This page explains about implantable port removal and what to expect when your child comes to Great Ormond Street Hospital (GOSH) to have this procedure.
What is an implantable port?
An implantable port provides easy and reliable access to your child’s bloodstream. The port may need to be removed because it has become infected, broken or has stopped working. The skin over the reservoir may have become infected or broken down. It may not be needed any more if your child has finished treatment.
What happens before the procedure?
If your child is having their implantable port removed at the end of treatment, you will already have received information about how to prepare them for the procedure in your admission letter. You may need to come to GOSH before the procedure, so that your child can have a pre-admission assessment to check that they are well enough. The appointment may involve taking blood samples and other tests.
If your child has developed an infection that means the implantable port needs to be removed, they will usually already be in hospital having treatment for the infection.
Before the procedure, the doctor will explain it in more detail, discuss any worries you may have and ask you to sign a consent form giving permission for your child to have the procedure. If your child has any medical problems, please tell the doctors.
What does the procedure involve?
Your child will need to have a general anaesthetic for this procedure. It is important that your child does not eat or drink anything for a few hours before the anaesthetic. This is called ‘fasting’ or ‘nil by mouth’. Fasting reduces the risk of stomach contents entering the lungs during and after the procedure.
You will be informed the night before the procedure of the time that your child should be ‘nil by mouth’ – in other words, have nothing to eat or drink before the anaesthetic. Fasting times are provided in your admissions letter – in broad terms, this is six hours for food (including milk), four hours for breast feeding and two hours for clear fluids before the procedure.
It is equally important to keep giving your child food and drink until those times to ensure they remain well-hydrated and get adequate nutrition. This may involve waking your child in the night to give them a drink which we recommend.
Once your child is under general anaesthetic, the doctor will make a small incision in the skin to remove the reservoir and catheter. Wherever possible, they will go through the scar created when the port was inserted, so that your child only has one scar. However, this may not be possible if the skin is infected or broken down.
They will not need to make a neck incision as the entire port can be removed through the incision on the chest. The doctor may inject some local anaesthetic into the area to make it numb for a few hours afterwards. The incision will be closed with dissolvable stitches, sticky paper stitches and a dressing. The area should be kept dry for five days after the procedure.
Are there any risks with the removal procedure?
The implantable port is removed while your child is under general anaesthetic. Although every anaesthetic carries a risk, this is extremely small. There is a small risk of bleeding when the port is removed but this is minimised by applying pressure to the area for a few minutes afterwards.
What happens afterwards?
Your child will return to the ward after they have recovered from the general anaesthetic. Some children feel sick and vomit after a general anaesthetic. Your child may have a headache or sore throat or feel dizzy, but these side effects are usually short-lived and not severe.
The area where the port was removed will feel uncomfortable for a while afterwards, but this soon passes. The nurses will give your child pain relief as needed. Your child can start eating and drinking as normal once they feel like it.
If your child does not need to stay in hospital for treatment, you can return home. Due to the risk of infection, children are not allowed to keep their port as a souvenir after it has been removed.
You should call the hospital if:
The chest incision looks red, swollen and feels hotter than the surrounding skin.
The incision is oozing with blood or pus.
Your child is in a lot of pain and pain relief does not seem to help.
Your child has a temperature of 38°C or higher.
Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals.