A port (port-a-cath or implanted venous access device) is a small, disc-shaped medical device placed completely beneath the skin to provide long-term, reliable access to the bloodstream. It consists of a port chamber connected to a thin, flexible catheter. The catheter is threaded into a large central vein, usually the superior vena cava near the heart, allowing medications and fluids to be delivered directly into circulation. Since the entire system is implanted, it eliminates the need for repeated needle sticks into smaller peripheral veins, protecting them from damage and simplifying long-term treatment.
Medical Reasons for Port Placement
The primary purpose of port placement is to facilitate intravenous (IV) therapy delivered over an extended period. Frequent or prolonged treatments can lead to the scarring or collapse of smaller peripheral veins. A port is often recommended for delivering medications harsh on peripheral veins, such as certain chemotherapy drugs or vesicant solutions, which are better tolerated in the rapid flow of a large central vein. Ports are also used for individuals requiring frequent blood draws for laboratory testing, eliminating the need for multiple venipunctures. Patients needing long courses of IV antibiotics, extended parenteral nutrition, or regular blood product transfusions may also receive a port. The device provides a stable, secure access point that can remain in place for many months or even years, simplifying chronic medical care.
The Port Placement Procedure
Port placement is a minor surgical procedure performed by a surgeon or an interventional radiologist, often in an outpatient setting. The patient receives local anesthesia and moderate sedation to ensure comfort. The entire procedure typically takes about one hour or less.
The clinician makes a small incision, usually on the upper chest, to create a pocket for the port chamber. A second, very small incision is made near the neck to access a central vein, such as the jugular or subclavian vein. The catheter is inserted into the vein and guided using real-time imaging (fluoroscopy) to position the tip correctly in the superior vena cava. The catheter is then “tunneled” under the skin to connect to the port chamber. This tunneling secures the device and reduces infection risk by separating the port site from the vein entry site. The port chamber is secured to the underlying tissue with sutures, and the incisions are closed with sutures or surgical glue. Patients typically go home the same day after a short recovery.
Maintenance and Life After Surgery
Immediate care involves managing mild pain or soreness at the incision sites, often with non-aspirin pain relievers. The surgical sites must be kept clean and dry for several days. Patients are advised to avoid heavy lifting or strenuous activity that strains the chest area for a few weeks. Once healed, the port is completely internal, allowing normal activities, including showering and swimming, to resume without restriction.
When the port is used, a special non-coring needle is inserted through the skin into the self-sealing septum of the reservoir. A numbing cream can be applied beforehand to minimize the sensation of this needle stick. To prevent clotting, the port must be flushed with a saline solution and sometimes a blood thinner like heparin after each use, or at least monthly when not actively accessed.
While the device is durable and functional for years, potential complications include infection (presenting as redness, swelling, or pain) or a catheter blockage. If the port is no longer needed after treatment, it can be surgically removed in another minor, outpatient procedure using local anesthesia. Removal involves a small incision over the port site to disconnect and withdraw the catheter and the port chamber.