The procedure (a description for the curious)

The procedure has two stages.

First stage

The port is most often placed on the right side, but if, for example, the right breast is affected and/or radiotherapy or surgery is planned in the area where the port chamber would be, both incisions are made on the left side.

The first stage begins with an ultrasound scan of the neck. After examining how the blood vessels, muscles and nerves lie in relation to each other, a skin incision a few millimetres long is made on the side of the neck, 2–3 cm above the collarbone, usually the right one. It allows the catheter to be inserted into the internal jugular vein.

Next, a place for the port chamber is prepared in the tissue under the skin below the collarbone, the length the catheter needs to be is assessed, and the catheter is connected to the port chamber and inserted into the vein. There are no steps in the first stage that can be skipped. The skin must be disinfected as recommended by the maker of the disinfectant. The operating field is marked off with sterile drapes that cover the patient from head to foot, and some parts of the draping are stuck to the face and neck. The vein into which the catheter goes always has to be punctured, the place for the port chamber always has to be prepared, the port chamber always has to be connected to the catheter, and the right length of the catheter has to be judged and the catheter left in the correct position. This stage takes about 10–12 minutes.

Second stage

In the second stage the incisions have to be closed surgically. How long this stage takes depends on how carefully we do it. If three simple single stitches are put in, it takes maybe 3 minutes, and the whole procedure is finished within 15 minutes.

But who benefits from that?

The patient? The stitches have to be removed. Very few patients can do that themselves. The vast majority have to go to a surgical outpatient clinic, or they can come back to the hospital where the procedure was done, though I doubt the operator would deal with it. Either way, a few days after the procedure the patient has to spend a few hours on it. On top of that, such stitches usually leave unsightly scars.

The operator? If the procedure takes 15 minutes instead of 30–35, twice as many procedures can be done. An operator whose income depends on the number of procedures done may be tempted to take advantage of this.

If we want the scars from the incisions to be almost invisible, we need to spend some time on it and take a little care. With this approach fewer procedures are done, because the whole procedure then takes 30–35 minutes, but the patient does not lose time having stitches removed, and the cosmetic result is completely different.

The time in the operating room is about 45 minutes.