Portacath Insertion
A Portacath (or port) is a special small medical device placed to allow access to the veins. It allows you to have chemotherapy or transfusions without having to undergo repeated conventional vein needle access and without damaging your veins. Ports can also be used to allow vein access in patients who have damaged veins as a result of previous medical treatment.
Why have a portacath inserted?
Ports allow venous access and prevent the need for multiple needles. Your doctor or nurse can use the port to give drugs, chemotherapy or transfusions as well as take blood without putting a needle in your arm. Our ports can also be used to allow x-ray dye (or contrast) to be given again without using an arm needle.
Ports are buried under the skin and therefore have a much lower risk of infection than other forms of vein access.
The placement of ports in central veins also means more toxic medication can be given without damaging the vein.
Is it permanent?
Ports can be left in place for as long as required. At the end of a treatment plan, a port can be removed using a minor procedure under sedation and local anaesthetic. If required they can be left in place and function well and safely for many years. If not used then a regular flush of saline is required to prevent the port from blocking.
How is it placed?
The procedure is performed by a specialist interventional radiologist – an expert in this area. A small plastic tube (<3mm) is placed in a vein at the bottom of the neck. This is connected to a metal port placed under the skin on your upper chest. The port can usually be felt under the skin. When placed by an interventional radiologist, this is a minimally invasive procedure. An incision about 5 cm long is needed to place the port.
Ports are placed under local anaesthetic and sedation. The procedure usually takes 30-45 minutes.
You will go home later that day once you have adequately recovered from the sedation. You will not be able to drive yourself home.
Ports can also be placed surgically but ports placed this way carry higher risks from insertion and malfunction more commonly.
How does it work?
A special needle is used to access the port through the skin on the chest. This can be done following the use of local anaesthetic cream to numb the skin. The port has a rubber drum that seals once the needle is removed, allowing the port to be used over and over without a problem.
What about cosmetics?
The pocket under the skin in which the port is placed is closed with absorbable sutures and sometimes special skin glue. Once the skin is healed the port will be much less visible. Depending on how thin you are you may notice the port or the tubing. As a port is buried you can carry on with your normal activities, including sport and swimming without worrying about the port moving or breaking.
What are the risks?
This a minimally invasive procedure and risks or complications are very unlikely.
- Infection – as the port requires a skin incision there is a small risk of skin infection, this is minimised by dressing the wound until healed. The port should only be accessed to reduce the risk of introducing infection. If a port infection develops then, unfortunately, it will usually have to be removed.
Frequently Asked Questions
How do I know if I am a candidate?
Usually your specialist will have referred you for a port placement. We can meet with you in our consulting rooms to discuss any concerns you may have prior to the procedure.
What investigations or scans are needed?
Usually, none. It is useful to know if you have had any previous vascular access procedures or 'lines' in your neck veins. Any prior or planned chemotherapy using Avastin is also important at this can affect wound healing.
How long is the procedure?
Under one hour.
Do I need an anesthetic?
No, we insert ports under local anaesthetic and sedation.
How is the procedure performed?
A portacath is placed by a surgical procedure where a small incision is made, usually in the chest. A catheter is then inserted into a large vein, typically the superior vena cava, and connected to a small reservoir (the port) that is implanted under the skin. This allows easy access for intravenous medications or blood draws. The procedure is typically done under local anesthesia with sedation.
How long will I be in the hospital?
You will stay a few hours until the sedation has fully worn off.
What is the recovery period?
There are no major side effects. You may have minimal discomfort for a few days. You will have to keep the wound clean and dry for a week until healed. You can return to non-physical work and non-strenuous activities prior to this.
Safe, effective treatments with less pain and quicker recovery.
Ensure you know all your options prior to invasive surgical treatment, schedule a consult with Dr Shaun Quigley.