Patient education: Port insertion (The Basics)

What is a port? — 

This is a type of central line, which is a special kind of IV. Sample brand names for ports include Port-a-Cath, BardPort, PowerPort, Infuse-a-Port, and Mediport.

Ports have a small "reservoir" that is attached to a thin, flexible tube called a "catheter" (figure 1). Both the reservoir and the catheter are under the skin, most often in the upper chest. The catheter goes into a large blood vessel that leads to the heart. The reservoir is a round disc covered with a special silicone. The silicone lets the port be used over and over.

You might get a port if you:

●Need to get medicines or fluids for a few weeks or months

●Need certain kinds of medicines that smaller veins might not be able to handle

●Are taking medicines that need to be given through an IV, and the veins in your arm are very hard to find

With a port, you can get the nutrients, fluids, blood, and medicines you need. The medical staff might be able to draw blood for lab tests through the port. When you have a port, you might also need fewer needlesticks for IVs or blood tests.

How is a port different from a simple IV? — 

A simple IV only goes a little way into a blood vessel. Most simple IVs last only for a few days. A port goes into a larger blood vessel and can stay in place for months or years.

The medical staff can "access" the port using a special type of needle. The needle goes through the skin and into the reservoir (figure 2). When the port is not being accessed, only a small bump under the skin is visible.

A port can have 1 or 2 reservoirs. These are also called "access sites" or "lumens." You can go home from the hospital with a port, unlike a regular IV.

How do I prepare for a port? — 

The doctor or nurse will tell you if you need to do anything special to prepare. Before the procedure, the doctor will talk with you about the port.

Your doctor will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any ports or other central lines you've had in the past, no matter how long ago – Also tell them if there were any problems with your lines, like blood clots.

●Any implanted electronic devices like a pacemaker or "ICD"

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding or clotting problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

●If you cannot have medicines that make your skin numb – These types of medicines are used when you have stitches or dental work (sample brand names: Xylocaine, Novocain).

Your doctor will also do an exam before the procedure. They might do an imaging test called an ultrasound to look at your veins. Imaging tests create pictures of the inside of the body.

You will also get information about:

●Fasting – This means not eating or drinking anything for a period of time. Whether you need to fast, and for how long, depends on if you will need medicines to help you relax during the procedure.

●Lowering the risk of infection – The doctor or nurse might need to trim (not shave) your body hair before your procedure. They might also have you wash your body with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or help you care for the port at home.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a port insertion? — 

Doctors usually insert a port in an operating room. When it is time for the procedure:

●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure.

●The doctor will clean your skin with a special soap and cover your body with sterile towels and sheets. They will wear a face mask, hat, gown, and gloves to help prevent infection.

●The doctor will access your vein in 1 of 2 ways. They will either make a small cut ("incision") in your skin on your neck or near your collarbone, or go through your skin with a needle. They will use ultrasound to help guide the needle into your vein.

●The doctor will thread a wire into your vein and use that to place and position the catheter. They will take out the wire before they attach the catheter to the port.

●They will make another incision on your chest to make a pocket under your skin for the reservoir. They will make a small tunnel under your skin between the pocket and the vein.

●They will use fluoroscopy (a continuous type of X-ray) to help them guide the catheter into a large vein near your heart.

●They will connect the catheter and the reservoir. Then, they will tuck the reservoir into the pocket under your skin.

●They will check the port. They will often do a chest X-ray to make sure the catheter is in the right place.

●When the procedure is done, the doctor will close and bandage the incisions. They will put a special angled needle into the reservoir and "flush" the port with a sterile fluid.

●The procedure takes 45 to 60 minutes.

What happens after port insertion? — 

You might be able to go home. If you are in the hospital, having a port placed will not make your stay longer.

What are the risks of getting a port? — 

The doctor or nurse will talk to you about all the possible risks and answer your questions. Possible risks include:

●Infection

●Blood clot

●Bleeding

●The port not working, breaking, or leaking

●Damage to the tissues around the port if it leaks

●The tip of the catheter moving out of place

●A collapsed lung (called "pneumothorax")

What else should I know? — 

If you are going home with a port, you might need a family member or friend to help you care for it. Some people have a home health nurse come to their home to help with this.

The staff will also give you a card with information about your port. It's important to keep this in case you need these details in the future. The card will note if you have a "power-injectable" port. This is a specific kind of port that can be used to inject dye when you have special tests. Keep the card with you, and show it to your doctors before you have any tests or procedures.

More on this topic

Patient education: How to care for a port (The Basics)
Patient education: Port removal (The Basics)
Patient education: Lowering the risk of a central line infection (The Basics)
Patient education: Central line infection (The Basics)