Prior to the procedure, a nurse places an IV in the patient’s hand or arm so that a sedative may be administered during the procedure.
The patient lies flat on the procedure table and the skin at the base of the neck and the upper chest are sterilized. A local anesthetic is administered at the planned port placement site and extended under the skin towards the vein that will be used for venous access.
After adequate local anesthesia is provided, the doctor will make a small incision below the collarbone. A small space for the port is made under the skin. Next a small curved needle is guided under ultrasound from the small incision to the vein being used for access. Most commonly the jugular vein located at the base of the neck is used. A small wire is threaded through the needle and into the chest. The needle is removed. Over the wire, the catheter of the port is threaded into the vein and a live x-ray is used to guide positioning of the catheter. Typically, the catheter is placed so that its tip is located either just into the heart or just above the heart in a large vein called the superior vena cava. The catheter is then connected to the port which is then placed into the pocket and stitched in placed. The port’s function is tested for both giving fluids and drawing blood. After confirming its function, the small incision in the chest is stitched closed. An overlying sterile dressing is placed. The port is ready for immediate use.
Patients may experience discomfort around the incision site that can be relieved with over-the-counter medications if needed. Patients are provided with proper wound care instructions and are discouraged from engaging in strenuous activity or heavy lifting after the procedure. Once the incision heals, normal everyday activities may continue.