February 3, 2015

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People interested in participating in the sixth annual Edmond T. Gonzales, Jr. Surgical Research Day must submit an abstract by Monday, February 9. Anyone involved in surgery-related research is encouraged to participate.

Authors of top peer-reviewed abstracts will have the opportunity to present their research at the event, which will be from 7 a.m. to 1 p.m., Friday, May 8, in Texas Children’s Pavilion for Women fourth-floor conference center.

Authors who are not selected for an oral presentation will be invited to present their work as a poster, with a prize awarded to the top scoring one. The third annual Samuel Stal Research Award also will be presented at Surgical Research Day to recognize outstanding research by a resident or fellow in the Department of Surgery.

Hosted by the Department of Surgery and the Department of Research Administration, and started by Edmond T. Gonzales, Jr., a Texas Children’s urologist and the organization’s first surgeon-in-chief, Surgical Research Day includes invited lecturers, presentations and posters that showcase the academic efforts of the surgical faculty, post- graduate trainees, nursing personnel and operating room staff.

Have questions or need additional information? Please contact Stacey Staples at Ext 4-3366 or email Research Administration at resadmin@texaschildrens.org. To submit an abstract click here.

January 20, 2015

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Taking care of conjoined twins, Knatalye Hope and Adeline Faith Mata, is hard, even for the highly-trained medical staff charged with looking after the two 9-month-old girls.

Diaper changes, baths, feedings, even moving the girls from one place to the other takes a lot of effort, thought and hands. So, when the team of surgeons assigned to the twins asked the girls’ primary nurses and physical therapist to figure out a way to help the twins sit up, Frank McCormick, Jennifer Pitlik and Jennifer McGinnis were stumped.

“We were all just deer in the headlights,” said Pitlik, one of the twins’ primary care nurses.

McCormick, the twins’ physical therapist, had devised things to hold the girls upright before, but Knatalye and Adeline always outgrew them.

“We had to come up with something else,” McCormick said.

The surgeons wanted the girls upright to keep pressure off the custom-made tissue expanders they put in the girls’ chest and abdomen area last month. The expanders will help stretch the babies’ skin in preparation for their separation surgery, which is expected to take place next month. The surgeons also wanted the girls to spend time sitting up so they could continue to develop normally.

“Most 9-month olds are crawling and pulling up on things,” Pitlik said. “So, for them to just lay in a hospital bed all day is difficult.”

For a little more than a month, Pitlik, McCormick and McGinnis, the twins’ other primary nurse, worked with Hope Whitten, an orthotist and prosthetist at Hanger Clinic, to come up with a device that would safely keep the twins upright for a large portion of each day.

What they came up with was a u-shaped device that supports the twins’ backs, bottoms and heads. The device’s headrests are removable to allow for more movement and the main portion of the device is equipped with growth liners that can be taken out as the girls continue to get bigger.

In addition, the device suspends from a Hoyer, which normally is used to lift patients who are unable to move from one place to another on their own. In the twins’ case, the Hoyer will allow staff to lift the girls up or down while they are in what has come to be called, “the swing.”

“They love it,” McGinnis said of the swing. “They push off with their feet, so they are able to swing and move around, and since they are both upright, they’re able to look at people in the face.”

Whitten, who helped build the device based on a computer-generated model and body scan of the girls, said she knew she had done something right when she saw the girls sleeping in the swing.

“I was really very, very happy,” she said. “I was happy they were comfortable enough to sleep in this device, which is very foreign to them.”

McCormick, who was initially brought on to help the girl’s with their club feet, said the entire experience has been “truly amazing.”

“It’s just been a neat process to watch it (the swing) evolve over time and how things have changed and what we’ve had to do,” he said.

Pitlik and McGinnis agreed and said they both stepped out of their comfort zones to do what was best for Knatalye and Adeline.

“We’re all here for them and we all love them,” Pitlik said. “We have that end in mind.”

Knatalye and Adeline were born April 11 at Texas Children’s Pavilion for Women. Delivered via Caesarean-section at 31 weeks gestation, the twins each weighed 3 pounds, 7 ounces.

The girls’ parents, Elysse and John Mata, and their 5-year-old brother, Azariah, learned during a routine ultrasound on January 13 that Elysse was carrying twins and they were conjoined. Subsequently, the family was referred from a physician in Lubbock, their hometown, to the Texas Children’s Fetal Center where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care.

Now 9 months old, the babies are doing well as they continue to be cared for by a team of specialists in the Level IV Neonatal Intensive Care Unit at Texas Children’s Hospital.

January 13, 2015

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Renowned tissue engineering expert and Harvard Medical School John Homans Professor of Surgery Dr. Joseph Vacanti will be the featured speaker at this year’s Denton A. Cooley Lectureship in Surgical Innovation Tuesday, February 10.

Beginning at 7:30 a.m. in the fourth-floor Conference Center at Texas Children’s Pavilion for Women, Vacanti will discuss “Tissue Engineering and The Care of Children,” a burgeoning area of research that has untapped potential for people who need new organs. His talk will be streamed on West Campus in room 150.10 as well as in the auditorium at Children’s Hospital of San Antonio. Please RSVP to Lesa Porterfiled at Ext: 6-5722 or Importer@texaschildrens.org if you plan to attend.

Vacanti’s academic surgical career has included both clinical innovation and basic research related to organ transplantation and tissue engineering, a mission that stems from his long-held interest in solving the problem of organ shortages.

While at Boston Children’s Hospital, he launched the nation’s first liver transplantation program specifically for the pediatric population and instituted New England’s first successful pediatric extracorporeal membrane osygenation, or ECMO, program.

He then began to conceptualize the design of implantable systems that would generate new tissue and replace lost function. Vacanti’s approach to developing tissue involves a scaffold made of an artificial, biodegradable polymer, seeding it with living cells, and bathing it in growth factors. The cells can come from living tissue or stem cells. The cells multiply, filling up the scaffold, and growing into a three-dimensional tissue. Once implanted in the body, the cells recreate their proper tissue functions, blood vessels grow into the new tissue, the scaffold melts away, and lab-grown tissue becomes indistinguishable from its surroundings.

Vacanti earned his Bachelor of Science, summa cum laude, from Creighton University; his medical degree, with high distinction, from University of Nebraska College of Medicine; and a Master of Science from Harvard Medical School. He trained in general surgery at the Massachusetts General Hospital, in pediatric surgery at Boston Children’s Hospital, and in transplantation at the University of Pittsburgh.

Since 1974, Vacanti has held academic appointments at Harvard Medical School. He currently holds the following positions at Massachusetts General Hospital: co-director of the Center for Regenerative Medicine, director of the Laboratory for Tissue Engineering and Organ Fabrication, and chief of Pediatric Transplantion.

In addition to being a founding co-president of the Tissue Engineering Regenerative Medicine International Society (TERMIS), which has 4,000 active members from 80 countries worldwide, Vacanti has authored more than 320 original reports, 69 book chapters, 54 reviews, and more than 473 abstracts. He also has 81 patents or patents pending in the United States, Canada, Europe, and Japan, and was elected in 2001 to the Institute of Medicine of the National Academy of Sciences.

Among others, Vacanti has received the Thomas Sheen Award presented by the New Jersey Chapter of the American College of Surgeons and the 2013 William E. Ladd Medal, the highest honor awarded by the Surgical Section of the American Academy of Pediatrics. He now will be one of several distinguished visiting professors to speak at the Denton A. Cooley Lectureship in Surgical Innovation.

Created seven years ago, the lectureship honors Dr. Denton A. Cooley, a living legend in cardiovascular and surgical innovation. Last year, Cooley was named the most innovative surgeon alive for his groundbreaking work in cardiovascular surgery. He ranked No. 1 on the list of 20 surgeons for the accolade given by Healthcare Administration Degree Programs, which is a website that provides free information for those seeking a career in the medical industry.

Cooley might be best known for performing the first successful human heart transplant in the United States in 1968 and the first human implant of a total artificial heart in the world in 1969. However, his many other contributions are even more important, including his techniques for repairing diseased heart valves and aortic and ventricular aneurysms. Cooley also promoted and popularized the use of non-blood prime for the heart-lung machine, sparing patients unnecessary exposure to blood and allowing more operations to be performed.

Before he retired from the operating room, he and his team had performed more than 100,000 open-heart operations at the Texas Heart Institute, which he founded in 1962. Cooley has authored or coauthored 13 books and more than 1,300 scientific papers. He also has won several awards, including Texas Children’s Hospital’s Distinguished Surgeon Award.

Cooley currently is chief of cardiovascular surgery at St. Luke’s Episcopal Hospital; surgeon-in-chief emeritus at the Texas Heart Institute; consultant in cardiovascular surgery at Texas Children’s Hospital; and clinical professor of surgery at The University of Texas Medical School at Houston.

January 6, 2015

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Historically, it has been difficult to schedule surgery from Texas Children’s Hospital locations outside Main Campus. A pilot project launched a few months ago in the Division of Otolaryngology has overcome this challenge and made scheduling surgery from remote locations easier.

Surgeons now can insert an order into Epic at the time of a patient visit. Previously, when otolaryngologists traveled to see patients, they faxed or transported paper forms to Main Campus or called to schedule surgery.

“Those methods of scheduling surgery from offsite locations were less efficient and rife with opportunities for missed communications,” said Dr. Carla Giannoni, the Texas Children’s otolaryngologist who spearheaded the project.

Now, surgeons can use Epic to immediately submit an order for surgery.

“When I am at a satellite office, I am able to request the exact procedure I want, including special details, without depending on a faxed piece of paper to get to my scheduler at Main Campus,” Giannoni said. “The need to communicate about an upcoming surgery is resolved instead of having to be logged, tracked, and communicated back at a later date and time.”

In addition, the project provides for more secure patient information and increases HIPAA compliance.

“The potential to lose patient information has been eliminated with this new process,” she said. “The program has worked very well for me.”

Plans to roll out this program to other Department of Surgery divisions are underway. Surgical Services Director Trent Johnson said it will likely start early this year in the Division of Ophthalmology.

December 23, 2014

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Conjoined 8-month-old twin girls, Knatalye Hope and Adeline Faith Mata, underwent a five-hour surgery December 16 at Texas Children’s Hospital Main Campus to place custom-made tissue expanders into their chest and abdomen area. The tissue expanders will help stretch the babies’ skin in preparation for their separation surgery, which is expected to take place early next year.

During their recent surgery, the infants also had an examination to help assess their anatomy and the placement of PICC catheters in preparation for the twins’ separation. Dr. Alberto Hernandez with Interventional Radiology performed the examination. Chief of Plastic Surgery Dr. Larry Hollier and Dr. Ed Buchanan with the Division of Plastic and Reconstructive Surgery conducted the tissue expander placement surgery. Dr. Helana Karlberg led the anesthesia team and Audra Rushing led the surgical nursing team.

“We are pleased the babies did so well during the surgery,” Hollier said. “A multidisciplinary team continues to monitor them in our neonatal intensive care unit as they recover.”

The tissue expander placement surgery requires a recovery time of six to eight weeks, during which additional fluid will be added to the tissue expanders, which are like balloons, to allow the skin to be stretched gradually. The extra skin is needed to provide coverage once the babies are separated.

During the girl’s recovery, the planning process for the separation surgery will continue among a team of multidisciplinary specialists in pediatric surgery, urology, plastic surgery, orthopedic surgery, cardiovascular surgery and pediatric gynecology.

“We have been preparing for the twins’ separation surgery for months and the process is ongoing,” said Dr. Darrell Cass, pediatric surgeon and co-director of Texas Children’s Fetal Center. “In addition to multidisciplinary meetings, our plans have included, among other things, building a 3-D model of their organs, conducting simulations of the surgery and post-operative care they will receive, as well as helping create devices to support their care, such as a swing which will hold the girls upright to alleviate pressure on their healing incisions.”

Anticipated to take approximately 24 hours, the separation surgery will involve two teams of surgeons who will work together to separate the twins, who share a chest wall, lungs, pericardial sac (the lining of the heart), diaphragm, liver and pelvis. The separation team will start the surgery and the reconstruction team will complete the procedure.

Surgeons at Texas Children’s Hospital in 1992 successfully separated Tiesha and Lesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs. The separation of Knatalye and Adeline will be the second such procedure performed at the hospital.

Cass said he expects the surgery to go well and for each child to be able to live independently and to have a good life.

Knatalye and Adeline were born April 11 at Texas Children’s Pavilion for Women. Delivered via Caesarean-section at 31 weeks gestation, the twins each weighed 3 pounds, 7 ounces.

The girls’ parents, Elysse and John Mata, and their 5-year-old brother, Azariah, learned during a routine ultrasound on Jan. 13 that Elysse was carrying twins and they were conjoined. Subsequently, the family was referred from a physician in Lubbock, their hometown, to the Texas Children’s Fetal Center where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care.

Now 8 months old, the babies weigh about 15 pounds each and are doing well as they continue to be cared for by a team of specialists in the Level IV neonatal intensive care unit at Texas Children’s Hospital.

Elysse Mata said the day before the tissue expander placement surgery she is confident her girls are in good hands at Texas Children’s Hospital.

“I have an extreme amount of faith in the team at Texas Children’s and in God,” she said. “I know He put us here for a reason.”

December 16, 2014

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No parent ever wants to hear their child will need to have surgery – whether it’s a routine procedure that only takes minutes or it’s something more serious. That’s why the Department of Surgery goes out of its way to make the surgical experience at Texas Children’s a good one for patients as well as their families.

The department’s most recent effort to ensure a positive surgical experience is had by all is a video for parents that talks about what to expect when their child has surgery at Texas Children’s. The video, available in English and Spanish, covers eating and drinking instructions, what to bring to the hospital and what parents will experience while their child is in surgery.

After doing more than 25,000 surgical procedures each year, we know parents need to be prepped for surgery just as much as their children do. We hope this video helps parents who are going through that process.

“Our goal in the Department of Surgery is to have our patients and their families prepared as well as possible for the surgical experience,” Chief of Plastic Surgery Dr. Larry Hollier said. “Setting appropriate expectations is crucial to patient satisfaction. This surgical video covers all important issues pertinent to the patient’s arrival, registration, surgery, and discharge.”

Other efforts the Department of Surgery has made to enhance the surgical experience for patients and families at Texas Children’s include:

  • Pre-surgery paperwork have been streamlined to lessen parent’s preparation load before they bring their child in for surgery.
  • A greeter program has been implemented to help patients and their families more easily find our surgical admission areas. Greeters wearing blue vests are positioned at various entrances of the West Tower, the Abercrombie Building and the Clinical Care Center to help guide surgical patients to such locations.
  • Colorful, kid-friendly animal signage has been posted inside and outside the elevators, lobby, hallways and connecting bridges at the Clinical Care Center and the West Tower to improve navigation to the surgical suites at those locations.

All of these efforts have been based on feedback from parents, something the Department of Surgery is always eager to hear. While taking care of our patients is our top priority, we like to take care of their parents too.

December 9, 2014

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Patients treated at the Texas Children’s Hospital Hand and Microvascular Surgery Clinic now benefit from not only two physicians whose focus is on hand and upper extremity care but also from a full-time certified hand therapist.

Plastic and reconstructive surgeons Dr. Mitchel Seruya and Dr. Thomas Hunt III formed a multidisciplinary team with certified hand therapist Tara Haas.

Seruya, Hunt and Haas work with registered nurses, occupational hand therapists and medical assistants to perform clinical evaluations, formulate diagnoses and provide treatment plans for patients.

Haas has been a certified hand therapist since 2008 and has primarily worked in academic medical centers, most recently at the University of Colorado Hospital. She has a Master’s in Occupational Therapy from Seton Hall University and completed the Evelyn J. Mackin Hand Therapy Fellowship at the Philadelphia Hand Center. Hass’ areas of interest are trauma, burns, and tendon lacerations and repairs.

Hunt, professor and chair of the department of Orthopedic Surgery at Baylor, has dedicated his career to treating sports injuries of the hand, wrist and forearm in athletes of all ages and at all levels of ability. He serves in the capacity of team physician for a national football league franchise, national medical advisor for professional golf and as a resource for elite athletes worldwide. Hunt is a graduate of Stanford University and Vanderbilt University School of Medicine. He completed his orthopedic surgery residency, along with a research fellowship focused on bone regeneration, at the University of Kansas. He also completed a fellowship in hand, upper extremity, and microsurgery at the Hospital of the University of Pennsylvania. Recently, he graduated with a Doctor of Science Degree in Administration-Health Services from University of Alabama in Birmingham. Hunt is a board-certified orthopedic surgeon who holds a certificate of added qualification in hand surgery. He is a member of numerous national and regional specialty societies including the American Society for Surgery of the Hand, American Association for Hand Surgery, American Orthopaedic Society for Sports Medicine, American Academy of Orthopaedic Surgeons and the American Orthopaedic Association.

Seruya, who also serves as assistant professor of Plastic Surgery at Baylor, received his undergraduate and medical degrees at Columbia University. He completed his residency at Georgetown University and his craniofacial and hand/microvascular fellowships at Royal Children’s Hospital in Melbourne, Australia. Seruya’s clinical interests include neonatal brachial plexus palsy, cerebral palsy, congenital hand anomalies and traumatic hand injuries. His research interests are focused on understanding clinical outcomes following pediatric upper extremity surgery and optimizing functional restoration. Seruya is a candidate member of the American Society of Plastic Surgeons and the American Society of Maxillofacial Surgeons.

Haas, Hunt and Seruya treat patients with hand and upper extremity problems developed at birth or from trauma or infection. Some of those conditions include cerebral palsy, webbed fingers and multiple joint contractors. Other services include microvascular surgery and distraction lengthening.

“The hallmarks of Texas Children’s Hand and Microvascular Surgery Clinic are centralized services and multidisciplinary care, allowing patients to be seen by all necessary specialists in the same location on the same day,” Seruya said. “This is more convenient for the patient and family and it also enhances quality and continuity of care.”

Located on the fifth floor of Texas Children’s Hospital West Campus, the Hand and Microvascular Surgery Clinic is open on Wednesday and Thursday, from 8:30 a.m. to 12:30 p.m. A fully functional radiology suite is adjacent to the clinic, streamlining the process from diagnosis to management.