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Optimizing the Management of Patients with Ventriculoperitoneal Shunts in Breast Surgeries
Osama Darras, MD, PhD(c), Sara Yacoub, BA, MPH, Diwakar Phuyal, MBBS, Steven Bernard, MD, Raffi Gurunian, MD, PhD, Sarah N. Bishop, MD.
Cleveland Clinic
2025-01-10
Presenter: Osama Darras, MD, PhD(c)
Affidavit:
Raymond Isakov, MD
Director Name: Raymond Isakov, MD
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
PURPOSE:
Ventriculoperitoneal (VP) shunts are commonly used in neurosurgery. Their catheters often pass through the chest, necessitating caution during breast surgeries.
METHODS:
This is a descriptive study. The management of two cases who underwent breast surgeries and had preexisting VP shunts at the time of the surgery was reported.
RESULTS:
One case underwent superomedial breast reduction and the other underwent breast reconstruction with prepectoral implants. After approving the surgery, the neurosurgical team was informed to intervene should any complications arise in the operating room. Chest X-rays were taken to identify the position of the shunt in the chest to avoid any intraoperative interference. Once the shunts were identified, Breast surgery was performed similarly to the conventional surgical technique with extra caution given while dissecting the area in which the shunt was inserted. After the operation, another X-ray was performed to verify the position of the VP shunt. A postoperative neurological exam was performed for confirmation.
CONCLUSION:
With the interdisciplinary approach involving neurosurgery, the chances of avoiding VP shunt complications are high. Intraoperative X-ray was found to be beneficial in identifying the position of the shunt. Ensuring a rapid intervention by the neurosurgery team in case of complications is also important which enables immediate corrective action.
