Insertion of Long Term Intravenous Access Device/ Infusaport
The venous system is often accessed to obtain blood, administer medications and perform other medical procedures. Usually the peripheral veins in the arms or legs are accessed. Some procedures however require long-term or repeated access to the bloodstream which may damage the peripheral veins and cause discomfort. Infusaport is a device used for long-term access to the bloodstream. This device helps to minimise patient discomfort and protect the venous system.
Once in place, an Infusaport helps to deliver intravenous administration of chemotherapy or other medications, IV nutrition, blood products, as well as taking blood samples for testing.
It is made of two components - the port and the catheter. The port is 2cm wide and made of metal and plastic. It has a central chamber for injections. It is placed beneath the skin, normally on the right side of the chest wall.
It can be used multiple times with a specialised needle. The port can be felt and sometimes seen under the skin. The catheter is a soft hollow tube which runs down the vein towards the heart.
How is the port system inserted?
The procedure is carried out in theatre normally under a general anaesthetic. First a needle is inserted into the vein just below the collar bone. A wire is then fed along the vein and X-rays are used to check the position. A small pocket is then made under the skin and the port is placed in this pocket on the chest wall. The catheter is then passed down the wire into the vein and stops just above the heart. Heparin (an anticoagulant) is injected to stop any clots forming in the catheter. A chest x-ray is performed immediately after the operation. This is usually performed as a day case.
How is the port system used?
The port is accessed using a special "Huber" needle, which does not damage the port's central chamber. It should only be accessed by only specialist doctors and nurses trained to use this system.
When Can I Get Back To Normal Activities?
Chemotherapy can be started the next day if needed. You can shower or bathe the next day and pat the dressing dry. Keep the dressing over the wound for at least 2 weeks to help the skin heal. When the skin is healed normal activities can be resumed.
How Long Does The Port Stay In For?
The port can stay in indefinately, but is normally removed after treatment has finished. Removal is a minor procedure and A/Prof Fosh can do this under local anaesthetic in theatre.
What Are The Potential Complications?
- Pain -Usually immediately after the operation, this should decrease with time
- Infection-This can be treated with antibiotics, but severe infections may result in removal of the port
- Bleeding-This can happen at the site of the operation and will normally stop if pressure is applied. Very rarely, the vessels can be damaged during the operation which is a serious complication and would require further intervention.
- Blood clot in the catheter-This sometimes means a new port must be inserted
- Fracture of the catheter-A rare complication, but sometimes the end of the catheter can break off and will need to be removed
- Movement of the port-This can happen even when the port is attached to the chest wall
- Lung collapse-This occurs in less than 1% of patients, but occasionally the access needle can damage the outer lining of the lung and cause a collapse of the lung (pneumothorax). This normally needs a tube to reinflate the lung and a prolonged stay in hospital. This can sometimes delay adjuvant treatment
- Skin problems-Occasionally there can be thinning of the skin over the port and may result in needing a new port placed in a different site.