Preparing for Port Placement: What to Expect

An implanted port is placed in a minor surgical procedure — more involved than a bedside PICC placement but much simpler than major surgery. Understanding what to expect allows you to prepare, reduces anxiety, and helps ensure the smoothest possible recovery.

Before Your Procedure

Who places a port?

Port placement is performed by either a surgeon (typically a general surgeon or thoracic surgeon) or an interventional radiologist — a specialist who uses imaging guidance for minimally invasive procedures. Both are highly skilled at port placement; the setting and approach may differ slightly.

Surgical setting: Operating room or procedure suite; often uses local anesthesia with sedation (monitored anesthesia care, or MAC)
Interventional radiology (IR): Procedure suite with fluoroscopic (live X-ray) guidance; typically uses local anesthesia with moderate sedation

Your physician will tell you which provider is placing your port.

Pre-operative testing

Before placement, you may need:

Blood work (complete blood count, coagulation studies to assess bleeding risk)
Possibly a chest X-ray or other imaging

These are usually done in the days before your procedure.

Medications to discuss with your team

Before your procedure, tell your surgeon or IR team about all medications, vitamins, supplements, and herbal products you take.

Blood thinners require special attention:

Warfarin (Coumadin) — typically held 5 days before; INR checked
Apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa) — typically held 1–2 days before; discuss with your team
Enoxaparin (Lovenox) — typically held 12–24 hours before
Aspirin at low dose (81 mg) — often continued; confirm with team
Clopidogrel (Plavix), ticagrelor — typically held 5–7 days before
NSAIDs (ibuprofen, naproxen) — hold 3–5 days before if possible

Do not adjust medications without specific guidance from your team. Some patients on blood thinners for critical reasons (e.g., mechanical heart valve) need a bridging plan.

Fasting (NPO) instructions

Port placement under sedation requires fasting:

Nothing to eat for typically 6–8 hours before the procedure
No clear liquids for typically 2 hours before (or 4–6 hours for some protocols)
Your team will give you specific instructions — follow them exactly. Arriving with food in your stomach may require cancellation of the procedure for safety.

What about my morning medications? Many medications should still be taken with a small sip of water on the morning of the procedure (e.g., blood pressure medications, thyroid medications, heart medications). Your team will tell you which to take and which to skip.

Arrangements to make

You will need a driver. Sedation medications impair driving — you cannot drive yourself home after port placement, even if you feel fine. Arrange for a responsible adult to drive you or arrange transportation.
Plan for a quiet day at home after the procedure. Most patients feel well enough to return to normal activities within 1–3 days.
Wear comfortable, loose-fitting clothing that can open at the chest or neck easily.

The Day of Your Procedure

Arrival and preparation

Arrive at the time instructed — typically 1 hour or more before the scheduled procedure time for registration, paperwork, and preparation.
An IV will be started in your arm (for medications and sedation).
The surgical or IR area will be cleaned and prepared.
You may be asked to wash your chest with a CHG antiseptic cloth (your team provides this) the night before or the morning of.
You will be asked to remove jewelry, particularly any necklaces.
You will change into a hospital gown.

Before the procedure, your surgeon or interventional radiologist will discuss the procedure with you, review risks and benefits, and answer questions. You will sign a consent form. This is your opportunity to ask any remaining questions. (See our guide: Your Rights: Informed Consent and Decision-Making.)

Anesthesia/sedation options

Local anesthesia only (fully awake): A small number of procedures are done with local anesthetic only — you are awake throughout. Some patients prefer this to avoid sedation side effects; others find it very uncomfortable. Ask your surgeon what is standard at your facility and what is possible.

Monitored anesthesia care (MAC) / moderate sedation: This is most common. An IV sedative (often midazolam and/or fentanyl, or propofol) is given. You are sedated and may be drowsy or sleep lightly, but you are not fully unconscious. Local anesthetic is still used at the incision sites. This is sometimes called “twilight sedation.”

General anesthesia: Occasionally used if the patient prefers it, has significant anxiety, or if there are clinical reasons. You are fully unconscious.

Discuss your preference and the options available to you with your team.

The Procedure: Step by Step

Total time is typically 30–60 minutes once the procedure begins.

Positioning: You lie on your back, arms at your sides, head slightly turned away from the side of port placement. The neck and upper chest area are cleaned with antiseptic.
Sterile draping: Large sterile drapes are placed over most of your body. Only a small area of the upper chest and neck is exposed within the sterile field.
Local anesthetic: Injected at two sites — the area on your chest where the port reservoir will be placed, and the area on your neck or upper chest where the catheter will enter the vein. The injections sting briefly.
Vein access: Using ultrasound guidance (typically), the catheter portion of the port is inserted into a large vein — usually the subclavian (under the collarbone) or internal jugular (neck) vein. Fluoroscopy (live X-ray) is used to guide the catheter to the correct position in the superior vena cava.
Creating the port pocket: A small incision (2–3 cm) is made in the upper chest, and a small pocket is created under the skin to hold the port reservoir.
Tunneling: The catheter is tunneled under the skin from the vein entry point to the port pocket.
Connecting the port: The catheter is attached to the port reservoir, which is positioned in the pocket.
Closing: The incision is closed with dissolvable sutures, skin glue, or staples (your team will tell you what was used). An additional, smaller incision at the vein entry site is also closed.
Confirming position: Fluoroscopy confirms the catheter tip position before the procedure is complete.
Accessing the port (optional): In many cases, the nurse or physician will access the newly placed port immediately with a Huber needle to confirm it works and begin using it.

Immediately After the Procedure

Recovery

You will be observed in a recovery area for 30–60 minutes (longer if sedation was used) while the sedation wears off. Vital signs are monitored. Pain medication is available if needed.

What to expect to feel

Soreness at the incision sites — the area will be tender for several days, worse with arm movement on that side. This is normal.
Bruising around the incisions — common, resolves over 1–2 weeks
Swelling at and around the port site — normal initially; significant or rapidly increasing swelling should be reported
A bump under the skin — this is the port reservoir. It may feel firmer initially due to swelling; this softens over days to weeks.
Stiffness in the neck and shoulder — from positioning and the procedure; improves with gentle movement over days

What you should NOT feel

Significant, sharp chest pain (beyond expected incisional soreness)
Shortness of breath
Fever in the first 24 hours (some mild temperature elevation is normal; fever above 38.5°C is not)

Activity after port placement

Rest for the remainder of the day of the procedure
Avoid raising the arm on the port side above shoulder height for the first 24–48 hours
No lifting over 5–10 lbs (2–4 kg) with the arm on the port side for approximately 1 week, or until cleared by your surgeon
No strenuous exercise for 1–2 weeks
Normal daily activities (eating, light walking, sitting, working from home) can resume the day after in most cases
Driving: Do not drive the day of the procedure (sedation). Most patients can drive again within 1–3 days when comfortable.
Return to work: Desk/office work within 1–3 days for most patients; physical labor may require 1–2 weeks.

Incision Care

Your surgeon or IR team will provide specific wound care instructions. General principles:

Keep the incision(s) clean and dry for at least 48–72 hours
No submersion (bathing, pools, hot tubs) until the incision is fully healed (typically 1–2 weeks)
Showering is usually permitted after 48–72 hours — let water run over the site gently; do not scrub; pat dry
Wound closure strips or Steri-Strips: Leave them in place until they fall off on their own (usually 1–2 weeks) or until your surgeon removes them
Dissolvable sutures: Will dissolve on their own; no removal needed
Staples: Will be removed at a follow-up appointment (typically 7–14 days after placement)
Do not apply lotions, ointments, or creams to the incision unless specifically instructed

Signs of incision complications to report

Increasing redness spreading from the incision edges
Warmth and swelling that is worsening after the first 48 hours
Discharge or pus from the incision
Fever (≥38°C / 100.4°F)
The incision opening or separating

When Can the Port First Be Used?

This is one of the most common questions after port placement.

In many cases, the port is accessed and tested during the placement procedure itself and can be used for infusions starting the same day or the following day.
Some surgeons prefer to wait 24–48 hours for the surgical site to stabilize before first access (particularly for patients who received sedation and need to remain NPO briefly).
Your oncologist or infusion team will confirm your first use date.

The port cannot be accessed through the incision wound — once the incision is healed, accessing will be through intact, healthy skin over the port reservoir.

Your Port Identification Card

Before you leave, make sure you receive a port ID card that lists:

The brand and model of your port
Whether it is power injectable (suitable for CT contrast injections)
The placement date
The surgeon/facility contact

Keep this card in your wallet at all times. You will need it at every future appointment where your port is used, and whenever you seek care from providers unfamiliar with your port.

This guide is for educational purposes and is not a substitute for instructions from your specific surgical team and facility.