Port Placement
A port (or portacath) is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical “needle stick”.
Ports are used mostly to treat hematology and oncology patients, but recently ports have been adapted also for hemodialysis patients.
The port is usually inserted in the upper chest, just below the clavicle or collarbone, leaving the patient’s hands-free.
A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava). Ideally, the catheter terminates in the superior vena cava, just upstream of the right atrium. This position allows infused agents to be spread throughout the body quickly and efficiently.
Ports have many uses:
- To deliver total parenteral nutrition to those unable to take (adequate) food orally for a long period of time.
- To deliver chemotherapy to cancer patients who must undergo treatment frequently. Chemotherapy is often toxic, and can damage skin and muscle tissue, and therefore should not be delivered through these tissues. Portacaths provide a solution, delivering drugs quickly and efficiently through the entire body via the circulatory system.
- To deliver coagulation factors in patients with severe hemophilia.
- To withdraw (and/or return) blood to the body in patients who require frequent blood tests and in hemodialysis patients.
- To deliver antibiotics to patients requiring them for a long time or frequently, such as those with cystic fibrosis and bronchiectasis.
- Delivering medications to patients with immune disorders.
- For treating alpha 1-antitrypsin deficiency with replacement therapy
- For delivering radiopaque contrast agents, which enhance contrast in CT imaging.
- To fill or withdraw fluid from the Lap-Band or Realize gastric bands used in Bariatric surgeries.
