Procedures

Procedural Experience

Dr Herath is an interventional bronchoscopist with formal international training and a post specialist fellowship in interventional bronchoscopy in thoracic malignancy, completed at McGill University Montreal Canada in 2013.
She is one of the very few interventional bronchoscopists who have completed formal training in a North American Centre.
Dr Herath started up new services for minimally invasive Radial EBUS and Cryobiopsy in Middlemore Hospital Auckland and New Zealand as well as Westmead Hospital, Sydney Australia.
She has completed over 1500 bronchoscopies with over a 1000 EBUS procedures with excellent published success rates.
Dr Herath frequently performs the following procedures

A pleural effusion is a build-up of fluid between the tissues that line the lungs and the chest.
This procedure helps to drain fluid from around the lungs easily and painlessly when needed.
The procedure prevents the need for repeated injections and tubes every single time the patient requires drainage.
During this procedure, a catheter is inserted through the skin with the patient under local anaesthetic as a same day outpatient procedure.
When the patient goes home, fluid drainage can be done by a trained family member or qualified healthcare provider.

This is mainly used for patients who have recurrent fluid in their lungs mainly due to various types of cancers that had spread to the lungs.
Selected groups of patients with heart failure and liver failure may benefit from this as well.
This ultrasound guided procedure is not curative but can provide enormous comfort and relief palliatively for patients with advanced malignancies of the lung, breast, lymphoma and ovary who have a pleural effusion.
It is also used for patients with congestive heart failure.

You will be awake for the procedure.
This is done by injecting a local numbing agent to your chest wall whilst you are lying on the bed.
You can have the procedure done at Westmead Public Hospital on a Wednesday afternoon.

Pleural catheter insertion is not an urgent procedure.
It also takes time to discuss a management plan for the pleural catheter as for most patients this will be a permanent equipment.
It can be removed anytime.

The procedure takes 30 minutes
This is usually a day procedure and you can go home 1-2 hours post procedure.
If we feel you need overnight monitoring, we will inform you prior to the procedure and may require a one-night stay.

Main preparation is to understand the need for a catheter and that you are happy to have this
You will need to discuss requirements with Dr Herath
Some patients can be offered the catheter with the view of taking it out in 6 weeks’ time
Some people require lifelong catheter
The management is different for the two groups and this needs to be discussed first
You do not need to be fasting

This is kept in your body for a lengthy period.
There is risk of dislodgement specially in the initial period if you stretch or tug at it.
There is a small infection risk (4%) at 3 months
Infection risk rises longer the catheter is in
Catheter blockage: you need to inform your nurse who will inform Dr Herath and organise a review

You can return to work and start all your normal medications including blood thinners the next day.

Usually there are no results to obtain. Plural catheters are inserted generally to patients who already know they have cancer.