Porta-Catheter Placement

Porta-Catheter PlacementA Porta-Catheter is a device placed completely under the skin on either side of the chest. The port is a small, round piece a little larger than a soda bottle cap that is connected to a catheter that is guided into a large vein that empties into the heart. The port is placed just under the skin, so it can be easily accessed by healthcare providers through the skin to deliver IV fluids, drugs, or blood products. A porta-catheter may stay in place for weeks or months and helps avoid the need for repeated needles sticks and injury to small vessels.

Indications:

 A porta-catheter is most often placed to deliver chemotherapy treatments. It can also be recommended for patients who require frequent infusions and have a history of difficulty or inability to start an IV due to the size and quality of their veins.

Pre-Op Evaluation and Prep: 

Patients will discuss porta-catheter placement with the surgeon. This may occur in a consultation days before surgery but oftentimes takes place the day of the procedure due to patient convenience and in an effort to get patients started on chemotherapy as soon as possible. In either case, the surgeon and patient will discuss right vs. left sided port placement before the procedure as the side of the port will depend upon a variety of factors including patient preference.

Routine blood work is usually not needed but may be ordered prior to surgery based on the patient's age and the presence of any existing medical problems.

You may be instructed to stop taking some medications before surgery. Make sure your surgeon knows all the prescription and over-the-counter medications you take, including natural or nutritional supplements. For more information related to preparation for surgery click here.

Procedure: 

Porta-Catheter placement may be performed under general anesthesia or sedation depending on patient health factors and preference. The surgeon will inject numbing medication in the area of the incision. Then a small incision will be made on the left or right side of the chest to create a pocket under the skin for the port. Next the catheter will be guided (threaded) under fluoroscopy to a large vein in the chest and tunneled under the skin. Once the port and catheter are in place, they will be connected. The skin will be sutured closed and covered with steri-strips and a gauze dressing or surgical glue.  The stitches are all under the skin, so nothing needs to be removed at a later date. The port may be used as soon as it is placed. In fact, we will usually leave the port accessed and ready to go for a treatment if the treatment is scheduled for the same day.

Recovery:

This varies from patient to patient. Many patients return to desk type work the next day. You will probably not have any lifting restrictions and can return to most normal activities.

While recovery instructions may be tailored to individualize a plan of care based upon your specific needs, these instructions are common following porta-catheter placement:

  • You will need to arrange for a ride home the day of your surgery and we recommend someone stay with you for the first 24 hours at home.
  • When you leave the facility after surgery, we will want you to go home and rest unless you are scheduled for a treatment. Avoid making any other plans on the day of your surgery. Starting the following day, you can increase your activity as you feel up to it.
  • Avoid fried foods, milk products and citrus juices for around one day after your surgery. Suggestions for foods to eat include soup, sandwich, pasta, potatoes, toast, and applesauce.  
  • The dressings applied to your surgical site will be specific to the location of your procedure. If surgical glue is used, there will be no dressings to remove. If bandages are applied, they can usually be removed at home in 24-48 hours or by the staff administering your chemotherapy if you are receiving a treatment within that window. You will receive care instructions specific to your procedure.
  • You may shower within a day or two after your surgery, but will need to avoid soaking in a tub or pool for around 1 week.
  • You will likely be given a prescription for pain medication following your surgery. The recovery nurse will discuss a pain control plan following surgery specific to you and your needs including activities like ice applied over incisions and a medication regimen. Often times we will recommend taking Tylenol and Advil (same as Motrin, Ibuprofen) or Aleve in addition to the narcotic pain medication.
  • It is often suggested to start taking a stool softener twice daily the day following your procedure. You will want to continue this regimen as long as you are taking narcotic pain medications.

For additional information for after surgery preparation click here.

To Schedule an Appointment

To find out more about Porta-Catheter Placement services offered at CSA Surgical Center in Columbia, Missouri, please call Columbia Surgical Associates at 573-443-8773 and schedule an appointment.