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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

Indwelling Pleural Catheter Insertion

What is an indwelling pleural catheter insertion?

  • 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.

What conditions is it used to treat?

  • 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.

Am I asleep for the procedure? Where can I have it done?

  • 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.

What is the wait period to get a Pleural Catheter?

  • 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.

How long does it take? How long will I stay in hospital?

  • 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.

What is the item number for this procedure?

  • The MBS item number for your health fund for this procedure 38806.

What should I do in preparation for Pleural Catheter?

  • 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

What are the side effects of a Pleural Catheter?

  • 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

When can you return to work?

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

When will the results be available?

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