Ventriculoperitoneal Shunt (VP Shunt)
A clear, patient-focused guide to what a ventriculoperitoneal shunt (VP shunt) is, why it is used in hydrocephalus, what the operation involves, and what to expect before and after surgery.
Drain excess CSF in hydrocephalus
General anesthesia
Often ~1–2 hours (case-dependent)
Usually a few days, depending on cause & recovery
What is a VP shunt?
A VP shunt (ventriculoperitoneal shunt) is a system of thin catheters and a valve that is surgically implanted to divert excess cerebrospinal fluid (CSF) from the brain’s ventricles to the abdomen (peritoneal cavity), where it can be safely absorbed.
The valve regulates flow so that “only what is needed” is drained. Some systems also include an antisiphon mechanism, helping to prevent over-drainage when a person stands upright.
Why is a VP shunt placed?
In hydrocephalus, CSF accumulates, raising intracranial pressure and potentially impairing brain function. A shunt reduces pressure by diverting the excess fluid.
Common causes of hydrocephalus
- Congenital conditions (infants/children)
- Hemorrhage (e.g., subarachnoid or intraventricular)
- Infection/meningitis or inflammation
- Tumors or obstructive lesions that block CSF flow
- Normal pressure hydrocephalus (in selected adults)
Goals of treatment
- Reduce intracranial pressure
- Improve symptoms (depending on the cause)
- Prevent complications from prolonged pressure on the brain
- Individualize valve type/settings when indicated
Before surgery
Preparation focuses on safety and on ensuring you fully understand the “why” and “what to expect.” Instructions are tailored to your history and the type of hydrocephalus.
Clinical assessment & symptom review
Neurological examination; assessment of balance/gait, memory/concentration, headache, or other symptoms.
Imaging & planning
CT/MRI to confirm the diagnosis, evaluate ventricular size, and plan a safe catheter trajectory.
Pre-operative work-up
Blood tests, anesthesia evaluation, and medication review (especially anticoagulants/antiplatelets).
Day-of-surgery instructions
Fasting, arrival time, home preparation, and post-discharge arrangements.
How is a VP shunt placed?
The procedure is performed in the operating room under general anesthesia. A catheter is placed into the brain, connected to a valve (usually behind the ear), and tunneled under the skin to the abdomen, where it terminates. In many cases, the total operative time is about 1–2 hours, depending on complexity.
Field preparation
A small area of hair may be shaved; small incisions are made on the scalp and abdomen.
Placement of the ventricular catheter
A small burr hole is created and the catheter is advanced into the ventricle, with or without guidance depending on the case (neuronavigation, endoscopy).
Valve & subcutaneous tunneling
The valve is positioned under the skin (often behind the ear) and the catheter is tunneled beneath the skin toward the abdomen.
Abdominal placement
The distal catheter is placed into the abdominal cavity so CSF can be absorbed. Laparoscopic assistance may be used in selected cases.
After surgery: recovery & follow-up
After shunt placement, the team closely monitors neurological status, the surgical sites, and shunt function. Length of stay varies with the cause of hydrocephalus and the recovery course.
What is commonly expected
- Observation in recovery, then transfer to the ward
- Pain control, antibiotics when indicated, gradual mobilization
- Wound-care instructions and guidance on symptoms requiring prompt contact
- System check/adjustment (especially with programmable valves), as appropriate
Important considerations
- If you have a programmable valve, strong magnetic fields may affect its setting (model-dependent).
- After MRI, same-day verification of valve settings may be required, per your surgeon’s instructions.
- Before any abdominal surgery or if abdominal infection is suspected, notify your care team immediately.
*The information above is general and does not replace individualized medical advice. For discharge instructions and “red flag” symptoms, our team will provide case-specific guidance.
Risks & potential complications
As with any surgery, risks exist. Our goal is prevention, early recognition, and appropriate management— with clear instructions for patients and families.
May include
- Infection (wound, shunt, meningitis)
- Bleeding or thrombosis
- Swelling
- Seizures
- Neurological deficit (case-dependent)
- Anesthesia-related complications
Shunt-related issues (case-dependent)
- Obstruction/malfunction (under-drainage) with recurrence of hydrocephalus symptoms
- Over-drainage (excessively rapid CSF removal) causing headache/nausea, etc.
- Need for revision or adjustment, particularly in growing children (case-dependent)
Risk varies with diagnosis, anatomy, age, and overall health and is discussed in detail before surgery.
When to contact us urgently
After discharge, contact our team if new, worsening, or concerning symptoms occur— especially if they suggest hydrocephalus recurrence or infection.
Contact us if you develop
- Fever or signs of wound infection (redness, tenderness, discharge)
- Severe or worsening headache, confusion, or drowsiness
- Persistent nausea/vomiting
- New weakness, speech, or visual changes
- Seizure
- Worsening gait/balance or other neurological symptoms
Frequently asked questions (FAQ)
Concise answers to common practical questions. The exact plan is always individualized.
How long does VP shunt surgery take?
How many days will I be hospitalized?
When can I return to daily activities?
What about MRI and “magnets” if I have a programmable valve?
Could I need re-operation or future “adjustment”?
Which symptoms mean I should contact the team immediately?
Speak with a neurosurgical team
If you have been advised to undergo ventriculoperitoneal CSF diversion (VP shunt) or would like a second opinion, our team can review your imaging and discuss a safe, individualized management plan tailored to your case.