A new procedure at Dubbo Hospital is reducing the distress of patients with terminal cancer and saving them from costly trips to Sydney.
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Senior respiratory physician Dr Sugamya Mallawathantri has introduced thoracoscopy to the surgical theatres of the hospital for the benefit of "very unwell, very breathless" patients, most of them suffering late-stage lung cancer.
The procedure, involving the use of a viewing tube called a thoracoscope, allows for the draining of fluid from the lining of the lungs.
Dr Mallawathantri also applies talc in a bid to prevent the fluid from returning and in the worst cases inserts a permanent catheter.
"The ultimate result of this is to take all the fluid out so the patient's lung can re-expand and they become less breathless and the fluid reaccumulation becomes less likely," she said.
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In Australia, cardiothoracic surgeons usually perform the procedure but there are none working within the Western NSW Local Health District.
"In other parts of the world respiratory physicians do this procedure," Dr Mallawathantri said.
Trained in Britain and Europe, the doctor performed the procedure for more than a decade before moving to Australia.
Dr Mallawathantri said in the past dying patients needing the procedure were offered the opportunity to have it in Sydney.
"Most of the time they declined that offer because patients don't want to go to Sydney," she said.
"They want to stay close to their home and family."
Dr Mallawathantri said when a patient took up the offer they were "airlifted in patient transfer" from Dubbo to Sydney at a cost of $6000.
"We also have to wait for a bed to come up in a tertiary centre and that can vary from two days to 14 days and we are looking at approximately $1000 a day," she said.
"So sometimes we spent close to $20,000 per patient for these patients to go to cardiothoracic surgeons."
The respiratory physician said the introduction of the procedure was a "great opportunity for patients in this area to undergo this procedure locally and closer to home and for the health system we are actually saving a large amount of money".
Dr Mallawathantri has trained under a leader in the field, Professor Philippe Astoul of Marseille, France, who has agreed to be part of a "national course" next year.
"My dream is to hold it in Dubbo," she said.