Surgery – Page 28 – Texas Children's News

May 11, 2015

Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your subsmissions and feedback.

April 28

Countdown to ICD-10: Deadline to meet educational requirements is September 1

On October 1, Texas Children’s and hospitals across the nation will switch from ICD-9 to the ICD-10 coding system to report patients’ diagnoses and procedures. The ICD-10 codes will allow greater specificity and accuracy in describing a patient’s diagnosis and classifying inpatient procedures. Texas Children’s education teams have developed helpful tools to ensure all employees are prepared for this mandatory conversion.

“We believe that communicating the change clearly and consistently will help ensure a smooth transition,” said Texas Children’s Chief Safety Officer Dr. Joan Shook. Read more

April 28

Super Star Physician: Dr. Stephanie Marton

Dr. Stephanie Marton from the Center for Children and Women – Greenspoint is the latest Texas Children’s Super Star physician. “Every day I see patients coming in to the Center, and I directly see the impact that Texas Children’s Hospital is making in this community.” Read more

April 28

Giardino to serve on ABMQ Board of Directors

Texas Children’s Chief Quality Officer and Senior Vice President Dr. Angelo Giardino was recently unanimously confirmed to serve on the American Board of Medical Quality (ABMQ) Board of Directors. The organization is closely associated with the American College of Medical Quality of which Giardino is a distinguished fellow. Read more

April 28

Patel receives distinguished fellowship award

Dr. Akash Patel will be presented with the 2015-2016 Christopher R. Getch Fellowship Award from the Congress of Neuroligical Surgeons Fellowships Committee during its annual meeting in September. This prestigious award provides $100,000 for advanced training and is given to a neurosurgeon or fellow engaged in clinical research that promises to significantly impact the field of neurosurgery. Read more

April 28

Dr. George Bisset receives prestigious award

Radiologist-in-Chief Dr. George Bisset will be honored for his contribution to pediatric radiology at the 45th annual Sociedade Paulista de Radiologia (SPR) meeting held in Brazil. The conference is the biggest diagnostic imaging meeting in Latin America and the fourth largest in the world. Bisset will be the first non-Brazilian to receive honorary membership in this organization. Read more

April 21

New Cain Labs website promotes groundbreaking epilepsy research

Texas Children’s has launched a new website dedicated to innovative epilepsy research conducted at the Cain Foundation Laboratories in the Jan and Dan Duncan Neurological Research Institute and other test centers around the world. The website also includes a repository of helpful information about epilepsy treatment programs for patients and their families, including a link to Texas Children’s Level IV Epilepsy Center. Read more

April 21

Surgeon-in-chief speaks at Texas Surgical Society meeting

Surgeon-in-Chief Dr. Charles D. Fraser, Jr. spoke at a Texas Surgical Society meeting on April 11 in Galveston. Fraser, who is the son-in-law of Dr. Denton A. Cooley, talked about the hospital’s 60-year history of pediatric heart surgery and the roles played by Cooley and himself. More

April 20

Texas Children’s Hospital helps determine standard of care for children with cleft lip and palate

Representatives from Texas Children’s Hospital: Dr. Laura Monson, pediatric plastic surgeon; Christy Hernandez, director of the Texas Children’s Hospital Outcomes and Impact Service; and Dr. John Wirthlin, craniofacial orthodontist, joined an international group of medical professionals, patients and parents to determine a standard set of outcome measures for children born with cleft lip and palate. These guidelines will help all institutions develp a standard treatment of care of this population of patients and will be available for implementation starting in February. Read more

April 14

Lee recognized for his contribution to fetal imaging advancements

Dr. Wesley Lee, co-director of Texas Children’s Fetal Center and section chief for women’s and fetal imaging at Baylor College of Medicine, recently received the William J. Fry Memorial Lecture Award from the American Institute of Ultrasound in Medicine (AIUM). Read more

April 14

New PAPRs help provide full complement of PPE

Texas Children’s recently acquired 30 powered air purifying respirators (or PAPRs) to protect emergency responders from chemical, biological, radiological and nuclear agents. This addition to our PPE inventory helps ensure the safety of our health care professionals when they are treating patients with highly contagious infectious diseases. Read more

April 14

Texas Children’s, AAP partnership helps physicians advocate for their patients

Texas Children’s and the American Academy of Pediatrics (AAP) signed a first-of-its-kind partnership agreement whereby every eligible faculty member of the Baylor College of Medicine Department of Pediatrics is a member in the AAP and the Texas Pediatric Society (TPS). Since this partnership began a year and a half ago, the following Texas Children’s faculty have been actively involved with the AAP and TPS to champion the health, safety and well-being of children: Dr. Robert Voigt, Dr. Robert Ricketts, Dr. Mark Gilger, Dr. Fernando Stein, Dr. Carol Tapia, Dr. Mark Ward, Dr. Krithka Lingappan and Dr. Bruno Chumpitazi. Read more

April 14

Texas Children’s Hospital receives Healthcare Informatics Magazine’s 2015 Innovator Award

Texas Children’s Hospital has earned second place in Healthcare Informatics Magazine’s fourteenth annual Innovator Awards. The award was given to Texas Children’s for its quality improvement work to identify, deploy and measure new best practices and improve outcomes for children with appendicitis.

“We felt there was an urgent need in the health care industry to accelerate the identification and deployment of shared guidelines of care,” said Dr. Charles Macias, Texas Children’s Chief Clinical Systems Integration Officer and Evidence Based Outcomes Center director. Read more

April 14

New pediatric urologist joins Department of Surgery

Dr. Duong Dai Tu has joined Texas Children’s as a new pediatric urologist. Tu, who started April 1, has been appointed assistant professor of urology and attending surgeon in urology at Baylor College of Medicine.

“Dr. Tu is bringing an exciting vision to the surgery team that will help us continue to develop a preeminent program, enabling us to better serve our patients and their families,” chief of Urology, Dr. David Roth said. Read more

April 7

Texas Children’s welcomes new surgeon and researcher, Dr. Sundeep Keswani

Dr. Sundeep Keswani joined Texas Children’s as a pediatric and fetal surgeon and an associate professor at Baylor College of Medicine. He also is the principal investigator of a National Institutes of Health (NIH) funded laboratory. Read more

April 7

Transplant team perform 95 organ transplants in 2014

Transplant teams with Texas Children’s Hospital performed 95 solid organ transplants in 2014, continuing to serve as one of the largest, most active and successful pediatric transplant programs in the nation. The heart and the lung transplant programs were the largest in the country last year with 32 heart transplants and 16 lung transplants.

“Texas Children’s Transplant Services continues to earn its reputation as one of the best pediatric transplant programs in the country,” said Dr. John Goss, medical director of Transplant Services. Read more

April 7

CRC presents resarch award to Dr. Srivaths

The Clinical Research Center presented the Clinical Research Award for First Quarter 2015 to Dr. Poyyapakkam Srivaths, Department of Pediatrics – Renal, Baylor College of Medicine. Dr. Srivaths’s research activities in the CRC focus on investigating cardiovascular morbidity associated with end stage renal disease (ESRD) in children. Read more

April 21, 2015

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Surgeon-in-Chief Dr. Charles D. Fraser, Jr. spoke at a Texas Surgical Society meeting on April 11 in Galveston. Fraser, who is the son-in-law of Dr. Denton A. Cooley, talked about the hospital’s 60-year history of pediatric heart surgery and the roles played by Cooley and himself.

In 1954, Texas Children’s Hospital opened, and soon thereafter, Cooley initiated a surgical program for children with congenital heart disease. Initial efforts focused on palliative procedures, including the Blalock-Taussig Shunt, followed by early intracardiac repairs using the heart-lung bypass machine.

Texas Children’s was quickly established as a center for the development of surgical techniques for children with all forms of cardiac disease. In 1995, an integrated, dedicated children’s heart center was developed by Fraser, adding additional focus on complex repairs, particularly in newborn babies.

Since the inception of the program in 1954, there have been more than 27,000 cardiac operations performed at Texas Children’s, including successive increases in case volume in each decade. In the present era, more than 20 percent of patients are newborns and 50 percent are infants.

To provide every available therapeutic option, a pediatric cardiac transplant program was initiated in 1984 and to date, more than 325 pediatric heart transplant operations have been performed. In 2001, a lung transplant program was opened and to date, 165 pediatric lung transplants have been performed.

Each decade has seen increasing case volumes and complexity, but with steadily improved mortality rates, now consistently <2 percent and specifically <1 percent in 2014, which is well above the national average of 3 percent.

April 14, 2015

41515TuDuong175 Texas Children’s Hospital is excited to announce Dr. Duong Dai Tu has joined the hospital as a new pediatric urologist. Tu, whose appointment was effective April 1, also has been appointed assistant professor of urology and attending surgeon in Urology at Baylor College of Medicine.

Tu’s clinical interests include complex urogenital reconstruction, such as treating patients with spina bifida, hypospadias and disorders of sexual differentiation. His research will focus on improving the quality and safety of care for such patients and developing stronger outcomes for pediatric patients with both acute and chronic urologic conditions.

Dr. Tu is trained in the pediatric robotic surgery program and has experience with the da Vinci Si Surgical System. Through the use of robotic surgery, surgeons are able to perform minimally invasive reconstructive procedures in patients of all ages.

Tu earned his bachelor’s degree from the University of Missouri and his medical degree from The University of Texas Medical Branch in Galveston, Texas. He completed his surgical training at St. Louis University Hospital and urologic residency at Columbia University Medical Center/New York Presbyterian Hospital. Additionally, he completed his pediatric urology fellowship at Harvard Medical School and Boston Children’s Hospital.

The Texas Children’s Urology Division offers the most advanced surgical care for routine urological needs, as well as genitourinary problems related to congenital birth defects, trauma and a range of other medical conditions. The team has special expertise in minimally invasive, laparoscopic surgical techniques, including extremely delicate procedures in newborns and infants, anorectal malformations, urological conditions caused by neurological problems, such as spina bifida, and management of stone disease.

April 7, 2015

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Texas Children’s Hospital is excited to announce the addition of Dr. Sundeep Keswani. Keswani, whose appointment was effective March 2, is a pediatric and fetal surgeon at Texas Children’s and an associate professor at Baylor College of Medicine. He is also the principal investigator of a National Institutes of Health (NIH) funded laboratory.

“I am thrilled to welcome Dr. Keswani to our team,” said Dr. Jed Nuchtern, chief of the division of pediatric surgery at Texas Children’s Hospital and professor of surgery and pediatrics at Baylor. “Dr. Keswani provides expertise in several important areas that our division is expanding or creating. These include fetal diagnosis and therapy, pediatric wound care and general pediatric surgery. He also brings a significant NIH-funded research effort that will be a substantial addition to our current research portfolio.”

Keswani completed his surgical residency at Louisiana State University in his hometown of New Orleans and a fellowship in fetal surgery and surgical research at The Children’s Hospital of Philadelphia and the Hospital of the University of Pennsylvania. He subsequently trained in pediatric surgery at the Saint Louis Children’s Hospital and the Washington University School of Medicine.

Keswani’s research interests closely pair with his clinical interests and include fetal regenerative wound healing, gene therapy applications, bone marrow contribution to tissue repair and fetal diagnosis and treatment. Currently, he is the principle investigator of a R01 and K08 grant from the National Institute for General Medical Sciences at the NIH. The goal of his research is to understand the underlying mechanisms of how the fetus heals without scarring to achieve postnatal regenerative tissue repair in various organ systems.

Texas Children’s division of pediatric surgery is one of the most robust pediatric surgery programs in the country with 16 full-time pediatric surgeons on staff. The range of surgical procedures performed by the division include fetal surgery, abdominal and thoracic surgery, pediatric surgical oncology, minimally invasive surgery including laparoscopic and thorascoscopic diagnosis and treatment, endocrine and biliary surgery, and adolescent bariatric surgery. In 2014, the division of pediatric surgery completed 5,792 surgeries and 11,809 clinic visits.

Texas Children’s Fetal Center works hand-in-hand with the division of pediatric surgery and is committed to providing the best possible care and outcome for each mother, baby and family. The core staff of Texas Children’s Fetal Center includes fetal and pediatric surgeons, maternal fetal medicine specialists and specialized coordinators. The Fetal Center’s physicians are recognized leaders in fetal medicine and fetal and neonatal surgery. As one of only a few centers in the United States to provide the full spectrum of fetal therapies, Texas Children’s attracts parents from around the world seeking the ultimate in care for their unborn child.

March 31, 2015

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One month after their successful separation surgery, Knatalye and Adeline Mata are progressing well as two separate little girls.

Knatalye can breathe on her own and was recently transferred to the Progressive Care Unit where she will resume her recovery. Her sister, Adeline, is still on a ventilator in the Pediatric Intensive Care Unit (PICU), but her doctors remain optimistic that she will breathe on her own just like her twin.

“Knatalye’s progress has been a tiny bit faster than Adeline, but it was just because of where they started out,” said Dr. Darrell Cass, co-director of Texas Children’s Fetal Center. “We’re still in the acute recovery phase of care where we’re working on breathing, sedation and pain management and working on their intestinal function.

Prior to the girls’ separation surgery, Knatalye and Adeline spent the first 10 months of their life in the Neonatal Intensive Care Unit (NICU) where they received daily care from their team of NICU nurses. To adequately prepare them for their separation surgery, the NICU nurses helped engineer a custom bed space for the girls in the NICU and collaborated with Hanger Clinic, to devise a swing that would safely keep the twins upright for a large portion of each day after their tissue expanders were in place.

“We emotionally, physically and intellectually invested a lot of care in the girls,” said Alex Luton, a clinical nurse specialist at Texas Children’s Newborn Center. “I know it was a difficult but necessary transition for them to go to the PICU.”

To ensure a smooth transition of care for the girls and their family, the NICU nurses partnered with the PICU team before and after the separation surgery.

“We sent a couple of nurses per shift for the first few days post operatively to kind of be there as a familiar face for the family as they began to build their relationships with nurses in the PICU,” Luton said.

Each of the babies had a PICU nurse and a NICU nurse for the first few days after separation surgery.

“As they stabilized and their condition improved, one nurse was assigned for each baby,” said Shannon Holland, assistant director of nursing in the PICU. “Now, they have one nurse for the two babies together.”

In addition to receiving around-the-clock care from the PICU nurses, Knatalye and Adeline receive therapy every day – physical therapy in the morning and occupational therapy in the afternoon to optimize their muscle development and motor coordination.

“We are practicing a lot of reaching and grabbing using both hands, bringing their hands together, banging toys together, visual tracking, “said Texas Children’s occupational therapist Chelsea Pierce.

Texas Children’s physical therapist Frank McCormick assists the girls with head control, trunk control, stretching, range of motion and working with their feet.

“The sessions are dictated by kind of what they can tolerate,” McCormick said. “Usually 30 minutes is a window, but if they can go further and are still awake and participative, then it can go upwards of 45 minutes to an hour.”

While Knatalye and Adeline’s recovery will take some time, their doctors are optimistic about their future.

“We would expect their gait, their walking stride, to be somewhat altered initially,” Cass said. “We’ll have to monitor them. With some therapy, we’re optimistic that they will be able to walk and live a normal life.”

Texas Children’s Surgeon-in-Chief Charles D. Fraser also shares that same spirit of optimism.

“This is another example of why a case like this should be done at Texas Children’s because we have the team and expertise to handle complex medical conditions,” Fraser said. “I am very, very confident that we will continue to move them on a positive recovery trajectory.”

Connect videos of the Mata twins:

Voices of Nursing: NICU nurses’ reflection on caring for the Mata twins

Hope, faith and expertise: Surgical team leads historical Mata conjoined twins surgery

3D Model of Mata twins helps surgeons prepare for girls’ separation

Positioning team designs, builds swing to help conjoined twins sit up

Mata conjoined twins take first step toward separation with tissue expansion

March 24, 2015

32415PedSurgeryFINAL900 — Click on the image for a larger view.

The Department of Surgery at Texas Children’s Hospital represents a dedicated team of more than 80 pediatric-focused surgeons representing at least 9 different subspecialties. Another 600 employees help make up the department, which is dedicated to caring for and improving the health of children through patient care, education and research.

The surgical team treats children in and around the greater Houston area via our five Health Centers and two, soon to be three, hospitals. It also sees patients at other hospitals around the country and the globe. Annually, Texas Children’s surgeons perform 25,000 operative cases and 115,000 clinic visits, including 90 fetal procedures and about 20 neurological laser ablations.

“We have a tremendous team here,” said Surgeon-In-Chief Dr. Charles D. Fraser, Jr. “The scope and breadth of expertise, that gets fielded here every single day is amazing.”

Click on the picture to the right to see more fast facts about Surgery.

March 17, 2015

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Dr. Howard Epps, assistant chief of Orthopaedic Surgery and medical director of Pediatric Orthopaedics and Scoliosis, was recently appointed leadership positions in two orthopaedic surgery professional organizations.

Epps will join the Board of Directors of the American Academy of Orthopaedic Surgeons as a member-at-large Thursday, March 26 and he will become president of the Texas Orthopaedic Association Saturday, April 18.

“I am honored to have been named to two such distinguished positions,” Epps said. “I take my responsibility with these organizations very seriously and will work hard in these leadership roles to continue to place the field of orthopaedic surgery at the forefront of modern medicine.”

Founded in 1933, the American Academy of Orthopaedic Surgeons is the preeminent provider of musculoskeletal education to orthopaedic surgeons and others in the world. Its continuing medical education activities include a world-renowned annual meeting, multiple CME courses held around the country and at the Orthopaedic Learning Center, and various medical and scientific publications and electronic media materials. The Board of Directors manages the affairs of the academy and the association. It is the administrative authority of the academy and the association and considers all of its activities and determines its policies.

The Texas Orthopaedic Association was founded in 1936 as the united voice of orthopaedic surgeons in the state. Its mission is to ensure outstanding musculoskeletal health for Texans.

Epps is renowned as a leader in the field of pediatric orthopedics, distinguishing himself in a variety of research, clinical and academic roles. His clinical interests include limb deformity and reconstruction, fractures, clubfoot, musculoskeletal infection and cerebral palsy, which led him to author more than 35 book chapters and publications in various academic and medical journals.

After earning an undergraduate degree from Harvard University, Epps received his medical degree from Johns Hopkins University School of Medicine. He did an internship in general surgery at Massachusetts General Hospital and his residency at the Harvard Combined Orthopaedic Surgery Residency Program. Epps also completed a fellowship in pediatric orthopaedic surgery at the Hospital for Sick Children in Toronto, Canada.

In 2002, Epps was an American Academy of Orthopaedic Surgeons Leadership Fellow and has served on the academy’s Patient Safety Committee, Nominating Committee, the Member Communications Oversight Group, the editorial board of AAOS Now, and the Board of Specialty Societies Health Policy Committee.

Epps currently serves as vice present of the Texas Orthopedic Association and secretary of the Pediatric Orthopaedic Society of North America.

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