What to Know About VP Shunts

Written by Lisa Guthrie
Medically Reviewed by Jabeen Begum, MD on January 29, 2026

A ventriculoperitoneal (VP) shunt is a narrow plastic tube that drains excess cerebrospinal fluid into your abdomen (belly).

Cerebrospinal fluid (CSF) protects your brain by acting as a shock absorber. It also helps carry nourishment to the brain and take waste products away from the brain. But too much CSF can put pressure on the brain and cause problems.

A buildup of excess cerebrospinal fluid (CSF) is called hydrocephalus. The extra CSF can build up because the body is either making too much of it or is not draining it properly. The symptoms of hydrocephalus include:

  • Headaches
  • Nausea and vomiting
  • Fatigue
  • Confusion
  • Problems with balance and walking

‌A VP shunt has a one-way valve, a device that only allows fluid to move away from the brain. The valve has a pressure setting. When there is too much CSF and pressure starts to build, the valve opens and allows CSF to drain until the pressure is restored to the setting chosen by your doctor.

‌Fixed valves have three to five pressure settings. A higher pressure setting typically drains less CSF, while a lower pressure setting usually drains more fluid.

The setting of a fixed valve is chosen before the shunt is placed. It cannot be changed without further surgery. In clinical trials, fixed and programmable valves have worked equally well. The different brands of valves also tend to work about the same in these trials.

Programmable valves, also called adjustable valves, can be adjusted without further surgery. Your doctor can change the pressure setting of this valve during an office visit, using a special magnet. Surgeons tend to choose programmable valves for most shunt placements.

‌The operation to place the shunt takes about an hour. You cannot have a visitor with you in the operating room, but a family member or friend can be nearby in a waiting room. 

The shunt itself will not be visible. But you may be able to feel the plastic tubing under the skin of your neck.

‌Your surgeon will give you specific care instructions. Generally, there is no day-to-day care needed for a shunt. It is important to attend all follow-up visits with your surgeon. They will check your pressure setting and make sure your shunt is still working properly.

You will probably also need to:

  • Tell your surgeon if you ever need abdominal surgery so they can talk with your surgery team about any special precautions.
  • ‌Let your surgeon know if you ever had an abdominal infection, such as appendicitis or diverticulitis.
  • ‌If you have a programmable valve and must have an MRI, set up an appointment to have the pressure setting adjusted on the same day.

If you have a programmable valve, set up an appointment to have the pressure setting checked if you have any of the following symptoms:

  • Persistent headaches
  • ‌Nausea and vomiting
  • More drowsiness than usual
  • Weakness
  • Seizures
  • Slurred speech
  • Problems with balance

‌Shunts are generally safe but can get infected, which is a medical emergency. Your surgeon will give you a list of symptoms of shunt infection and explain what to do if you have those symptoms. It is important to follow their instructions carefully.

Shunts tend to need replacement or adjusting from time to time. This requires another surgery.

Signs your VP shunt isn't working properly

If your shunt is no longer working properly, you would usually have the same symptoms that you had with hydrocephalus before the shunt was placed. Your surgeon will give you a list of signs that you need to call for an appointment.

You may have: 

  • Extreme sleepiness
  • Headache
  • Vomiting

If it's your child who has the shunt, it may be harder for them to tell you their symptoms, especially if they're very young. Watch for the signs of headache and sleepiness. Swelling along the path of the shunt and a fever could mean an infection. If your child starts behaving differently, that also could be a sign of a shunt that isn't operating correctly.

Keep in mind, you may not have all these signs (or see them in your child), but be ready to get medical attention right away if you do see them.

Shunts usually ease the symptoms of hydrocephalus, often within days of placement. Full recovery can take weeks or months. The shunt will need to remain in place, even after you feel better.

Most importantly, VP shunts treat hydrocephalus well. They relieve the pressure on the brain, cutting the risk of damage from the pressure.

How long do VP shunts usually last?

It's hard to predict how long a VP shunt will last, but some doctors say about half of all shunts will need to be fixed or replaced after six years.

Is VP shunt placement a major surgery?

The shunt procedure is done in a hospital under general anesthesia (meaning you'll be asleep). It may take 30 minutes or a little longer, plus time to wake up from anesthesia. You'll be monitored at the hospital for at least 24 hours after surgery. It's considered a simple operation, but it does involve implanting a tube in the skull and body, and it can have complications.

Can a VP shunt be removed permanently?

Most people who have shunts will have them all their lives. But sometimes, if their hydrocephalus gets better or doctors find a better way to circulate the brain fluids, patients may no longer need their shunts. A specialist will closely examine the patient's health and situation before deciding it's safe to remove the shunt.

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