Expert: Ronald Levy, M.D. - 4/21/2009

Question
QUESTION: I have cancer and had a port placed in my left upper chest to recieve the treatments.  Taxol and Cisplatin (forgive the spelling) were admisitered from November 2008 to March 2009.  I also had computer assited, targeted external beam radiation.  In later part of March 2009 I had three (3) internal radiation "fractions" of the cervix.  Of which I was required to under go a procedure to have a "Smit's Sleeve" placed.  I have a fear of needles and asked if they could just use my port.  I was told no because of safety reasons on a working chemo port.

I am now schedualed for Laproscopic total hystorectomy on May 1.   At my last appointment with the chemo doctor he stated that the port is no longer needed for chemo and cleared it for and used in cluding hospital/anthesia.

Other than the cancer which shows to be dead, and being obease.  I have no other health issues. I am 5 foot and 4 inches tall and weigh 270 pounds.

My question is this:

Is there any reason why a perfectly good port attached to a main vein in my neck cannot be used for surgery and anesthesia?

I asked this question to my surgical oncologist and she deffered to the anesthesian.  This was before the chemo doctor cleared the use of the port.

ANSWER: If the port is not being used (and is an external port), there is no reason it can't be used for anesthesia. There are some caveats. If the catheter is small, the port can be used to induce anesthesia but then an IV will be placed after you're asleep so you won't see the needle. If the port is not needed, then why haven't they taken it out? They may still feel like they might need to use it later, otherwise they would remove it.


Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: The port is just under the skin and it is about the size of an american nickle (five cent piece).  The surgeon told me that the hystorecomy needs to be done. Then after I heal from that the port will more than likely be removed.

She (the surgeon) stated after the surgery there should be no reason for more chemo.

In any case thankyou so much for answering my question.  When I was told simply "It is for safety reasons"; all that did was get me upset and a little angry.  It was as if my question was not worth answering; or that I was being impertanat for questioning them; or that the answer was too complex for me to understand/too long to explain.

If they had just explained as you it would have save ALOT of agrivation and time.  

Thankyou again, good luck with this web site and your pratice.

         Vivian

Answer
The problem with a subcutaneous port is twofold. First of all, you need a special needle to access it that anesthesiologists don't have. The other reason is that there is no way to secure the needle in place so if it were to fall out, it would have to be replaced. We have used them in patients who have no other IV access or in emergencies to get them to sleep but then we would always try to place an additional IV after they were asleep.

Good Luck,

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston