This information leaflet has been produced to give you general information and hopes to answer most of your questions regarding a port insertion. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
What is a Port?
A port is a thin, soft, silicone tube with a small port attached to it. The ports are sometimes called portacaths or subcutaneous ports. A port is required when you need to have medication given into a large vein over a long period of time. The tube attached to the port lies in a large vein in your chest which allows drugs to be delivered safely into your veins. It is called a totally implanted port as the area accessed to deliver drugs lies underneath you skin and is not visible to the naked eye.
Why do I need this procedure?
A port can be needed for different reasons:
- You may need to be administered long term antibiotics
- You may need to be administered chemotherapy
- You may need to be administered medications and nutritional products
What are the benefits of the procedure?
Having this port enables your doctor to either start your treatment or if it is no longer possible to put a cannula (plastic needle) into the veins of your arm, it will allow existing treatment to continue. Having a port reduces the need to have needles put in a vein in your arm. Some medications must be given through a line that is in a large vein in your chest and cannot be delivered through a cannula. As the port is underneath your skin it is not visible to others. This also means it cannot be accidentally caught or tugged.
How do I know if this is a suitable procedure for me?
Your doctor has suggested this as the most suitable route for your treatment to be administered. You will need to attend the radiology pre-assessment clinic to establish your general health. At this appointment you will need to have your blood pressure measured, and blood samples taken. A nurse will talk to you about the procedure. There will be plenty of time during this appointment to answer your questions. If you are an inpatient this will take place on the ward.
Can I take my medication as normal?
Most medication can be taken as normal. If you are taking any blood thinning (anti-coagulant or antiplatelet) medication such as Aspirin, Warfarin, Clopidogrel or Rivaroxiban it is important that you let us know at your pre-assessment appointment.
What happens during the procedure?
Going to the ward
The procedure is usually a day case but occasionally an overnight stay is required (we recommend you pack an overnight bag just in case). You will be asked to go to a ward an hour before the procedure. On the ward you will be asked to put a hospital gown on. You can continue to eat and drink normally.
A nurse will complete a checklist with you before leaving the ward. The procedure is performed in the x-ray department.
In the x-ray department
On entering the x-ray room, a radiologist (x-ray doctor), radiographer (person who takes the x-ray pictures) and a nurse will greet you. They will check your personal details and discuss the procedure with you, including the site of access. A consent form will be completed if this was not done at your pre-assessment appointment.
You will be asked to lie flat on the x-ray table with a pillow under your head. You will be awake during the procedure and there will be a member of staff nearby at all times to support you. Your blood pressure, oxygen levels and heart rate will be measured regularly. It is possible to perform the procedure through a vein in your neck, chest or arm.
The skin over the vein where the line will be inserted will be cleaned. Some local anaesthetic will be injected into the skin and tissue around the area and also in the area where the port will be placed under the skin. The local anaesthetic will make this part of your body go numb, like dental anaesthetic.
You may feel some pressure/pushing on your chest or arm during the procedure. This should not be painful. Two small cuts will be made; the first is to make a pocket under the skin for the port and will be approximately 3-4 cm long and the second is where the catheter is placed.
The port goes under your skin, the catheter attaches to the port and is passed through under your skin to the small cut. You will have an x-ray to ensure the port is in place.
You will have some stitches where the cuts were made; these will usually be under the skin and dissolve on their own. Sometimes, special glue is also used to close the area.
The procedure takes about one hour, in some cases this can be longer and the nurses monitoring you during the procedure will keep you informed.
What happens after the procedure?
You will be helped back onto a trolley. There will be someone with you until the ward nurse arrives to escort you back to the ward.
You will be able to mobilise immediately.
A nurse will observe your access site regularly and continue to measure your blood pressure, oxygen levels and heart rate. If you feel any swelling, oozing or pain in the area of the access site, please inform the nurse immediately.
You will still be allowed to eat and drink after this procedure. You will be monitored for 2 hours after your procedure and if you are well enough after this time you will be allowed to go home.
You may not be able to drive for up to 7 days after this procedure.
If you are an inpatient, the ward staff will advise when you are to be discharged.
What complications can happen?
As with all procedures there are some risks involved with the insertion of a port.
There is a small risk of serious or life threating complications occurring in less than 2% of patients. These include air embolism (air tapped in the vein), arrhythmia (fast heart rate) and pneumothorax (air in the lining of the lungs).
The main risk of a line insertion is infection after the procedure, which may require treatment or in some cases the line may need to be removed. This risk is reduced as the procedure is performed as a sterile procedure and every risk of infection has been checked before you have your line inserted.
How soon will I be back to normal?
Most patients go home the same day, but you may be asked to stay in hospital overnight following the procedure. This will be discussed with you at your radiology pre-assessment appointment.
The nurses will only send you home when they are satisfied with your recovery after the procedure. If you are an inpatient this will be discussed with you by your doctor.
Following the port insertion, we recommend that you avoid strenuous exercise for at least two weeks following the insertion, this enables your body to heal.
If the port has been inserted in your arm do not lift anything heavier than 15lbs.
Only certain needles called ‘Huber Needles’ should be used on your port.
What happens if I decide not to have the investigation?
If you decide not to have the port you will be referred back to your doctor and other options will be discussed. There are alternative types of line that can be placed into a larger vein. Some alternative lines are not suitable for long term use. Your consultant will discuss this with you before you have your procedure.
What if I have any special requirements?
If you have any special needs or requirements please discuss this with the nurse or doctor at your pre assessment visit or contact the x-ray staff on the numbers below.
Where can I get more information?
Radiology nurses can be contacted on:
0191 445 3260 or 0191 482 0000 hospital switchboard then ask for bleep 2687
Monday to Friday 9am to 5pm
NHS 111