Ports

A port, also called a mediport, implanted port or port-a-cath, is a small medical device that sits completely under your skin, usually a couple of inches below your collarbone. It has a round chamber about the size of a large coin, with a thick self-sealing silicone top. A thin, soft tube, the catheter, runs from the chamber into a large vein, with its tip resting where that vein meets the heart.

To use the port, a nurse presses a special bent needle, called a Huber needle, through your skin into the silicone top. Medicine then flows straight into the large vein, and blood can be drawn out. When treatment is done for the day, the needle is removed and nothing is left outside your body except a small bump.

On a chest X-ray, the port shows up as a bright round disc under the collarbone, with a thin line curving up into the neck and then down to the heart.

A port is a good choice if you need IV treatment on and off for months, especially chemotherapy. It is also used for frequent blood draws, blood transfusions, iron infusions, immune treatments, and long-term IV medicines. It helps when your arm veins are small or hard to find, and it protects arm veins from medicines that irritate them.

For a side-by-side look at all the options, see central lines.

See before your procedure and sedation for more on the day.

The procedure is done at El Camino Hospital in the interventional radiology suite with nurses, a radiology technologist and your interventional radiologist. Your heart rate, blood pressure and oxygen are monitored throughout, and you receive an antibiotic through your IV to lower infection risk.

1. 1
   Relax and numb

   You receive moderate sedation through your IV. We clean the neck and chest and numb the skin with local anesthetic.

2. 2
   Enter the vein

   Using ultrasound, we place a small needle into the jugular vein at the base of the neck and guide a wire toward the heart on X-ray.

3. 3
   Create the pocket and place the port

   We make an incision of about 2 cm below the collarbone and form a small pocket under the skin for the port. The catheter is tunneled under the skin to the neck vein, trimmed to the right length, and its tip placed at the entrance to the heart.

4. 4
   Test and close

   We confirm the position on X-ray and check that the port flushes and draws blood. The incision is closed with dissolving stitches under the skin and skin glue, so there are no stitches to remove.

Placement usually takes about 30–45 minutes. You rest in recovery for about 30–60 minutes, and can eat and drink before going home.

1. Same day
   The port can be used right away if needed. No driving, alcohol or important decisions until the next day because of the sedation.
2. First 2–3 days
   Soreness and mild bruising over the port and neck are normal. Acetaminophen (Tylenol) or ibuprofen (Advil) usually helps, unless your doctor has told you to avoid them.
3. First week
   You can shower the evening of the procedure; pat the glue dry. Do not soak in a bath, hot tub or pool for 1 week. Avoid heavy lifting and strenuous upper body exercise.
4. 1–2 weeks
   The skin glue peels off on its own. Do not pick at it.
5. Long term
   No special care between treatments except a flush on the schedule your treatment center uses, usually every 4–12 weeks.

The first few times the port is accessed, it may be tender. Ask your infusion center about a numbing cream that you apply about an hour before your appointment.

Port placement is a low-risk procedure. The main long-term risks are infection and clots, and both are uncommon.

When your treatment is finished and your doctor agrees you no longer need it, call us at 650-404-8445 to schedule removal. Removal is simpler than placement. It is usually done with local numbing, and light sedation is available if you prefer.

We numb the skin, open the old scar, free the port from the tissue around it, and slide the catheter out of the vein. Then we close the skin with dissolving stitches and glue. It takes about 15–30 minutes. You can usually shower the next day, and should avoid soaking or heavy lifting for about a week while the incision heals.

When I place a port, I think about the next year of your life, not just today. I ask about your bra strap, your seatbelt, the side you sleep on and any breast surgery, and I place the port where a nurse can find it easily but where it will not rub. I also tell patients that removing the port at the end of treatment is a good day, and I enjoy that visit.

Fabio Komlos, MD, interventional radiologist · About Dr. Fabio Komlos