A properly functioning shunt does not require manipulation of the pump. If the system is draining sluggishly a decision is sometimes made to have the family speed it up with the pump. In addition, the pump should not be utilized to test shunt function. There is often little correlation between function and what is noted on depressing the pump. If a child is asymptomatic there is no need to manipulate the apparatus, and this may in fact cause problems with drainage.
Shunts commonly function for many years without problems of any sort.
The answer is almost always yes. The overwhelming majority of children will remain shunt-dependent all their lives. In a few patients, serial abdominal X-rays will reveal that the shunt has become distracted from the peritoneal cavity. A decision must then be made as to whether or not the tube is to be lengthened. If the CAT scan discloses a small ventricular system there is no question that the shunt is functional, and it is reasonable to lengthen it before the child becomes symptomatic.