Implantable ports are often used to give chemotherapy or other medicines to someone with cancer. They are sometimes called portacaths or subcutaneous ports.
We hope this information answers your questions. If you have any further questions, ask your doctor or nurse at the hospital where you're being treated.
An implantable port is a thin, soft, hollow tube made of plastic. It’s put into a vein in your chest or arm.
It has an opening just under the skin. This is called the port. The port is a disc about
2.5–4cm (1–1.5in) in diameter.
It can be used to give medicine into your vein, or to take blood.
The tube is usually put in (tunnelled) under the skin of your chest or sometimes in your arm. One end of the tube goes into a large vein just above your heart. The other end connects with the port. This goes under the skin on your upper chest or arm. You'll be able to see and feel a small bump underneath your skin.
What implantable ports are used for
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A port can be used to give you treatments such as chemotherapy, blood transfusions, antibiotics and intravenous (IV) fluids. Ports can also be used when you need to have blood tests. This means you won’t need to have needles put into your arms every time you have treatment.
You can go home with the port in. It can be left in for weeks, months or, for some people, years.
A port may be useful if doctors or nurses find it difficult to get needles into your veins.
How the implantable port is put in
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Your port will be put in at the hospital by a specialist nurse or doctor. It's usually done in the operating theatre or an area called the vascular radiology unit. You will usually have a local anaesthetic to numb the area. A general anaesthetic is sometimes used. You may like to discuss the position of the port with your doctor, before it’s put in.
A small needle will be put into a vein in your arm or hand and you'll have medicine to help you relax. Your nurse or doctor will inject a local anaesthetic into your skin to numb a couple of small areas on your chest and neck. You might feel some pressure on your chest (or arm) during the procedure, but you shouldn’t feel any pain.
You'll have two small cuts (incisions) made in your skin. If the port is put into a vein in your chest, it will be placed in an incision on your upper chest. If the port is put into a vein in your arm, it will be placed in an incision on the inner side of your arm. The incision will be about 3–4cm (1–1.5in) long. There will be a smaller incision above this, usually less than 1–2cm (0.5–1in) long.
The port will be placed under the skin. The tube attached to the port will be tunnelled under your skin to the smaller incision where it will be put into a vein in your chest. The incisions are then stitched.
You'll have a chest x-ray to make sure the port is in the right place.
You may have a small dressing to cover the wounds for a day or so after the procedure. The nursing team will teach you how to look after this.
You may feel a bit sore and bruised for a few days after the port is put in. You can ask your doctor or nurse which painkillers you should take to help with this.
Immediately after the port has been put in, and for a few days after, check for any redness, swelling, bleeding, bruising, pain or heat around the wounds. Let your hospital doctor know straight away if you have any of these. You could have an infection which may need to be treated.
If the stitches are not dissolvable, they will be removed after about 7–10 days when the wound heals.
How the implantable port is used
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The port can be used soon after it has been put in. About half an hour before it’s used, the skin over the port will be numbed with an anaesthetic cream.
Just before you have your treatment or blood test, the skin will be cleaned. The nurse will then push a special needle, called a Huber needle, through the skin and into the port. This shouldn’t be painful, but you may feel a pushing sensation.
The Huber needle connects to the catheter, allowing treatment to be given directly into the bloodstream or blood samples to be taken.
If you're having a short treatment, the needle will then be removed. For longer treatments, you’ll have a dressing taped over the needle to hold it in place until your treatment is finished. The needle is then removed.
Caring for your implantable port
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After each treatment, a small amount of fluid is flushed into the catheter so it doesn't get blocked. The port will need to be flushed every four weeks if it’s not being used regularly.
If you feel up to it, the nurses at the hospital will teach you how to do this. They can also teach a relative, partner or friend. A district nurse can also do it for you at home.
Your port will not need any other care.
Possible problems with implantable ports
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It's possible for an infection to develop inside the catheter or around the port. You should tell your hospital if you:
have redness, swelling or pain around the the port
develop a high temperature (fever)
feel faint, shivery, breathless or dizzy.
If an infection develops, you'll be given antibiotics. If the infection doesn’t get better, the line may need to be removed.
It's possible for a blood clot (thrombosis) to form in the vein where the catheter sits. You should contact your hospital doctor or nurse if you notice any swelling, tenderness or redness in the neck or arm on the same side of the body as the port. This depends on where the catheter is.
If a clot does form, you’ll be given medication to dissolve it. Your line may have to be removed.
The inside of the catheter can sometimes become partly or completely blocked.
If this happens, it can be difficult to give treatment or to take blood tests. The catheter may be flushed with a solution to try to clear the blockage, or the port may need to be removed.
How the implantable port is removed
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When you don’t need the port anymore, it will be taken out. This is usually done by a specialist doctor. A local anaesthetic is used to numb the area. The port will sometimes be removed under a general anaesthetic.
The doctor will make a small incision over the site of the port and remove it. They will gently pull the catheter out of the vein. The wound is then stitched and covered with a small dressing.
You may feel a bit sore and bruised after your port is removed. You can ask your doctor or nurse which painkillers you should take to help with this.
Other information about implantable ports
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The port shouldn't interfere with your daily activities. It's best to avoid strenuous exercise for a few weeks after surgery, so your body can heal. Your doctor or nurse can give you information about this.
If the port is in your arm, don't let anyone take your blood pressure or take blood from a vein in that arm. Don't lift anything heavier than 15lb (7kg).
Only the Huber needles should be used on your port. Don't let anyone use any other type of needle.
You may want to wear a medical ID bracelet saying you have an implanted port.
This section has been compiled using information from a number of reliable sources, including:
Bishop, et al. Guidelines on the Insertion and Management of Central Venous Access Devices in Adults. International Journal of Laboratory Haematology. 2007.
British Committee for Standards in Haematology. Guidelines on the insertion and management of central venous access devices in adults. 2006.
Dougherty, et al. The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 8th edition. 2011. Wiley Blackwell. Perry MC. The Chemotherapy Source Book. 4th edition. 2008. Lippincott Williams and Wilkins.
With thanks to Ms Elaine Chapman, Lead Chemotherapy Nurse, who reviewed this edition.
Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our information to grow.
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