Implantable ports

An implantable port is a thin, soft, silicone tube with a small reservoir (port) attached to it. Implantable ports are sometimes called portacaths or subcutaneous ports. You can have chemotherapy and other drugs through the port. It can stay in place until all your chemotherapy treatment is finished.

A nurse or doctor will insert your port, usually using a local anaesthetic. They insert the port under the skin, usually on your chest, and the attached tube goes into a vein near the heart.

You can see a small bump underneath your skin where the port is. A special needle is passed through your skin into the port to give your chemotherapy into the vein. The skin over the port can be numbed first so you don’t feel any discomfort.

If it is not used regularly, the port is flushed every four to six weeks to stop it blocking. Contact your doctor if there is redness, swelling or pain near or around the port, or if you don’t feel well. These may be symptoms of an infection or a clot.

What are implantable ports?

An implantable port is a catheter with a small reservoir (port) attached to it. It can be used to give chemotherapy or medicine into your vein, or to take blood.

Implantable ports are sometimes called portacaths or subcutaneous ports.

The catheter is a thin, soft, flexible tube made of silicone. It 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 to the port. The port is a disc that’s about 2.5–4cm (1–1.5in) in diameter. It goes under the skin on your upper chest or arm. You will be able to see and feel a small bump on your skin where the port is.

An implantable port
An implantable port

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What implantable ports are used for

A port can be used to give you treatments such as:

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

A specialist nurse or a doctor will put your port in at the hospital. It is 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 will usually be able to go home on the same day. You may like to discuss the position of the port with your doctor before it is put in.

A small needle will be put into a vein in your arm or hand and you will have medicine to help you relax. Your nurse or doctor will inject a local anaesthetic into your skin to numb a few 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.

Two small cuts (incisions) will be made in your skin. The first is made to create a pocket under the skin for the port. It will be about 3–4cm long. There will be a smaller incision above this where the catheter is put into the vein. This incision is usually less than 1–2cm long. If the port is being put into a vein in your chest, the incisions are made on your upper chest. If the port is being put into a vein in your arm, they will be on the inner side of your arm.

The port will be put under the skin. The catheter 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 will 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. Sometimes a ’skin glue’ is used instead.

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.

Straight 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 to 10 days, when the wound heals.


How the implantable port is used

The port can be used soon after it has been put in. About half an hour before it is used, the skin over the port can 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.

Treatment can then be given directly into the bloodstream, or blood samples can be taken.

If you are having a short treatment, the needle will then be removed. For longer treatments, you will have a dressing placed over the needle to hold it in place until your treatment is finished. The needle is then removed.


Caring for your implantable port

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 to six weeks if it is not being used regularly.

If you feel able to, the nurses at the hospital will teach you how to do this. They can also teach a partner, relative 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

Infection

It is 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 port
  • develop a high temperature (fever)
  • feel faint, shivery, breathless or dizzy.

If an infection develops, you will be given antibiotics. If the infection doesn’t get better, the line may need to be removed.

Blood clots

It is 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
  • 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 will be given medication to dissolve it. Your line may have to be removed.

Blocked line

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 through it. 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

When you don’t need the port any more, it will be taken out. This is usually done by a doctor or specialist nurse. A local anaesthetic is used to numb the area. The port will sometimes be removed under a general anaesthetic.

The doctor or nurse will make a small incision over the site of the port and remove the port and the catheter. 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

The port shouldn't interfere with your daily activities. It is 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.

If you need more information, you can ask your doctor or nurse at the hospital where you're being treated.

Back to Being treated with chemotherapy

Where can I have chemotherapy?

Usually chemotherapy is given in a chemotherapy day unit. Some may people stay in hospital, or have treatment at home.

Central lines

A central line is a long, thin hollow tube. It is inserted into a vein in your chest to give chemotherapy and other drugs.

PICC lines

A PICC line is a long, thin, flexible tube known as a catheter. It’s put into the arm to give chemotherapy and other medicines.