Overview
How is a central venous catheter placed?
An external tunneled catheter is inserted, by a pediatric surgeon, in the operating room under general anesthesia.
A small incision is made on the right or left side of the chest or neck to insert the catheter into the vein. The catheter is then tunneled under the skin to an exit site on the chest. The exact site will be determined by the surgeon based on what is best for your child. At the exit site, there may be small stitches placed around the catheter securing the tubing to the skin to keep it from coming out. These stitches can be left in place until they break loose from the skin, usually by two to four weeks.There will be a small dressing over the insertion site on the upper chest or neck which may be removed in two days and a dressing over the catheter exit site that is to be changed the day after insertion. The nurses will teach you how to do this and instruct you in the frequency of dressing changes to be done at home.
A port is placed in the same fashion as a tunneled catheter. However, there is no exit site because the catheter is placed completely under the skin. There is an incision located just above or below the injection port. There will be small dressings over the insertion site and one near the injection port. Your child may leave the operating room with a needle inserted in the port and taped in place for immediate use of the port.
How will I care for my child's catheter?
Your child's nurses will teach you how to care for the catheter or port while your child is in the hospital. They will also arrange for home nursing care and supplies if needed once your child is discharged home.
How will the catheter be removed?
You will be referred to the Pediatric Surgery office when it is time to schedule catheter removal. This is a short out patient procedure performed under anesthesia.
External catheter removal
External catheter removal is usually performed under anesthesia on an outpatient basis. In most patients both the catheter and the cuff are easily removed. In some cases, the cuff remains firmly under the skin and only the catheter can be pulled out. This cuff does not usually cause a problem and can remain under the skin permanently. Removal of the cuff requires a separate skin incision and therefore this is not generally done. Prior to catheter removal, please feel free to ask your child's surgeon any questions you may have about the procedure.
Totally implantable catheter removal
Removal of an implanted catheter is also done under anesthesia as an outpatient. Both the catheter and the injection port are removed through the same small incision used for implantation. Prior to catheter removal, please feel free to ask your child's surgeon any questions you may have about the procedure.
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