What is a Portacath?
A portacath is a system which gives simple access to a large blood vessel. The portacath system can be used to deliver fluids, nutrients and medication including chemotherapy directly into the blood stream. There are two parts to the portacath system, the port and the catheter. The port is a small round device made of titanium metal. It has one chamber covered by a plastic membrane. It is through this membrane that a needle will be inserted to deliver the medication or withdraw blood etc. The catheter is a hollow soft tube which is connected to the port at one side with its other end lying in the right side of the heart.
Why you may need a Portacath?
Due to the nature of your treatment, you may require frequent access to your veins. With chemotherapy drugs, the process can damage the smaller veins of the body and may be painful. To make the therapy more comfortable, convenient and safe, a portacath system can be inserted.
How is the portacath inserted?
You will be asked to fast for 4 hours prior to your appointment (apart from taking medication with a small sip of water). The procedure will be performed in a clean, operating theatre environment, using X-ray machines and ultrasound machines to obtain the correct position for the portacath.
The skin just underneath the collarbone and on the side of the neck will be cleaned (usually the right side). The right side can usually be used even if you have had previous surgery to the right breast or chest area. Local anaesthetic will be given in the right side of neck and a small tube will be placed into the right side of the heart. You will be given further local anaesthetic just below the collar bone. An approximately 4cm long incision will be made under the collarbone. The port will be sited approximately 5mm deep to the skin at this site. A small tunnel will be made under the skin where the catheter will be passed and placed with its tip in the right side of the heart. At the end of the procedure, an X ray will be taken to check the proper placement of the catheter. You will have a suture to cover the small incision in the right side of the neck as well as a suture at the site of incision below the collar bone. A small sterile dressing will cover these areas until healing takes place. After the chest X-ray has been taken and there is no evidence of any bleeding, you will be free to go home after approximately one hour following the procedure. You will not be able to drive for 24 hours.
Following the insertion
The area around the port may be swollen and tender for a few days. Although the system can be used the same day it is inserted, your Doctor may allow several days for the swelling to go down before using the port. When the anaesthetic wears off, you may feel some discomfort at the site of the incision and therefore you may require some simple analgesia such as paracetamol. The portacath system requires no daily care by yourself. You will be asked to return to the chemotherapy suite approximately
8-10 days following the insertion for the removal of the stitches and dressings.
You may shower 24 hours after the portacath has been inserted with the waterproof dressing in place. You may have a bath after 2 weeks. Once the wound is healed no dressing will be required.
It is recommended that you do not perform any strenuous exercises or do any heavy lifting for 2 weeks following the procedure.
Your doctor or nurse would have discussed potential complications of the procedure.
You should contact the Chemotherapy Nurse immediately if you have any of the following:
- Chest pain
- Pain, swelling or drainage of pus or redness around the port site or incisions
- Swelling of the neck, face or arm on the side where the port is inserted
- Shortness of breath or dizziness
The portacath can be left in place for several years. If this is the case, we will arrange for monthly flushes of heparinised saline into the port, so that the port doesn’t become blocked.
Please note that the port has no electrical components and therefore can be used in any environment. It only has a small amount of metal and does not usually set off alarms at airports, but you may wish to carry a card with you explaining that you have this device in place. When the time comes for removal of the portacath, this is usually a simpler procedure than inserting the catheter. It is removed under local anaesthetic as a day case/outpatient procedure.