SHUNT
Definition
This surgery is performed to relieve intracranial pressure caused by hydrocephalus. The fluid is shunted from the ventricles of the brain into the abdominal cavity.
Description
This procedure is performed in the operating room under general anesthesia. A flap is cut in the scalp and a small hole is drilled in the skull. A small catheter is passed into a ventricle of the brain. A pump is attached to the catheter to keep the fluid away from the brain. Another catheter is attached to the pump and tunneled under the skin, behind the ear, down the neck and chest and into the peritoneal cavity (abdominal cavity).
Indications
In hydrocephalus, the ventricles of the brain become enlarged with cerebrospinal fluid. This condition causes the brain tissue to become compressed against the skull, thus causing serious neurological problems. Shunting is necessary to drain the excess fluid and relieve the pressure in the brain. This should be done as soon as hydrocephalus is recognized to give the child the best possible neurological outlook.
Expectations after surgery
The outcome from the actual surgery is good. This defect, though, is often associated with other conditions such as spina bifida, brain tumor, meningitis, encephalitis or hemorrhage. These conditions would influence the patient's prognosis. The degree of hydrocephalus prior to surgery will also affect the outcome. Support groups for families of children with hydrocephalus are available in most areas.
Convalescence
Vital signs and neurological status are closely monitored. Medication is given for pain. Intravenous fluids and antibiotics may be given. The patient is monitored closely to ensure that the shunt is functioning properly. Two to three days of bedrest in the hospital are usually required and then the child may go home.
Risks
Risks for any anesthesia are:
- reactions to medications
- problems breathing
Risks for any surgery are:
- bleeding
- infection
Common complications of VP shunt include shunt malfunction or blockage, infection. Malfunction may be related to growth and the shunt will need to be replaced with a longer catheter. Symptoms of shunt malfunction or infection include headache, fever, drowsiness and convulsions.
Cost
The cost of any surgery varies significantly between surgeons, medical facilities, and regions of the country.
Surgery costs can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.
1. Surgeon's fee: averages $1,500
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or X-ray exams), medical supplies, or equipment use.
Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.
