Locations for Placement
Implantable ports can be located in the chest, abdominal region and arms of a patient. The diagram below courtesy SmithMedical (2003) is an excellent representation of where ports can be surgically placed.
Open-ended Implantable Ports
Both open-ended and closed-ended implantable ports can be placed in a traditional operating room or an interventional radiology suite. The region can be anesthetized locally or the patient can receive general anesthesia for the procedure.
The picture below illustrates the basic elements of port placement with an open-ended catheter. A "port pocket" is created after the skin is incised. This is where the portal will reside. A tunneled region or path is created where the catheter will be passed through and connected to the portal. The open-end of the catheter will be passed into the patient's venous system over a guide-wire. A catheter clamp or ring is slipped onto the part of the tubing that is proximal to the portal. The catheter is then joined with the portal appendage. The catheter clamp is pulled towards the juncture of the catheter and portal appendage. If the catheter has a juncture sleeve, this will be pulled over the union, further securing the union. The portal is sutured within the "port pocket". The Incision is then sutured shut and the area is covered with a pressure dressing.
Closed-ended Implantable Ports:
CLICK HERE for diagrams courtesy Bard Access (1995) depicting the steps in placing a long-arm low profile closed-ended port.
Post Insertion Care
Monitor the following:
- Bleeding at the cutdown site: Notify physician for excessive bleeding
- Fever
- Swelling over the portal site: There will be some erythema post operatively, report excessive swelling or hematomas
- Pain at the site: Provide pain relief as ordered
- Dressing should by kept dry
To continue the next section of the course, click on "Surgical Placement of Implantable Ports" found below under "Useful Links"
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