October 10, 2017

Texas Children’s collaborative work to develop a novel device to anchor the chorio-amniotic membranes during fetal surgery was recently funded by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD) of the National Institutes of Health (NIH).

Partnering with Baylor College of Medicine, the Department of Bioengineering at Texas A&M University, and local life sciences commercialization firm Fannin Innovation Studio, the $225,000 Small Business Innovation Research (SBIR) grant will be used to advance the development of a device that can be introduced into the uterine cavity under ultrasound guidance to anchor the chorio-amniotic membranes, thereby reducing the risk for premature rupture of membranes (PROM) during fetal surgery.

Preterm PROM is the most frequent complication associated with fetal surgery and can increase the risk of premature delivery that could potentially add the insult or prematurity to the fetal anomaly that leads to the need for fetal surgery.

Through the Texas A&M undergraduate and graduate design program, a group of Texas A&M engineering students collaborated with Dr. Jimmy Espinoza and OB/Gyn-in-Chief Dr. Michael A. Belfort, obstetricians and gynecologists, and fetal surgeons at Texas Children’s and Baylor, to create the device in 2016. Espinoza and Belfort challenged the students to develop innovative tools that could be percutaneously introduced into the uterus during fetal surgery to anchor the chorio-amniotic membranes in order to reduce the risk of preterm PROM.

Fetal surgery is a relatively new discipline that aims to reduce the risk for fetal death in conditions such as twin-to-twin transfusion syndrome, severe fetal anemia, congenital diaphragmatic hernia or fetal hydrops, or reduce the long term complications and improve the quality of life in conditions such as spina bifida. Texas Children’s and Baylor are at the forefront on fetal surgery in the U.S. and have innovated techniques to make fetal surgery safer for the mothers and their unborn children.

After extensively collaborating with Texas Children’s surgeons to understand the challenges of anchoring the chorio-amniotic membranes during fetal surgery and the need for refinement, the collaborative team developed a device that can be percutaneously introduced into the uterine cavity under ultrasound guidance in order to anchor the chorio-amniotic membranes to reduce the risk for preterm PROM. This new innovation in fetal surgery could potentially be used in all fetal surgeries because of its percutaneous approach and should reduce the risk for the most common complication associated with fetal surgery, namely pre-term PROM.

“The development of new devices and new approaches in fetal surgery is very important to make fetal interventions safer not only for the fetus but also for the mother,” said Espinoza, co-director of the Fetal Center at Texas Children’s. “The decision to proceed to fetal surgery is very altruistic for the mothers because they will be exposed to risks associated with surgery for the benefit of their unborn child. Thus, we have the obligation to minimize those risks. This award recognizes the academic partnerships that are necessary to advance the frontiers of fetal surgery.”

The team’s invention has won the top prize at Texas A&M University’s 2016 annual Engineering Design Showcase. The project was judged against over 700 students on more than 150 other projects.

September 19, 2017

Since the topping out celebration of Texas Children’s Legacy Tower nearly seven month ago, significant construction milestones have been reached inside the tower’s 400-foot-tall structure at Texas Children’s Medical Center campus.

Carefully designed to promote the safest possible environment to care for our most critically ill patients and their families, construction is underway on the patient care rooms in the cardiovascular intensive care unit (CVICU), pediatric intensive care unit (PICU) and the progressive care unit (PCU). Last year, a series of patient care simulations were conducted to identify and eliminate any latent safety defects in the final design of the critical care tower before actual construction began.

Based on helpful feedback from our providers and patient families, the size of the critical care rooms inside the Legacy Tower will be between 350 to 450 square feet – three times the size of the hospital’s current ICU rooms. The rooms will feature a dedicated family space, a bathroom and shower, and care teams will have enhanced visibility and monitoring between patient rooms and into the patient rooms from the nurses’ work stations. The ICU rooms also will be equipped with state-of-the-art technology including a boom that will provide gas, power and data from the ceiling.

“Booms allow us to position the patient almost anywhere in the 360-degree circle,” said Chief of Critical Care Medicine Dr. Lara Shekerdemian. “This means that we can use some very state-of-the-art equipment for mounting all of the pumps, monitors and ventilators at the patient’s bedside while keeping the equipment off the floor.”

The Legacy Tower’s high intensity operating rooms and intraoperative state-of-the-art MRI suite also will provide dedicated subspecialty care for surgical patients.

“Our pediatric surgical patients are different than other ICU patients,” said Texas Children’s Chief of Plastic Surgery Dr. Larry Hollier. “For the first time, we’re going to have them in a setting where the care is designed specifically for that surgical patient, and that’s going to be located one floor above the operating rooms. The new tower will help us increase our OR capacity so we are not turning patients away from receiving critical care.”

The Legacy Tower will open in two phases. The first phase will occur in May 2018 when the PICU, PCU, operating rooms and Radiology open. A few months later, the Heart Center will move into the new tower in August 2018.

The 25-floor Legacy Tower will house 126 beds for pediatric and cardiovascular intensive care, six new operating rooms (ORs) with the latest technology to complement the hospital’s existing 19 ORs, and will be the new home of Texas Children’s Heart Center, including the outpatient clinic, four cardiovascular ORs and four catheterization labs. This vertical expansion will help reinvest in the programs needed to provide the highest level of care to our most critically ill patients.

“I don’t know of any other children’s hospital in the country that has the type of experience that Texas Children’s has in bringing all of these elements together,” Hollier said. “With larger, more functional spaces, we will be able to provide patients and families with the best possible environment to receive care.”

September 8, 2017

Dr. William Pederson has been named the Samuel Stal, MD Endowed Chair in Plastic Surgery, and Dr. Edward Reece has been named the Josephine Abercrombie Endowed Professor in Plastic Surgery Research.

“Both Dr. Pederson and Dr. Reece are exceptionally worthy recipients of these endowed positions,” said Dr. Larry Hollier, associate surgeon-in-chief for clinical affairs and chief of Plastic Surgery at Texas Children’s Hospital, and chief of Plastic Surgery at Baylor College of Medicine. “We are very fortunate to have received endowment funding from generous donors and hospital leadership in order to recruit and retain the most talented surgeons to care for our patients.”

Samuel Stal, MD Endowed Chair in Plastic Surgery

The Samuel Stal, MD Endowed Chair in Plastic Surgery was created through the contributions of Texas Children’s Hospital to honor the legacy of Dr. Samuel Stal, who served as chief of Plastic Surgery at both Texas Children’s and Baylor College of Medicine. For more than 30 years, Dr. Stal focused his Texas Children’s practice on helping children with craniofacial, cleft lip and palate deformities. He also created the Texas Children’s Center for Facial Surgery, which accepted all children with facial deformities regardless of their family’s ability to pay.

Pederson is a highly regarded hand and microvascular surgeon with faculty appointments in plastic surgery, orthopedics, neurosurgery and pediatrics at Texas Children’s and Baylor. His clinical interests include the management of vascular problems in the upper extremity, nerve injury and repair including brachial plexus, Volkmann’s ischemic contracture, facial paralysis and microsurgical reconstruction of complex extremity defects.

A leader in his field, Pederson currently serves as president of the American Association for Hand Surgery. Pederson was named a director of the American Board of Plastic Surgery in 2013 and is the chair of the Board’s Hand Surgery Examination Committee. He also serves as a member-at-large on the executive council of the World Society for Reconstructive Microsurgery. He has served as president of the American Society for Reconstructive Microsurgery and has served on the executive council of the American Society for Surgery of the Hand.

Pederson has authored more than 70 papers in peer-reviewed literature and 40 textbook chapters. He is an editor of the textbook “Green’s Operative Hand Surgery,” and serves on the editorial boards of the “Journal of Hand Surgery” and the “Journal of Reconstructive Microsurgery.”

Josephine Abercrombie Endowed Professorship in Plastic Surgery Research

The Josephine Abercrombie Endowed Professorship in Plastic Surgery Research was established by Ms. Abercrombie’s son, George Robinson, to honor his mother and the Abercrombie legacy of giving to Texas Children’s and Baylor. J.S. Abercrombie, Josephine’s father, was one of the founders of Texas Children’s Hospital.

Reece is the chief of Adult Plastic Surgery at Baylor College of Medicine. He specializes in plastic surgery and surgery of the hand. He is also a member of the Hand Surgery Program at Texas Children’s.

After earning a medical degree and Master’s degree in applied anatomical sciences at Case Western Reserve University School of Medicine, Reece completed his plastic surgery residency at UT Southwestern in Dallas. He went on to train under Dr. David Green at UT San Antonio in hand surgery and microvascular reconstructive surgery. He also earned an Executive MBA degree with an additional certification in health care supply chain from Arizona State University.

Reece conducts research in the areas of peripheral nerves, reconstructive surgery and telehealth as it relates to improving doctor-patient interactions and coordinating efficient care and affordable cost. He has founded several biomedical companies that seek to find efficiency and cost savings for institutions while preserving the highest quality to patients.

Three Endowed Positions in Plastic Surgery

This is the third endowed appointment for the Division of Plastic Surgery at Texas Children’s. Hollier holds the S. Baron Hardy Endowed Chair in Plastic Surgery. Dr. S. Baron Hardy was the first chief of Plastic Surgery at Texas Children’s. The endowment was gift from the T.L.L. Temple Foundation and was championed by Temple Webber, who serves as a T.L.L. Temple Foundation trustee.

August 22, 2017

Texas Children’s work to develop a novel non-invasive device for pediatric ureteral stent removal after a urinary tract procedure, with Baylor College of Medicine, Rice University’s Oshman Engineering Design Kitchen (OEDK) and Department of Bioengineering, as well as local life sciences commercialization firm Fannin Innovation Studio, was recently funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). The $225,000 Small Business Innovation Research (SBIR) grant will be used to conduct further development of an electromagnetic device for removal of ureteral stents in pediatric patients.

Through the Rice undergraduate design program, a group of Rice University engineering students collaborated with Dr. Chester Koh, a pediatric urologist and surgeon at Texas Children’s and Baylor College of Medicine, to create the device in 2015, after Koh challenged the students to develop an innovative tool that would simplify ureteral stent removals, a fairly common procedure that is performed on more than 2,000 pediatric patients nationwide each year.

After extensively collaborating with Texas Children’s surgeons to better understand the challenges of the current procedure and the need for refinement, the collaborative team developed a non-invasive device to remove ureteral stents from children using a small magnetic bead and a powerful custom-built electromagnet that was designed with the assistance of 3-D printing at Rice’s OEDK labs. The electromagnet safely pulls on the tiny metallic bead that is attached to the ureteral stent to allow passage through the urethra without the need for an invasive procedure or general anesthesia.

This new innovation in pediatric ureteral stent removal is less painful and costs two-thirds less than the standard procedure because it avoids general anesthesia and the time and equipment necessary for a surgical procedure. The team’s invention has won two significant awards: the top prize at Rice University’s 2016 annual Engineering Design Showcase and the Grand Prize for Student Design at the 2016 annual Design of Medical Devices conference in Minneapolis.

“The development of pediatric medical devices lags adult device development by more than 10 years,” said Koh, who has a mechanical engineering degree from the University of California, Berkeley. “This is an important example of why academic partnerships are needed to advance pediatric medical device projects, since the pediatric medical device pipeline is currently limited. I applaud the Rice and Fannin Innovation Studio team members for showing their dedication and passion to the kids under our care at Texas Children’s.”

Prior to coming to Texas Children’s to establish the robotic surgery program in 2013, Koh co-founded a U.S. Food and Drug Administration-supported pediatric device consortium based in Southern California. He is creating a similar initiative at Texas Children’s, drawing on the top engineering and device development talent in the region.

The early work for this project was supported by the Denton A. Cooley Fellowship for Surgical Innovation of the Texas Children’s Auxiliary and by the Texas Children’s Department of Surgery, which continues to support the pursuit of innovation solutions to the unmet surgical needs of children.

The SBIR Phase I grant from the NIDDK will allow the team to implement design modifications to further refine the device as well as perform benchtop and pre-clinical studies with a target goal of larger SBIR Phase II grants.

August 15, 2017

Orthopedic Surgeon Dr. Scott McKay was recently named a recipient of the 2017 Pediatric Orthopaedic Society of North America (POSNA) /Sociedad LatinoAmericana de Orthopedia Y Traumatologia Infantil (SLAOTI) Traveling Fellowship Award to South America.

McKay, alongside two other pediatric orthopedic surgeons, will spend the first two weeks of October in Argentina and Chile visiting and learning new techniques and exchanging ideas with their South American counterparts. The surgeons will end their trip in Brazil at the POSNA/SLAOTI meeting.

McKay, who specializes in injuries to the pediatric/adolescent athlete, was awarded the travel grant in March.

POSNA is a non-profit professional organization of over 1,200 surgeons, physicians and allied health members who are passionately dedicated to advancing musculoskeletal care for children and adolescents through education, research, quality, safety and value initiatives, advocacy, and global outreach to children in underserved areas.

The POSNA/SLAOTI annual traveling fellowship to South America allows three POSNA members a year to travel abroad and three members of an alliance society to tour in North America annually.

August 8, 2017

Texas Children’s is a large and growing health system with many specialties and sub-specialties. We take care of the sickest of the sick and provide routine pediatric care to otherwise healthy children. Many times that care involves not one medical expert but a team of medical experts, including pediatric anesthesiologist.

“The core role of the Department of Anesthesiology, Perioperative and Pain Medicine is to provide surgical anesthesia, but we are not just in the operating room,” Anesthesiologist-In-Chief Dr. Dean B. Andropoulos said. “We provide care in radiology, our Pain Medicine Clinic, in the Intensive Care Units, and at all three Texas Children’s Hospital campuses. We also are in the laboratory doing cutting edge research, writing some of the top textbooks in our field, and educating and training the next generation of pediatric anesthesiologists.”

During a recent Department of Surgery Grand Rounds, Andropoulos discussed the strategic goals of his growing department and how it touches almost every aspect of patient care.

The department’s 78 pediatric anesthesiologists represent the largest group of pediatric anesthesiologists in the country. All are board certified or are in the process of becoming board certified and all provide anesthetic care in almost 60 locations on a daily basis.

Across these locations, Texas Children’s anesthesiologists were involved in 43,456 cases last year, a 36 percent increase from the number of cases anesthesiologists participated in seven years ago. The majority of the cases worked last year, 68 percent, occurred in the operating room. The remaining 32 percent of cases happened outside the OR in various inpatient and outpatient settings.

“The fact that we do more than 40,000 anesthetics in a year lends to the level of expertise of our group,” said Medical Director of Perioperative Services Dr. Chris Glover. “I don’t know of another place where you can take your child to get the amount of expertise that exists here.”

This level of expertise was recently exemplified by the expansion of the Pre-Anesthesia Screening Service (PASS) Clinic to Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands. These clinics are involved in pre-anesthetic consultation and planning for patients with complex medical problems or who are undergoing complicated surgical procedures.

Patients are evaluated by anesthesiology nurse practitioners and anesthesiologists, and an anesthetic plan is developed that is communicated to parents, surgeons and procedural physicians. This planning leads to improved patient and family education, better outcomes and fewer delays and cancellations of surgery. This service emphasizes the increasing role of pediatric anesthesiologists as perioperative physicians whose expertise benefits patients all across the Texas Children’s system.

Being part of an academic center, Baylor College of Medicine, allows the Department of Anesthesiology, Perioperative and Pain Medicine to continue to strengthen and grow its already solid knowledge base, Andropoulos said.

In addition to providing top notch clinical care, the department’s clinical staff is involved in numerous clinical and basic science research protocols, many of which are funded by the National Institutes of Health.

Just last year, the department’s faculty published over 40 articles peer reviewed journals. They also served as editor and/or author of eight textbooks, including Anesthesia for Congenital Heart Disease, 3rd Edition. The textbook is the leading reference source for the field.

The department has taken a lead in educating anesthesiologists at Texas Children’s and beyond about the Federal Drug Administration’s recent warning that repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 or in pregnant women during their third trimester may affect the development of children’s brains.

“Parents know we are up-to-date on the very latest information,” Andropoulos said. They also know we all are aware that taking care of their child is a privilege, a real responsibility that we take extremely seriously.”

Members of the Department of Anesthesiology, Perioperative and Pain Medicine are always striving to do better and have set out three primary strategic goals for the next few years. These goals are:

  • To enhance patient experience by design and enhanced method of measuring anesthesiology patients satisfaction data.
  • Expand pain services by creating a strong business model for the service line and engaging and strengthening collaborative partnerships with clinical specialties to increase access to care for pain patients.
  • Increase research grant funding and resources by growing the volume of peer reviewed journal publications and grant proposals in the department and acquiring more funding from major grant proposals.

“We will continue to strengthen and grow our department,” Andropoulos said. “We want to remain one of the top pediatric anesthesiology programs in the country.”

Department leadership and contact information
  • Anesthesiologist-In-Chief, Dr. Dean B. Andropoulos
  • Associate Anesthesiologist-In-Chief Academic Affairs, Dr. Blaine Easley
  • Associate Anesthesiologist-In-Chief Clinical Affairs, Dr. Emad Mossad
  • Medical Director of Perioperative Services, Dr. Chris Glover

For more information about Texas Children’s Hospital Department of Anesthesiology, Perioperative and Pain Medicine, visit the department’s website at http://www.texaschildrens.org/departments/anesthesiology or call ext. 4-5800.

July 11, 2017

On June 28, Texas Children’s Transplant Services held a celebration in honor of reaching an important milestone – the completion of 1,500 transplants.

The milestone further solidifies Texas Children’s position as one of the most active pediatric transplant programs in the nation, per the U.S. Department of Health & Human Services Organ Procurement and Transplantation Network.

“Texas Children’s transplant program is key to our medical and academic success,” said Executive Vice President Mark Mullarkey. “This really differentiates us and I can’t thank you enough for that.”

Transplantation began at Texas Children’s in 1984 with a pediatric heart transplant that was performed by Dr. O.H. “Bud” Frazier. Since that time, liver, kidney and lung have been added and countless lives have been saved. Just last year, 86 organ transplants were performed at Texas Children’s – 32 kidney transplants, 25 heart transplants, 21 liver transplants and 8 lung transplants.

The Transplant Team’s 1,500th transplant occurred on May 21 when 17-year-old Joseph McCullough received a new liver, giving him a chance at a new life after battling primary sclerosing cholangitis, a life-threatening disease that causes end-stage liver disease. McCullough was at last month’s celebration and thanked everyone in the crowd.

“When I was little, I loved Super Heroes. Today, I know who the real Super Heroes are and that’s you,” McCullough said. “I am honored to be up here to say thank you and that transplantation is a beautiful process.”

Other transplant recipients in the audience were Amelia Hicks and Carson Kainer. Amelia received a heart transplant when she was an infant. She is now a thriving kindergartener. Kainer received a kidney transplant at Texas Children’s as a young adult and became the first professional baseball player to play after an organ transplant.

“I got to live out my dream after my transplant because of you here today,” Kainer said. “Thank you so much for what you’ve done, what you do today and the lives you will impact in the future.”

When Dr. John Goss, medical director of Transplant Services and surgical director of the Liver Transplant Program at Texas Children’s, took the podium, he thanked all of the donors who make the transplant process possible and his team for making stupendous strides in a complex field.

“I want you to understand how special you are,” Goss said. “We do a lot of very complex procedures here and we’ve gone from doing about 20 a year to around 100 and I foresee us doing even more in the future.”

For more information about Texas Children’s Transplant Services, click here. To register to become an organ donor, click here.