Placement and removal of port catheters

Overview

A port catheter is usually inserted when long-term intravenous drug therapy  or intravenous feeding is necessary. This is often the case with tumors, but may occasionally be required for other chronic diseases or inflammation.  The port chamber, located under the skin, is connected to the venous system close to the heart via a catheter. A secure connection to the venous system can be established by piercing the silicone membrane of the port chamber and medication can then be administered. The drug reaches the central circulatory system via the catheter and is then well-distributed throughout the body. Insertion of a venous catheter into a superficial vein over the arm or hand at every therapy appointment is therefore unnecessary. Blood samples may also be drawn through the port catheter.

Preparation

Once you have registered with our colleagues for port catheter insertion, pre-operative preparation is undertaken either in our outpatient clinic or during hospitalization. Blood tests and other investigations are performed to exclude underlying infection or blood clotting disorder. If you are taking blood thinners, the need for withholding these prior to insertion of the port catheter will be discussed with you. The ideal side for port implantation will also be discussed. The procedure of port insertion and placement will be explained to you well beforehand and you will have the opportunity to clarify any doubts you may have.

Operation

After pre-operative preparation, the port catheter is inserted under local anesthesia in the operating room on the date discussed with you. An anesthetic injection is administered first, followed by exposure of a vein in the subcutaneous tissue through a small skin incision measuring approximately three to four centimeters between the shoulder and the rib cage. The catheter is then inserted through the incision into the correct position under x-ray control. A small pocket is then created over the chest muscles for the port chamber, where it is fixed. The correct position of the entire system and its functioning are re-checked  before the surgical wound is closed and the operation comes to an end.  The actual operation lasts about 45 minutes, but you will be in the surgical wing for a total of about 1 – 1.5 hours for pre- and post-operative care.

Aftercare

Port catheter placement is usually undertaken on an outpatient basis with about three hours of post-operative monitoring in our day clinic.  Should there be no problems, you can either go home or the first dose of medication can be administered via the catheter immediately afterwards. We recommend that you rest the relevant arm after insertion of the port catheter in order to allow the port chamber to grow in well. You can expect to be off work for about a week after the operation if your work involves manual labor, and about one to two days if you work in an office.

Wound healing takes approximately ten to 14 days, during which time you are advised to avoid sports, bathing or taking a sauna. You may shower if waterproof plasters have been applied. The wound is generally closed with self-dissolving sutures and suture removal is not required. Regular inspection of the wound is however recommended. This may be done either by your family doctor or by the treating physician if drugs are already being administered via the port catheter.

Your port catheter may be used for several years with proper handling. Removal of the port catheter may be planned if it is no longer needed after definitive completion of therapy. This is also achieved by a small operation performed on an outpatient basis under local anesthesia.