This information describes your Medtronic® implanted liver infusion pump, including how it is placed, how it works, and how it is refilled.
Your chemotherapy will be given to you through a pump that is implanted in your liver. The pump is a small, disc-shaped device that is made of titanium metal. It is about 2 to 3 inches in diameter, about 1 inch thick, and weighs about 4 ounces. The pump will ensure that the medication flows directly to your liver.
How Your Pump Will be Implanted
Figure 1: Placement of the pump
Your pump will be implanted during surgery. You will be given general anesthesia (medication to make you sleep). Your nurse will give you more information about how to prepare for your surgery.
Your pump will be placed in a pocket that is made between the skin and muscle in your lower abdomen (belly). A catheter (small, flexible tube) that is attached to the pump will be placed into your hepatic artery. This is the main blood vessel that goes into your liver (see Figure 1). Your pump will be filled with medication through a port located in the center of the pump. While you're in the operating room, your doctor will program the pump to deliver medication to the liver at a constant rate.
Your surgery will take 90 minutes to 2 hours. You will then stay in the hospital for 4 or 5 days.
Your doctor or nurse will give you an identification card to carry with you while you have your pump. You must carry this card at all times while you have your pump.
How Medication Is Given Through Your Pump
Before your pump is used, you will have a procedure called a flow scan to make sure your pump is working properly. Your nurse will give you more information about this procedure before it is done.
After your flow scan, your pump will be filled with chemotherapy. Your nurse will give you information about your chemotherapy and possible side effects.
You may develop stomach ulcers during treatment. Your doctor will prescribe medication to take at home to help prevent ulcers.
How Your Pump Is Refilled
Figure 2: Taking medication out of the pump
The procedure to refill your pump will take 15 to 20 minutes. During the procedure, your nurse will clean your skin at the pump site and insert a needle into the center port. You may experience discomfort from the prick of the needle.
If any medication is still in your pump, it will be removed with a syringe and measured by your nurse (see Figure 2). You will not experience any discomfort while the medication is being taken out of the pump.
Figure 3: Refilling the pump with medication
Your empty pump will be refilled with medication through a syringe that is inserted into the inner chamber (see Figure 3). You will not experience any discomfort while the medication is being refilled.
Once your pump is refilled with medication, your nurse will place a device over the outside of your pump. This device is connected to a handheld programmer. Your nurse will reset the volume in your pump.
Your pump will only hold enough medication for 14 days. It must be refilled on the 14th day. It is very important that you keep all of your refill appointments. Your pump can run dry if it is not refilled regularly. If that happens, it could become clotted and damaged. Call your doctor or nurse if you cannot keep a refill appointment. Tell your doctor if you will be out of town at any point while you have your pump.
Do not have magnetic resonance imaging (MRI) while you have a Medtronic® implanted pump. Tell your doctor you have the pump so he or she can order a different test.
After you recover from your surgery, you can resume most of your usual activities. However, activities that can raise your body temperature will cause your medication to flow faster. Follow the guidelines below:
- Avoid rough physical activity, such as contact sports, that can cause an injury to your pump site.
- Avoid strenuous activity, such as running.
- Avoid deep sea or scuba diving. You can swim or snorkel.
- Avoid lifting objects 10 pounds or heavier, which can cause your pump to move.
- Check with your doctor if you plan to travel by airplane. Pressure changes in the cabin can cause your medication to flow faster.
- Do not place heating pads, electric blankets, or hot water bottles directly on your pump site.
- Do not take hot baths or showers.
- Do not go into a sauna or hot tub.
Call Your Doctor or Nurse if You
- Have a temperature of 100.4° F (38° C) or higher
- Have any signs of infection at your pump site, such as tenderness, drainage, or redness
- Have swelling over your pump site
- Hear any alarms coming from the pump
- Have plans to travel by airplane
- Cannot keep a scheduled refill appointment
- Have any unexplained or unusual reactions
- Have any questions or concerns