been given the opportunity to watch a VP shunting procedure....i know barely anything about them as i'm an EM physician not Neuro so can someone please lead me to the procedures rundown from start to finish....i have a 5hr whirlybird flight and want some good reading material so i know what i'll be seeing/not seeing.....
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Full explaination of VP shunts
- Thread starter BushDoc20
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been given the opportunity to watch a VP shunting procedure....i know barely anything about them as i'm an EM physician not Neuro so can someone please lead me to the procedures rundown from start to finish....i have a 5hr whirlybird flight and want some good reading material so i know what i'll be seeing/not seeing.....
Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure for cerebral spinal fluid (CSF) diversion. Typically, the indication is a form of hydrocephalus (obstructuve, normal pressure, pseudo tumor). There are also ventriculo atria/caval/pleural/cystic shunts that go to the heart, vena cava, lung, and bladder, respectively
The procedure itself, typically, takes less then 1 hour. Start to finish:
Patient brought to OR/identified/intubated. The patient is then placed in supine position for frontal shunt or shoulder roll for occipital shunt. The hair is then clipped and skin site from head to abdomen prepped with sterile prepping solution. The incision sites are marked with sterile pen and the patient draped with towels and adhesive drapes. The specifics for each surgeon are variable with respect to everything (e.g. some use ioban, some have a second or third incision along the catheter route to help pass the trocar, some use laparoscopy for assistance). Essentially, incisions are made in the abdomen (most often RUQ or periumbilical) and head (most often kocher's point: 11-13 cm from nasion 2-3 cm from midline for frontal and frazier's point 6 cm above and 4 cm lateral to the inion). For the head dissection is made to the periosteum and a pocket for the valve is created, then the periosteum incised/stripped and cranial burr hole made. For the belly dissection through the fat, anterior rectus sheeth, rectus muscle, posterior rectus sheeth, and preperitoneal sheeth devided and bowel visualized to ensure intrabdominal placement. A long metal tube called a trocar is tunneled in the subcutaneous fat and extends the length between the belly and the head. The shunt distal catheter tubing is passed through the tube. The dura is then opened and the ventricular catheter passed to the ventricle. A valve is then attached (some people use programmable, some use fixed pressure) to the distal/proximal tubes and CSF visualized flowing from the distal catheter. The wound copiously irrigated and then the skin is closed.
Hope this helps, fell free to PM me with questions
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Quite honestly and sincerely, that is one of the best, clearest, most helpful posts I've seen on SDN in years.
If we had a slashdot type system here, you would definitely get points.
If we had a slashdot type system here, you would definitely get points.
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Does VP shunt are exclusively for SCI patients?
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Does VP shunt are exclusively for SCI patients?
Not exactly sure what you are asking, but generally people with spinal cord injury (SCI) do not require a VP shunt.
