Removal of an implantable port

Information about the removal of an implantable port.

The doctors have decided that your child’s implantable port needs to be removed. 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. The doctors will explain the reason why they need to remove your child’s implantable port.

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. This appointment may involve taking blood samples and other tests.

Your child will need to be admitted to a bed on a ward in the hospital. The person bringing your child to the procedure should have “parental responsibility” for them. Parental responsibility refers to the individual who has legal rights, responsibilities, duties, power and authority to make decisions for a child. If the person bringing your child does not have parental responsibility, we may have to cancel the procedure.

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.

An anaesthetist will visit to talk to you about your child’s anaesthetic. The specialist performing the procedure will explain the procedure in more detail, discuss any questions 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 specialists.

Many of the procedures we perform involve the use of X-rays. Legally, we are obliged to ask anyone over the age of 12 whether there is any chance they might be pregnant, and we will also ask for the first date of their last period (if started). This is to protect babies in the womb from receiving unnecessary radiation.

You and your child will then be brought to the Interventional Radiology (IR) suite within the X-ray department for the procedure.

You will already have received information about how to prepare your child 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. This appointment may involve taking blood samples and other tests.

Your child needs to be fasted for the procedure for the general anaesthetic. If your child takes regular medication, please speak to your child’s team about when to stop these before the procedure.

As a general rule:

Food and milk:

• Breast-fed babies- can have their last feed three hours before the procedure. Breast milk is digested faster than solid food or formula.
• Bottle-fed babies and children- can have their last milk feed, food or milk drink, six hours before the procedure. They should not have any food or milk after this time.

Water:

• All babies and children can have a drink of water (but no other fluids), until one hour 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.

Please follow these instructions carefully, otherwise your child’s procedure may be delayed or even cancelled.

Once your child is under general anaesthetic, the doctor will make a small incision in the skin on the chest over the reservoir and catheter to remove them.

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.

Your child will be having the procedure under general anaesthetic. Every anaesthetic carries a risk, but 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.

The procedure may involve the use of X-rays. The levels that are used are low dose and therefore low risk. If you have any concerns regarding the use of radiation, please discuss this with the person performing your procedure beforehand.

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 incisions are 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 38⁰C or higher.

You can call the ward by calling the GOSH switchboard and asking for the ward your child was discharged from.

Telephone: 020 7405 9200

If you are unable to get through, please call NHS111 by dialling 111.

If you have any questions, please speak to you child’s doctor or nurse or call Interventional Radiology:

Telephone: 020 7405 9200

You can also contact us through MyGOSH.