What is hepatic artery infusion pump placement?

This is surgery to place a type of pump into your body. The pump puts chemotherapy medicine into the liver. It is used to treat colorectal cancer that has spread to the liver.

The pump is a small metal container that holds medicine. A thin, plastic tube called a catheter carries medicine from the pump into a blood vessel. The blood vessel is called the hepatic artery. It goes to your liver.

You will be asleep during the surgery. The doctor will make a cut in the right side of your belly near your waist. This cut is called an incision. The doctor will put the pump under your skin. Then her or she will put the catheter into the artery. The doctor will close the incision with stitches. It will leave a scar that will fade with time.

Your doctor also may take out your gallbladder. It is connected to the liver by tiny blood vessels. If the gallbladder is not removed, some of the medicine from the pump could get to gallbladder or cause other problems.

Your doctor probably will put medicine in your pump at your first follow-up visit. He or she will tell you more about the pump. You will learn how often you need to have it filled. When you no longer need the pump, you will have another surgery to take it out.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Try not to bend or twist at the waist a lot. These movements can cause the catheter to come loose.
• Check with your doctor before you use a hot tub, sauna, steam room, tanning bed, or other things that may raise your body temperature. Do not place a heating pad on your stomach.
• Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
• Ask your doctor when you can drive again.
• You will probably need to take at least 2 to 6 weeks off from work. It depends on the type of work you do and how you feel.
• You may shower, if your doctor okays it. Pat the incision dry. Do not take a bath until your doctor tells you it is okay.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

A hepatic artery infusion pump is a way to put chemotherapy medicine directly into the liver. The pump is used to treat colorectal cancer that has spread to the liver. The pump is a small metal container that holds medicine. A thin, plastic tube called a catheter carries medicine from the pump into a blood vessel that goes to your liver. The blood vessel is called the hepatic artery. The doctor made a cut (incision) in the right side of your belly to put the pump under your skin.

The incision may be sore at first. Your belly may be sore and swollen where the pump and the catheter were placed. This usually gets better in 1 to 4 weeks. You will probably need to take at least 2 to 6 weeks off work.

You will probably be able to see or feel the shape of the pump under your skin. With time, you may not feel the pump as much. It may be more comfortable to wear loose clothing over the pump while you are getting used to it.

Your doctor probably will fill your pump with chemotherapy medicine at your first follow-up visit. The pump probably will need to be refilled every 2 to 4 weeks. Your doctor will tell you more about your pump and how often you'll need to have it refilled.

The pump will release medicine at a set rate. An increase in your body temperature can make the pump release medicine at a faster rate. This can cause your liver to get too much medicine at once. So it's important to avoid strenuous activity, hot tubs, and other things that may raise your body temperature.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take at least 1 hour.