A port is a prosthetic device which helps us to administer chemotherapy in a convenient, predictable and safe manner. This booklet will briefly explain the mechanism, the pros and cons of the device, the procedure and the precautions to be taken after the procedure.
This is how a port looks like. The long tube like structure is the catheter and the raised stethoscope like structure is the port. It has a silicon self-sealing membrane through which the needle is pierced for injecting drugs and intravenous fluids.
PRE- OPERATIVE PROCEDURES:
Prior to the surgery, you will be required to undergo a set of tests for assessing your fitness for the procedure. A port insertion is routinely carried out under General anaesthesia, unless you are unfit for the procedure, in which case, suitable anaesthesia will be used. You will be seen by a physician as well, who will assess your fitness for the procedure. You may have to stop any blood thinning drugs, such as Ecosprin / Clopidogrel at least 4-7 days prior to the surgery. We generally try to combine the port insertion as well as the chemotherapy administration on the same day, for your convenience. This way, you can undergo the procedure, finish the chemotherapy and go home the very same day or the next day at the most.
You will be required to get admitted in the short stay services department, with overnight fasting (NO FOOD, NO LIQUIDS, NO WATER—ANY EARLY MORNING MEDICINES TO BE TAKEN WILL BE INFORMED BY YOUR ASSESSING PHYSICIAN).
The attending nurse will then fill out a nursing form, make sure all your belongings are taken care of , ensure that you have changed into a hospital outfit and give you general instructions. Our surgical registrar and the anaesthetist will be seeing you as well, to answer any last minute queries and to take a well informed consent from you and a relative/ witness.
You will then be shifted to the operative suite. In the operation theatre, you will undergo the procedure which roughly lasts for an hour or so. Sometimes it may take a little more time, which is no cause for concern. After the procedure is over, you will be shifted to the recovery suite and then to your room, once you are completely conscious, pain- free and comfortable.
You will notice two dressings, one on your neck and the other at the port insertion site. These dressings will come off after 7-10 days; following which you can start bathing over the operated site (till then, please prevent wetting these sites to prevent infection).
Once your chemotherapy is over, the nurse will disconnect the tubing from the port and you will be discharged with a separate set of instructions for the management of chemotherapy related side effects.
Port placement is generally not very painful; but we do advise painkillers for the first three days and then as required. Antibiotics are generally not recommended.
POST- OPERATIVE CARE:
Avoid getting the dressings wet for at least 7-10 days. Sutures are self-dissolving; they do not need to be removed. We will call you for a check dressing on the fourth and tenth post-operative day. After the surgery, you will have two scars; a tiny 2-3mm scar on the neck and a 3-4 cm scar at the site of the port insertion. Both these scars will generally heal well.
You will be advised to follow up for the next chemotherapy cycle by the medical oncologist. During every chemotherapy cycle, the nurse will first confirm that the flow through the port is satisfactory, before proceeding with the drug administration.
You will not feel any discomfort, pain, swelling or fever during the chemotherapy. However, if any of these signs occur, please alert the nurse immediately and ask her to stop the chemotherapy till a doctor reassesses you. Very rarely, the port may get infected, which may require the port to be removed.
WHEN TO REMOVE THE PORT :
Normally, the port is removed once your chemotherapy is over. This is decided mutually by you and your treating doctor.