is shaved and the patient is scrubbed with an antiseptic from the scalp to the abdominal area. These steps are taken in order to reduce the chances of an infection. Incisions are then made on the head and in the abdomen to allow the neurosurgeon to pass the shunt's tubing through the fatty tissue just under the skin. A small hole is made in the skull, opening the membranes between the skull and brain to allow the ventricular end of the shunt to be passed through the brain and into the lateral ventricle. The abdominal (peritoneal) end is passed into the abdominal cavity through a small opening in the lining of the abdomen where the excess CSF will eventually be absorbed. The incisions are then closed and sterile bandages are applied.


Tube-shunt surgery, or Seton tube shunt glaucoma surgery, is a surgical method to treat glaucoma. Glaucoma is a potentially blinding disease affecting 2-3% of the United States population. The major known cause of glaucoma is a relative increase in intraocular pressure, or IOP. The purpose of glaucoma treatment, whether medical or surgical, is to lower the IOP.

Aqueous fluid is made continuously, and circulates throughout the eye before draining though channels in the eye's anterior chamber. When too much fluid is made, or it is not drained sufficiently, the IOP rises. This fluid build-up can lead to glaucoma. Normal intraocular pressure is under 21 mm/Hg. Glaucoma develops at IOPs higher than 21mm/Hg. However, approximately 20% of glaucoma patients never have pressures higher than 21 mm/Hg.

The surgical procedure to implant a VP (ventricular peritoneal) shunt usually requires less than an hour in the operating room. After the patient is placed under general anesthesia, their scalp is shaved and the patient is scrubbed with an antiseptic from the scalp to the abdominal area. These steps are taken in order to reduce the chances of an infection. Incisions are then made on the head and in the abdomen to allow the neurosurgeon to pass the shunt's tubing through the fatty tissue just under the skin. A small hole is made in the skull, opening the membranes between the skull and brain to allow the ventricular end of the shunt to be passed through the brain and into the lateral ventricle. The abdominal (peritoneal) end is passed into the abdominal cavity through a small opening in the lining of the abdomen where the excess CSF will eventually be absorbed. The incisions are then closed and sterile bandages are applied.


After surgery

The patient generally stays under careful neurological observation for the first 24 hours following the procedure. Some neurosurgeons prefer to keep the patient flat in bed until nearly all the subdural air introduced during surgery dissipates. The bandages placed on the head and abdomen, covering the incision sites, are monitored for signs of infection. The patient will generally need to stay in the hospital from three to seven days. Follow-up visits will be necessary to check post-operative status and resolution of symptoms. Additional treatment, such as physical therapy, may be advised to help the patient attain previous levels of motor skills.