Portacath insertion and removal

A portacath (port) is a small device implanted under your skin in the upper chest, providing easy access to one of your larger veins.

Ports can be used for taking blood samples, nutritional feeding, long term IV medications, or chemotherapy. At Intra, ports are inserted for those patients who will be undergoing regular, and long term chemotherapy.

Some people have either very small veins which can be damaged with the toxicity of the chemotherapy drugs, or have difficult access, making a port ideal for them.

The advantage of a port, is that it is under the skin. This helps prevent infection in the line and ensures the portacath can be used for many years if required.

 

A portacath consists of two parts; the port and a catheter. The port we insert is designed specifically for use during special imaging studies such as CT or MRI scans.

Portacaths are made from materials that are safe for long term use in your body. Overall, a portacath should make receiving your treatment more comfortable for you.

Before the Procedure

Fasting: Please stop eating four hours before your procedure time

Allergies: Please inform Intra if you have any medication or food allergies, or sensitivities to plasters or dressings.

Diabetes: If you are a diabetic, please tell Intra staff at the time of booking. You may need to discuss your insulin/diabetes medication doses with your doctor.

Anticoagulants (blood thinner): If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please notify Intra staff at the time of booking. Intra will advise you if you need to stop this medication temporarily for a few days before your procedure.

Other regular medications: Please continue to take all regular medication unless otherwise advised by your doctor.

Portacath Insertion

A portacath insertion procedure usually takes 45-60 minutes and is performed by an interventional radiologist or vascular surgeon at Intra.

Before the procedure, the doctor will mark the site where the port will be placed on your chest. We will discuss the best place to put your port with you.

The neck and chest area for the port and catheter sites will be cleaned with an antiseptic solution. You will be covered with a large sterile drape to ensure sterility is maintained. Local anaesthetic is used to completely numb the area. This will sting a little as the local anaesthetic goes in.

Once the two areas are numb, the doctor will make two small incisions:

1. Incision one: near the bottom of your neck but above your collar bone.

2. Incision two: on your upper chest where the port will be placed under the skin.

You may feel pressure while a pocket is made under the skin for the placement of the port. If at any time you feel pain or are uncomfortable, please let your doctor know. More local anaesthetic or medication can be given to help you relax.

The pocket and incision for the catheter are closed with dissolvable stitches. Both incisions are covered with a water-resistant dressing. It is normal to feel and see a raised area on your chest where the port has been placed. You may also feel the catheter in the neck area which is normal.

Portacath Removal

A portacath removal procedure usually takes 30-45 minutes and is performed by an interventional radiologist or vascular surgeon at Intra.

The chest area where the port is inserted will be cleaned with an antiseptic solution. You will be covered with a large sterile drape to ensure sterility is maintained. The doctor will then administer medication via your portacath to help you relax and keep you comfortable.

Local anaesthetic is then used to completely numb the area around your port. This will sting a little as the local anaesthetic goes in. Once the area is numb, the doctor will make a small incision over the port. The port is freed from any tissue and the entire device is removed, including the catheter.

You may feel pressure while the port is removed. If at any time you feel pain or are uncomfortable, please let your doctor know. More local anaesthetic or medication can be given to help you relax.

The incision (wound) will be closed with dissolvable stitches and steri-strips. Sometimes surgical glue is used. The area is then covered with a water-resistant dressing.

After your Procedure

You will be taken to recovery where you will be given something to eat and drink. The nursing team will monitor your recovery and if appropriate you will be discharged after one hour.

Someone must drive you home or accompany you in a taxi. Please arrange for accompanied transport in advance.

Due to the sedation you may feel lethargic afterwards with reduced concentration. For this reason for 24 hours after your procedure please:

  • Do not drive.
  • Do not drink alcohol.
  • Do not make any legal decisions or sign legal documents.

You will usually be able to return to work the day after your portacath procedure. This depends on how physical your job is.

What are the risks?

As with any procedure, there are potential risks involved. Your interventional radiologist or vascular surgeon will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form. This will occur on the day of your procedure.