June 27, 2017

During his annual Department of Surgery year-in-review, Surgeon-in-Chief Dr. Charles D. Fraser Jr. asked his colleagues to take a moment to reflect on what they have accomplished over the past year and to contemplate the abundance of opportunities that lie ahead.

“Look at what went on in just one year,” Fraser emphasized by pointing to a timeline of accomplishments during the 2016-2017 academic year. “That’s a pretty big year.”

Over the past 12 months, the Department of Surgery has:

  • Greatly expanded its facilities at Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands, Wallace Tower, Texas Children’s Specialty Care Bellaire and Texas Children’s Specialty Care Eagle Springs. The department, along with the entire Texas Children’s system, announced an exciting initiative to bring Texas Children’s to Austin within the next year and held a topping out ceremony for Legacy Tower, a 19-floor vertical expansion that will house new operating rooms, a new Pediatric Intensive Care Unit, neuro ICU rooms, surgical ICU rooms, a progressive care unit and eight floors dedicated to just the Heart Center.
  • Continued to build a dedicated team of pediatric-focused surgeons across nine surgical divisions: Congenital Heart Surgery, Dental, Neurosurgery, Ophthalmology, Orthopedics, Otolaryngology, Pediatric Surgery, Plastic Surgery and Urology. Over the previous academic year, the team grew to more than 100 surgeons and 111 advanced practice providers. Several members of the team earned prestigious awards and promotions for their academic, clinical and research efforts.
  • Strengthened its commitment to support surgical research by dedicating space to the Department of Surgery Research Lab and building a strong team of multidisciplinary surgeon scientists.
  • Maintained its focus on patient care in seeing more than 175,000 outpatient visits and 51,000 operating room hours over 27,600 cases.

“As you can see, we are dedicated to meeting our mission and vision with multiple community health centers and three Texas Children’s Hospital locations throughout the Greater Houston area,” Fraser said. “We take great pride in caring for children from all around the globe no matter how complex the problem.”

The ability to provide such care will continue to grow and improve, Fraser said, emphasizing the opportunities Austin and Legacy Tower will bring.

“The Austin community will really appreciate the TCH approach to patient care,” he said. “The opportunities there are boundless.”

The same goes for Legacy Tower, which Fraser said will enable his department to continue to focus on providing the highest quality surgical care.

In closing, Fraser asked the members of the department of surgery to contemplate how each are to leave a mark on Texas Children’s legacy and keep improving the care they are able to give our patients. He said he believes that Texas Children’s will make its mark as one of the top pediatric surgical centers in the world by establishing more endowed chairs, building a surgical simulation laboratory, producing national and internationally known leaders and tackling some of society’s major public health problems.

“I humbly believe there is no other children’s hospital like Texas Children’s Hospital,” Fraser said. “I also believe that we continue to be presented with unique opportunities to become even better. Our job is to make sure we seize those opportunities, some of which could come around only once in a lifetime.”

To read the recently released 2016 Department of Surgery Annual Report, click here.

June 20, 2017

As the Department of Surgery continues to expand in the community at Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands, ongoing training is needed to be able to offer high-level surgical procedures.

Otolaryngologists Dr. Deidre Larrier and Dr. Mary Frances Musso have been leading that charge when it comes to training operating room staff in the removal of aerodigestive foreign bodies – obstructions in the esophagus and/or trachea.

Such obstructions can be emergent, and require rapid response using specialized equipment. During a four-year period between 2011 and 2015, there were 556 obstruction cases, 64 of which occurred at West Campus.

“The instruments used in obstruction procedures are very specific and are not used in general surgical procedures,” Larrier said. “Thus the need for supplemental training for our OR support staff.”

Led by Larrier, the training is for OR nurses and scrub technicians. The half-day course includes a lecture, hands-on skills lab, and in-situ simulation.

Musso is taking the Texas Children’s Hospital simulation instructor course this summer, which will allow her to enhance her mentoring skills during these sessions. Larrier is already an instructor and was instrumental in helping establish simulation education at the hospital. She leads the otolaryngology simulation sessions for not only OR staff but also residents, fellows, and mid-level providers. She recently led a training for Advanced Practice Providers on tonsillectomy surgery and the complications that can occur following such procedures.

“Dr. Larrier’s training of OR staff in the removal of aerodigestive foreign bodies and esophageal obstructions was very well received here in the Woodlands,” said Dr. Charles Hughes, a member of the otolaryngology team in The Woodlands. “Both Ramon Enad and Tom Cunningham, our OR staff leads, felt it was extremely beneficial for staff, in that these procedures are high risk and infrequent.”

Musso said, West Campus staff is very appreciative of the training and that it has helped improve their skills using this specialized equipment and treating these patients. “We plan to repeat this training session annually at West Campus to maintain the staff’s skill level.”

Larrier said she will gladly continue such training, something she views as a testament to how much the surgical capability at West Campus and in The Woodlands has grown.

Amee Moreno, a pediatric nurse practitioner in Neurosurgery, was recently selected for leadership in the National Association of Pediatric Nurse Practitioners (NAPNAP).

NAPNAP is the largest professional association for PNPs and pediatric-focused advanced practice registered nurses (APRNs) with more than 8,500 members. Their focus is centered around improving the quality of health care for infants, children and adolescents, and to advancing the APRN’s role in providing that care. Recently, NAPNAP held elections for their leadership positions and Moreno was selected to serve as president elect.

“We are so very proud of our own Amee Moreno for her tremendous accomplishments, her commitment to excellence, and for her major contributions to our Neurosurgery family,” said Texas Children’s Chief of Neurosurgery Dr. Howard Weiner.

June 13, 2017

Lynlee Boemer, a miracle baby who underwent fetal surgery performed at Texas Children’s Fetal Center to remove a large tumor (Sacrococcygeal Teratoma) growing from her spine, celebrated her first birthday on June 6.

Last week, Jeff and Margaret Boemer were at Texas Children’s for their daughter’s follow-up clinic appointment with Dr. Oluyinka Olutoye, co-director of the Fetal Center. Since their daughter’s surgery, Lynlee is meeting all of her milestones and is very active. She loves to crawl, pull up to stand and has several favorite words she likes to say like, “hi, bye-bye and Mama and Da-Da.”

“She has been in physical therapy, and thankfully, we have been able to take a break from that since she is doing so well,” said Lynlee’s mom Margaret Boemer. “She’s pulling up and almost walking. But we’re also seeing other doctors to check for GI and urology type issues. But other than that, she is doing really, really well.”

Boemer says one of the biggest blessings of sharing Lynlee’s story has been that other women pregnant with babies who have the same diagnosis as Lynlee are reaching out to her via social media, and she is able to give them hope and often refers them to Texas Children’s Fetal Center.

Boemer was 23 weeks and 5 days pregnant with her daughter Lynlee when she underwent emergency fetal surgery to remove the baby’s Sacrococcygeal Teratoma (SCT), a large vascular mass. Occurring in only 1 in 40,000 pregnancies, Lynlee’s SCT was robbing her blood supply and would eventually cause heart failure.

Lynlee had a 50/50 chance of survival. Olutoye and a surgical team worked for approximately five hours to remove the tumor growing from the baby’s tailbone, which was almost larger than the baby herself.

During the surgery, Lynlee’s heart stopped and had to be re-started and she was also given a blood transfusion. Surgeons made an incision in Margaret’s uterus and pulled out the baby from her legs to her torso so they could remove the tumor. Once the incision was closed, Lynlee was placed back inside of her mother and Margaret’s uterus was sewn shut and she was on bed rest for the remainder of her pregnancy. Surgeons were able to remove about 90 percent of the tumor, but as the pregnancy progressed, the tumor began to grow again.

Margaret was 36 weeks pregnant when Lynlee Hope was born for the second time via C-section on June 6, 2016 weighing 5 lbs., 5 oz. Lynlee was taken to the level 3 NICU for an evaluation, but was doing so well she was transferred to the level 2 nursery. At 8 days old, Lynlee underwent a second surgery to remove the rest of the tumor from her tailbone including some that had grown inside of her body.

Olutoye removed the remaining SCT tissue and Lynlee recovered wonderfully in the NICU and was able to go home just weeks after her surgery.

The family, from Lewisville, Texas, is now enjoying life at home as a family of five and they come to Texas Children’s for check-ups as Lynlee grows.

“We’re thankful that we gave her a chance at life,” Boemer said. “And we’re very grateful for all that the doctors at Texas Children’s have done to give her that life and all the wonderful care that they gave me and Lynlee while we were here.”

The Texas Children’s Hospital Department of Surgery recently announced the recipients of the 2017 Distinguished Surgeon Award. The award is given to those who have forged a path of innovation in surgical excellence, research and education within the hospital’s Department of Surgery. Leaders in the department chose the recipients and announced this year’s winners on June 2 at the department’s annual dinner event. Two of the four award recipients were honored posthumously. All of the distinguished surgeons have significantly contributed to the legacy of the Texas Children’s Hospital Department of Surgery.

This year’s Distinguished Surgeon Award winners are:

Dr. Grady L. Hallman (1930-2017)

In 1962, a young cardiovascular surgeon named Dr. Grady Hallman just out of cardiovascular surgical residency asked Dr. Denton A. Cooley, the founder of the newly established Texas Heart Institute, if he could join his practice and assist in his pioneering surgical work at Texas Children’s Hospital. Impressed with Hallman’s work, Cooley accepted him as his first associate at the Texas Heart Institute. Together, the surgeons collaborated for decades on innovative surgeries for children with congenital heart disease.

A native Texan born in Tyler, Hallman attended the University of Texas at Austin and graduated with honors. He went on to Baylor College of Medicine where he received a medical degree with honors in 1954, and was elected to the Alpha Omega Alpha Honor Medical Society. After serving his surgical residency in the Army Medical Corps, he returned to Baylor to complete his surgical training under Dr. Michael E. DeBakey. Hallman then joined Baylor’s Department of Surgery, when cardiovascular surgery was in its infancy. This is where he was introduced to Cooley.

The work between Cooley and Hallman led to many of the early advances in the field of congenital heart surgery and resulted in numerous publications, including the first comprehensive surgical textbook on the subject in 1966, Surgical Treatment of Congenital Heart Disease, and its revised editions published in 1975 and 1987. Hallman’s and Cooley’s other early contributions to the literature included journal articles on cardiovascular surgery in the first year of life; on congenital conditions such as coarctation of the aorta, tetralogy of Fallot, transposition of the great vessels, vascular rings, ventricular septal defects; and correcting congenital cardiovascular anomalies in adults. Throughout the course of his career Hallman authored 309 peer-reviewed papers.

Hallman was a member of many professional societies and gave generously of his time, serving as president of the Houston chapter of the American Heart Association, chairman of the membership committee of the Society for Thoracic Surgeons, and advisor to the State of Texas’ Crippled Children’s Services Program. He was the 1993-1994 Medical Honoree of the American Heart Association. Hallman was also honored as a Distinguished Alumnus of Baylor College of Medicine in 2003.

Dr. Thomas G. Luerssen

Dr. Thomas G. Luerssen is a neurosurgeon at Texas Children’s Hospital and professor of neurosurgery at Baylor College of Medicine. He was chief of Pediatric Neurosurgery at Texas Children’s from 2006 until 2016, and was Chief Quality Officer for Surgery from 2009 to 2017.

Luerssen attended Purdue University, graduating with a Bachelor of Science degree in 1973. He attended medical school at Indiana University, graduated in 1976, and completed his neurosurgery residency at Indiana University Medical Center. After residency, Luerssen entered private practice. His career in pediatric neurosurgery started in 1983 with fellowship training at the Children’s Hospital of Philadelphia under the direction of Dr. Luis Schut. After fellowship, Dr. Luerssen joined the faculty at the University of California San Diego. Working with Dr. Lawrence Marshall, he developed a clinical interest in pediatric neurotrauma which continued throughout his career. In 1988, he returned to Indiana University and spent 18 years as director of the pediatric neurosurgery service at the James Whitcomb Riley Hospital for Children.

In 2006, he was recruited as chief of Pediatric Neurosurgery at Texas Children’s to build upon the service started by Dr. William R. Cheek. Luerssen expanded the division by recruiting surgeons focused on subspecialties within pediatric neurosurgery. These subspecialties included: epilepsy, congenital abnormalities of the brain and spine, hydrocephalus, fetal conditions, neurotrauma and craniofacial abnormalities. He encouraged his faculty to apply innovative surgical techniques such as minimally invasive surgery and laser ablation that improved patient experience and surgical outcomes. He also saw the future of big data research and was an early proponent of value-based modeling.

At the time of his arrival, the hospital was completely revamping its Quality and Safety organizational structure. Luerssen was asked to undertake advanced training in quality improvement and patient safety. New positions of chief quality officers for medicine and surgery were created in 2009, and Luerssen was appointed chief quality officer for surgery.

In his quality position, Luerssen insistence on using data in an honest and transparent way to influence quality improvement laid the groundwork for many projects that are now considered standard operating procedure at Texas Children’s and the country. Among those are the pre-op time out, the use of surgical checklists, and the creation of the Surgical Quality Committee. He has also been a foundational participant in the hospital’s Daily Operational briefings version 1, 2 and now 3.0.

As one of the original partners on the Texas Children’s U.S. News & World Report project, Luerssen worked with the multidisciplinary teams to improve the quality of each service line as the ranking would follow the quality improvement. He has also been actively involved in the peer review process for surgeons on the Professional Practice Evaluation Committee at Texas Children’s.

He and his faculty at Texas Children’s and Indiana University have trained 18 fellows, most of whom remained in academic medicine. He has given more than 200 presentations at national forums and has published more than 200 articles or book chapters.

Dr. Melvin Spira

Dr. Melvin Spira served in the U.S. Navy during World War II where he completed his pre-dental studies. He graduated from Northwestern University Dental School with a dental degree in 1947. Soon after, he began practicing dentistry with his father in Chicago, IL. Called back to active duty in 1948, he served aboard the USS Philippine Sea and the USS Leyte where he had dental responsibilities for 700 Marines in the Mediterranean. After release to the reserves in 1950, he entered Northwestern University Graduate School intent on obtaining a master’s degree in oral surgery. However, he soon decided to focus on a career in plastic surgery. He spent three years in a general surgery residency at Duke University Medical Center and then completed his plastic surgery residency at Baylor College of Medicine in 1961, training at Jefferson Davis Hospital.

Spira joined the Plastic Surgery faculty at Baylor College of Medicine under Dr. S. Baron Hardy. When Hardy stepped down in 1976, Spira was appointed chief of Plastic Surgery by Dr. Michael E. DeBakey. Spira also served as chief of Plastic Surgery at Texas Children’s Hospital, Methodist Hospital, St. Luke’s Episcopal Hospital, the Veterans Affairs Medical Center in Houston and Ben Taub General Hospital. Spira retired as a full-time faculty member in 2003, moving to his home in Snowmass, Colo. He remained part of the Plastic Surgery faculty until his full retirement in 2012.

Beginning in the 1970s, Spira improved upon and developed microvascular surgery techniques used to reattach scalps, fingers, and eventually limbs. In addition, he did pioneering work with masseter-to-facial nerve transfers to reanimate facial muscles paralyzed by damaged facial nerves. The techniques he developed are still the standard used today. He also performed numerous surgeries to correct facial deformities, and improved on surgical techniques to correct clefts lips and palates, and associated nasal deformities. And he performed aesthetic cosmetic surgeries. In 1976, he was among the first physicians to call for Maxillofacial Surgery to be named as a distinct medical specialty.

During his career, Spira authored over 181 peer-reviewed articles published in many scientific journals, and authored 41 book chapters. For most of his professional career, and even after retirement, Spira volunteered with several organizations that sponsored surgical missions around the world. As an educator, Dr. Spira remained devoted to teaching the next generation of medical students and residents the important lessons he learned from his own professors and teachers.

Dr. Gunter K. von Noorden (1937-2017)

Dr. Gunter K. von Noorden was the first chief and founder of the Texas Children’s Hospital Department of Ophthalmology. He was known as one of the “fathers of pediatric ophthalmology” for his contributions to strabismus surgery and overall leadership in the field for more than 40 years.

Von Noorden committed his entire career to the study and treatment of strabismus and amblyopia. He was a pioneer researcher in the area of visual neurophysiology and transferred those new discoveries in strabismic and anisometropic amblyopia into improved clinical care. Through his relentless efforts and inspiration, ophthalmologists worldwide acquired new knowledge and understanding in pediatric ophthalmology and strabismus.

Born in Germany in 1928, Von Noorden’s family moved to Berlin in 1937. This had a profound impact on his life – exposing him to Adolf Hitler’s dictatorship and Nazi propaganda. Following his involvement in Battle of Berlin in 1945 and the end of WWII, Von Noorden was determined to dedicate his life to healing others, and he worked his way through medical school at the Johann-Wolfgang Goethe University.

Von Noorden began his medical career as a resident at the University of Iowa in 1957, which was followed by a fellowship at the University of Tuebingen Eye Clinic in Germany. He then returned to the University of Iowa, spending two years as an assistant professor of ophthalmology. In 1963, Von Noorden became a professor at the Wilmer Eye Institute at Johns Hopkins in Baltimore. In 1972, he moved to Houston to direct the Ocular Motility Service at Baylor College of Medicine.

Von Noorden was a professor of Ophthalmology and Pediatrics at Baylor, chief of the Ophthalmology Service at Texas Children’s Hospital, and adjunct professor of Neuroscience at the University of Texas at Houston from 1972 to 1995. Following an interval of retirement and appointment as professor emeritus, he rejoined Baylor as professor of Ophthalmology in July 2006 until October 2008. The Baylor Board of Trustees then appointed him Distinguished Emeritus Professor of Ophthalmology. Von Noorden passed away in Houston on February 18, 2017, at the age of 88.

In his lifetime, von Noorden published 310 scientific papers and authored 4 books, including Binocular Vision and Ocular Motility: Theory and Management of Strabismus. The book has been heralded as the “gold-standard text for ocular motility disorders.” He presented numerous lectures worldwide and received many honors.

In 2015, von Noorden was inducted in the American Society of Cataract and Refractive Surgery Hall of Fame as being “truly unique in his field and the ultimate triple threat: outstanding clinician, world-renowned teacher and author, and incredibly productive research scientist, highlighted by his path finding studies on the neuropathology of amblyopia.”

Drs. Hallman, Luerssen, Spira and von Noorden join the list of previous honorees, which includes: Dr. William Cheek, Dr. Denton Cooley, Dr. O.H. “Bud” Frazier, Dr. Ellen Friedman, Dr. Edmond Gonzales, Jr, Dr. Franklin Harberg, Dr. William Pokorny and Dr. David Wesson.

June 6, 2017

For Mark Wallace’s 20th anniversary as president and CEO, the Texas Children’s Board of Trustees created the Mark A. Wallace Catalyst Leadership Award in recognition of his commitment to leadership.

Since that time, Texas Children’s has recognized 30 of its finest leaders from all levels within the organization. Each has received a number of special honors which include mentoring by an executive, attending senior leadership meetings, being honored at the annual Employee Recognition Celebration, and for the past couple of years, a Texans home game made possible through our partnership with the Houston Texans. Additionally, the Catalyst Leaders of the Year were given the opportunity to further develop their talents by completing advanced training at a renowned leadership institution.

Wallace’s No. 1 maxim is, “Leadership always influences and determines outcomes – not some of the time but all of the time.” He believes each and every day people have a choice about what kind of leader they will be, no matter what role they serve at Texas Children’s.

In keeping with this maxim, people at all levels of the Texas Children’s workforce can be nominated for the 2018 Catalyst Leadership Award. Eligible nominees include all employees, formal leaders (excluding executives), physicians, and volunteers who have two or more years of service with Texas Children’s.

Everyone is encouraged to consider nominating someone whose personal leadership and contributions have positively impacted a team, a patient, a family, a process, an outcome, or any element of our mission while living our core values. Wallace will carefully review all nominations in partnership with other selection committee members, including representatives from Texas Children’s Board of Trustees, our senior executive team, and Human Resources after the nomination period closes at midnight on Friday, June 30.

You may visit the Catalyst Leadership Award website for complete details about the nomination process and this select leadership recognition and development program.

We all work with someone whose actions are the catalyst for the best possible outcomes. Who will you nominate?

Dr. Benjamin Arenkiel, a researcher at the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s has received a 2017 Michael E. DeBakey, M.D., Excellence in Research Award, a prestigious honor given annually to Baylor College of Medicine faculty who have made the most significant published scientific contribution to clinical or basic biomedical research during the past three years.

“Arenkiel is an extraordinarily gifted scientist who has made many exciting and notable discoveries in the area of neuroscience,” said Dr. Huda Zoghbi, director of the NRI who nominated Arenkiel for this prestigious award. “The papers he published in the last couple of years open up new exciting areas of research into sensory maps as well as the circuits of feeding behavior.”

Since joining the Baylor faculty, Arenkiel and his team have published and/or co-authored 32 manuscripts. In addition, the Arenkiel lab now focuses on three areas of science that each have resulted in publications in high-impact journals including Developmental Cell, Neuron, Nature, and Nature Neuroscience.

Arenkiel was presented with the DeBakey Excellence in Research Award on May 15. To learn more about the scientific research that garnered Arenkiel the DeBakey award, see below:

Nature Neuroscience: Using contemporary genetic approaches, the Arenkiel lab has recently described novel roles for neuropeptide signaling in synaptic remodeling within the adult nervous system. Synapse and circuit formation and function serves as a platform for their ongoing work. Arenkiel and his lab found that, in contrast to the refinement observed for excitatory maps, inhibitory sensory maps became broader with maturation. However, like excitatory maps, inhibitory sensory maps are sensitive to experience. These data describe the development of an inhibitory sensory map as a network, highlighting the differences from previously described excitatory maps.

Developmental Cell: In this paper, Arenkiel capitalizes on the olfactory system circuits system to understand how newly born neurons integrate into an existing network in the adult brain. Using the rodent olfactory system as a model, their work strives to understand how the circuits that comprise and modulate the olfactory bulb contribute to olfaction. This research shows that local corticotropin hormone signaling onto adult-born neurons promotes and/or stabilizes chemical synapses in the olfactory bulb, revealing a neuromodulatory mechanism for continued circuit plasticity, synapse formation and integration of new neurons in the adult brain.

Nature: Most recently, Arenkiel has initiated new and creative experiments to further probe neuronal synapse and circuit formation in the mouse brain. His lab has discovered a novel mechanism by which cholinergic signaling in the basal forebrain exerts a strong influence on body weight control. His group has serendipitously uncovered novel circuits that govern convergent hypothalamic circuits that influence feeding behavior, sensory processing and stress. He has since taken a keen interest in the feeding behavior circuits. This manuscript has been positively received by the scientific community as well as the pay press and was highlighted in the Wall Street Journal.