Implantable port insertion (port-a-cath)

An implantable port, often called a "port-a-cath", is a small reservoir about the size of a coin with a silicone membrane, placed under the skin of the upper chest. It is connected to a thin catheter running in a large vein up to the entrance of the heart. Medicines injected into the port are diluted in a high blood flow, which protects the veins. It is inserted under local anaesthesia, sometimes with light sedation. The catheter is introduced into a vein in the neck or under the collarbone, most often under ultrasound guidance, and its position is checked by fluoroscopy. The port is placed in a small pocket under the skin, closed with a few stitches. To use it, the nurse inserts a special needle through the skin over the port, which avoids having to find a vein for each treatment. The port is mainly used for chemotherapy, but also for intravenous nutrition, long courses of antibiotics or when arm veins are difficult. It is removed simply, under local anaesthesia, when no longer needed. At Clinique Pasteur Tunis, insertion is performed as day surgery in the operating theatre, in liaison with the oncology team, so that the port is ready when treatment starts.