An implanted port (port-a-cath or mediport) is a small medical device designed to provide a reliable, long-term entry point into the bloodstream. Placed entirely beneath the skin, typically in the upper chest, its primary function is to deliver infused medications, such as chemotherapy drugs. Utilizing a port reduces the need for repeated needle sticks in the arms, which can damage smaller peripheral veins. The implantation procedure is common in cancer care and significantly improves the comfort and convenience of long-term treatment.
Preparing for Port Placement
Preparation begins with a consultation where the surgeon or interventional radiologist reviews the patient’s medical history and current medications. Patients are instructed to adjust or temporarily stop blood-thinning agents, such as aspirin, several days before the procedure to minimize bleeding risk. Fasting (no food or drink after midnight) is required to ensure safety during sedation.
On the day of the procedure, the patient is asked to shower using antibacterial soap to sterilize the skin and lower the risk of infection. The medical team confirms the location for the port, usually in the upper chest near the collarbone, which provides the most direct route to a large central vein. A responsible adult must provide transportation home, as sedative medication will temporarily impair the patient’s ability to drive.
Details of the Insertion Procedure
Port placement is a minor surgical procedure, usually lasting less than an hour, performed in an operating room or interventional radiology suite. The patient receives local anesthesia to numb the area, along with intravenous sedation to promote relaxation and minimize discomfort. The physician cleanses and sterilizes the skin on the chest and neck to create a sterile field.
Two small incisions are made: one near the neck or shoulder to access the vein, and a second, slightly larger incision in the upper chest below the collarbone. The second incision creates a small subcutaneous pocket where the port reservoir (a disc-shaped device) will be secured. The catheter, a thin, flexible tube attached to the port, is threaded into a large vein, such as the jugular or subclavian vein, via the first incision.
The physician uses fluoroscopy (real-time X-ray imaging) or ultrasound guidance to navigate the catheter’s tip into the superior vena cava, the large vein just above the heart. Once the catheter is correctly positioned, the port reservoir is secured under the skin. The incisions are closed using dissolvable sutures or surgical skin glue, and a final X-ray confirms the correct position before the patient is moved to recovery.
Immediate Recovery and Care
Following the procedure, the patient is monitored in a post-anesthesia care unit (PACU) as sedation wears off, with nurses tracking vital signs. Mild soreness, tenderness, and bruising are common around the incision sites and along the catheter path. This discomfort typically peaks within the first 24 to 48 hours and is managed effectively with over-the-counter or mild prescription pain relievers.
Incision care is a priority during the first week to prevent infection. Patients must keep surgical dressings clean and dry for 24 to 48 hours. After this initial period, showering is permitted, but patients must avoid scrubbing the incision site or soaking the area in baths, hot tubs, or swimming pools until the skin is fully healed (one to three weeks). Physical activity is restricted for about seven days, requiring patients to avoid heavy lifting and strenuous arm movements to allow the device to settle securely.
How the Port is Accessed for Chemotherapy
Once the surgical site has healed, the port is ready for treatment, which is a sterile process performed only by trained healthcare professionals. The nurse locates the port reservoir and its central septum (a self-sealing membrane) by palpating the skin. The skin over the port is then thoroughly cleaned with an antiseptic solution to minimize the risk of infection.
To begin the infusion, a specialized, non-coring Huber needle is inserted vertically through the skin and into the port’s septum. The Huber needle’s unique design ensures it pushes the septum material aside, allowing the septum to reseal completely after the needle is removed. Once the needle is secure, the nurse confirms proper function by drawing a small amount of blood back into the line, verifying patency before administering medication.
Medications are infused directly through the needle and into the port, flowing through the catheter into the patient’s central circulation. After the treatment or blood draw is complete, the port is flushed with a saline solution, often followed by an anticoagulant like heparin, to prevent blood clots from forming inside the catheter. This routine flushing is also performed monthly when the port is not in active use to maintain patency.