February 4, 2019

On February 1, Texas Children’s officially welcomed Dr. Brian Smith as the new chief of the Division of Orthopedic Surgery.

“I am delighted that Dr. Smith has joined the Texas Children’s family,” said Surgeon-in-Chief Dr. Larry Hollier. “We believe he will provide seasoned leadership and mentorship for our Orthopedic Surgery faculty and staff.”

As chief of the Division of Orthopedic Surgery, Smith now helms one of the premier pediatric orthopedic surgery programs in the nation, with extensive expertise in the treatment of a variety of conditions, from minor fractures and sports-related injuries, to complex trauma and congenital and developmental disorders.

“I am honored and humbled to join the faculty at one of the very best children’s hospitals and pediatric orthopedic surgery programs in the country,” said Smith. “This division is poised to rise to an even higher level, and I couldn’t be more excited to help it get there.”

Smith joins Texas Children’s from Yale New Haven Children’s Hospital, where he served as Director of Pediatric Orthopedics for the past 11 years and also as Interim Surgeon-in-Chief from 2011 to 2012. Additionally, he served as Yale School of Medicine’s Orthopedic Surgery Residency Director from 2012 to 2018, with 25 residents and rotations at five area institutions.

Smith earned his medical degree and completed his orthopedic residency at Georgetown University School of Medicine before serving four years in the U.S. Air Force as an orthopedic surgeon, where he held the rank of major. He then completed a fellowship in pediatric orthopedic surgery at Boston Children’s Hospital.

Clinically, Smith’s primary interests are spinal deformities and spine surgery. Research interests include spinal deformity in children, maturity indicators in children to assess risk of scoliosis progression, and neuromuscular disorders and fractures.

An active member of the orthopedic professional community, Smith has served on the Board of Directors for the American Academy of Orthopaedics and the orthopedic section of the American Academy of Pediatrics. He has also been health council chair for the Pediatric Orthopaedic Society of North America and chairman of the ethics committee for the Scoliosis Research Society.

In addition to his clinical and research expertise, Smith brings a bright vision of the future for the Division of Orthopedic Surgery.

“My goal is to help us achieve even greater recognition as one of the preeminent destinations nationally and internationally for pediatric orthopedic care,” Smith said. “The opportunity to help this team reach new heights in terms of improving patient care and outcomes, facilitating research, and educating the next generation of pediatric orthopedists is incredible, and I’m looking forward to meeting the challenge.”

Learn more about the Division of Orthopedics and the services we offer.

December 18, 2018

For Lauren Meredith and her family, this holiday season has been a time of joy and gratefulness after the care and expertise they received from the experts in Texas Children’s Colorectal and Pelvic Health Program. It stands in sharp contrast to the nightmare she and husband, Ryan, experienced a year ago when their third child, Ava, was born with a rare congenital disorder of the colon that doctors thought would make her unable to pass stool. With sparse information and little time to weigh their options, the anxious parents had to make the quick decision to have Ava transported to a hospital in the Texas Medical Center for surgery – a colostomy – which she underwent at just 12 hours old.

Unfortunately, their long, hard journey was only beginning.

“We were sent home with relatively little information on how to properly care for her,” Meredith said. “I was making 10 to 15 calls a day to the doctor’s office, the insurance company and the medical supply company, but no one was helping. We felt completely alone and unprepared to tackle this complex medical issue.”

At a breaking point, Lauren began a search for help and answers online, where she first read about Texas Children’s Colorectal and Pelvic Health Program. On Christmas Eve 2017, she sent an email to Dr. Timothy Lee, pediatric surgeon and program director, explaining their ordeal.

The next day, the Merediths got their own holiday miracle.

“Dr. Lee emailed me back – on Christmas Day – and three days later we had our first appointment,” Meredith said. “The care, from the minute we walked in, was like stepping into a different world. The communication was incredible. I really felt like I was being heard for the first time.”

In August 2018, the colorectal and pelvic health team performed an operation to repair Ava’s initial defect and assess her gynecologic anatomy. And this past November, Ava had her colostomy reversal. Her prognosis is excellent.

Today, Ava – who turned one year old on December 13 – is a happy, healthy little girl who loves when her older brothers, Jackson and Greyson, sing to her and build forts for her to play in. She loves to snack, especially tacos. And she loves cuddles with her dad when he gets home from work.

“The team at Texas Children’s has given us so much to be thankful for,” Meredith said. “They took the burden off us and made us feel like they were on our side. We could tell from the very beginning that the entire Colorectal and Pelvic Health Program cared about Ava and wanted the best outcome.”

The full spectrum of care

A child’s diagnosis with a congenital disorder of the colorectal and urogenital system can be a heartbreaking and trying ordeal for families. Since these conditions are rare and often complex – and because no two cases are exactly alike – some institutions may lack the expertise necessary to provide effective treatment.

Fortunately, a highly skilled, multidisciplinary team of specialists at Texas Children’s Hospital offers patients and families the full spectrum of care for these disorders in our Colorectal and Pelvic Health Program.

Watch the video to learn more.

The Colorectal and Pelvic Health Program comprises four different specialties – pediatric surgery, pediatric urology, pediatric and adolescent gynecology, and gastroenterology – and provides treatment for several disorders and developmental anomalies, including imperforate anus, hirschsprung’s disease, cloacal malformation, cloacal exstrophy, and severe idiopathic constipation.

Regardless of the disorder, the team works together to develop a customized approach to care for these complex, and often sensitive, medical issues.

“Many of these conditions can have an extreme negative impact on the self-esteem of a child,” said Dr. Paul Austin, director of Texas Children’s Complex Urologic Reconstruction Program. “Knowing that we can make a positive difference through the care that we provide is extremely rewarding.”

Specialists collaborate to identify the patient’s specific issues and determine the best path to a positive outcome and improved quality of life, whether through surgery, medication or some combination of treatments. Additionally, the team has focused on improving patient care through clinical research and development of best practice pathways to standardize and streamline clinical care for this complex patient population.

“This hallmark of the program is providing multi-disciplinary collaborative care,” said Lee, pediatric surgeon and program director. “Even though these conditions aren’t common, we’ve seen more and more of them at Texas Children’s as our patient volume has grown. Parents can be confident when they come to us that they will be receiving truly comprehensive, collaborative care delivered by experts who have been treating these kinds of patients for years.”

Learn more about the Colorectal and Pelvic Health Program.

December 11, 2018

On December 3, a multidisciplinary surgical team at Texas Children’s Hospital The Woodlands became the first to perform a spine surgery at one of our community hospital locations. The 17-year-old patient was able to go home just two days later, a testament to the expertise and precision of the surgical team.

“This is a milestone for Texas Children’s and our patients,” said Surgeon-in-Chief Dr. Larry Hollier. “We have one of the largest teams of pediatric spine surgeons in the United States. We have the capacity in terms of expertise. Now we’re excited to expand that capacity to accommodate the growing demand in the areas surrounding Houston.”

Greater Houston is one of the fastest-growing metropolitan areas in the country. As the communities around Houston continue to grow, so do the needs of our patients – including the need for spine surgery, specifically for idiopathic scoliosis (the most common form of the spine abnormality). A review of comparative patient data and geographic analysis by teams at Texas Children’s revealed that a large number of patients with idiopathic scoliosis were coming to us from The Woodlands and other communities outside Houston.

“For the past couple of years, our patients and families from The Woodlands were traveling down to our medical center campus for all pre-operative visits and surgeries – and our teams were traveling there as well,” said Dr. Jeffrey Shilt, chief surgical officer at Texas Children’s Hospital The Woodlands. “We decided the best thing for our patients was to offer the same spine surgery expertise they would get at the medical center campus at our community hospital locations.”

Hospital leaders began laying the groundwork to grow Texas Children’s spine surgery capacity, first in The Woodlands and then at West Campus (March 2019). A team in The Woodlands led by Ketrese White, director of Patient Care Services in The Woodlands, Ramon Enad and Roxanne Vara, Assistant Clinical Directors, and Valencia Gant, Assistant Director of Ambulatory Services, began developing an expansion plan to ensure seamless work flow processes and to improve the patient experience.

“Previously, access to this kind of care was limited outside of the Texas Medical Center,” Enad said. “With increased surgical capacity, we will be able to schedule patients in a timely fashion and offer world-class surgery that’s closer to where they live.”

The expansion process has required multidisciplinary collaboration at every step and has included personnel from: Surgery, Anesthesia, Blood Bank, Nursing (perioperative and acute care), Admissions, Physical Therapy, Pediatric Radiology, Business Operations, and leadership from all hospital campuses.

Once the necessary infrastructure was in place in The Woodlands, including new surgical personnel and equipment, it was time to start testing the new system via Texas Children’s Simulation Center, which uses various scenarios to assess surgical space, processes, equipment and resources, and personnel roles.

The simulations followed the patient throughout the surgical journey, from check-in to the operating room to recovery, which is crucial for gauging needs and building capacity. Simulations provide a full picture of capabilities and allow teams to review lessons learned, and to see if any adjustments or enhancements need to be made to the process flow.

“This simulation and the first surgery were the culmination of months of meticulous planning, preparation and testing, with all stakeholders engaged across the organization,” said White. “This really was a multidisciplinary effort borne out of a commitment from everyone involved.”

The spine surgery expansion is just the latest effort in Texas Children’s ongoing mission to improve access for patients and families, to boost the patient experience, and to provide the best possible care for all who need us.

“It is our mission to provide our care and services in the safest, most convenient way possible,” Hollier said. “Bringing more complex procedures out of the Texas Medical Center and closer to home for thousands of our patients and families is, and will continue to be, a central focus for us.”

On November 30, faculty and staff from Texas Children’s Department of Surgery and Perioperative Services gathered for the inaugural presentation of the Department of Surgery Insight Series. The new series of inspirational lectures, given by well-known speakers, was created as a way to foster personal development within the department.

“We are so lucky to be able to do what we do every day for these children, and the professionals here at Texas Children’s do it with unmatched levels of skill, kindness and dignity; but it can exact a toll both physically and emotionally,” said Surgeon-in-Chief Dr. Larry Hollier. “Seeking inspiration in what we do and where we are is important to help ease these burdens. The purpose of these talks is to inspire our faculty and staff, and to teach them new ways to approach their professional and personal lives.”

If the first presentation of the series was any indication, members of the Department of Surgery have much to look forward to.

The afternoon’s speaker was Ronan Tynan – physician, multiple medal-winning and record-setting Paralympian, and member of the renowned singing group, The Irish Tenors – whose fascinating personal story of triumph in the face of adversity had the audience laughing one moment and crying the next.

Tynan, who grew up in Ireland, was born with a lower limb disability that caused both his legs to be underdeveloped. However, this didn’t hinder Tynan from leading an active childhood on his family’s farm, where his favorite activities were horseback riding and racing motorcycles. Another setback occurred when Tynan was twenty and both legs had to be amputated due to serious complications following an auto accident. But in only a few weeks, he was bounding up flights of stairs on prosthetic legs, and within a year, he was winning medals and setting world records in the Paralympics. After his success as an athlete, Tynan set his sights on yet another goal – to become a physician – and earned a degree from Trinity College, specializing in orthopedic sports injuries.

That impressive résumé would be the dream of many, but Tynan was just getting warmed up. At the encouragement of his father, he decided to pursue another passion – singing. Shortly after beginning his formal training, he won a string of vocal competitions and awards, which ultimately led to his big break with the chart-topping trio, The Irish Tenors.

Tynan cited the importance of relationships in our lives. He cited the encouragement and support of others as a driving force behind his many personal victories, and reminded the audience that preparation, belief in one’s self and abilities, and the willingness to take chances are necessary parts of growing, succeeding and finding happiness.

“We are so honored to have had Dr. Tynan with us for this special presentation,” said Hollier. “His amazing story, and the fact that he has chosen to be happy despite, or perhaps because of, the challenges he’s faced, is an inspiration and lesson all of us can learn from.”

December 3, 2018

Texas Children’s Hospital is excited to welcome Dr. Anna Messner as the new chief of the Division of Otolaryngology.

“Dr. Messner has a strong, clear vision for moving the Division of Otolaryngology to the next level,” said Surgeon-in-Chief Dr. Larry Hollier. “She is prepared to position Texas Children’s Otolaryngology clinics as a premier destination for subspecialty care.”

As chief of Otolaryngology, Messner will helm the largest group of pediatric otolaryngologists in the nation. She brings with her a collaborative, patient-focused approach to care, as well as a strong interest in training the next generation of ENT subspecialists. One of her main areas of focus will be working with each surgeon to help them develop their talents and grow in their professional career.

“Texas Children’s is a world leader in pediatric health care and I am delighted to be joining the team,” said Messner. “My goal for the Division of Otolaryngology is to be the leader in high-quality, efficient care for children with otolaryngology conditions and the premier training program for pediatric ENTs.”

Messner also plans to leverage Texas Children’s high clinical volume to develop and execute innovative new research studies around the care of children with common ENT disorders.

“The dramatic expansion of Texas Children’s Otolaryngology program in recent years creates an opportunity not only to improve patient care, but also to conduct groundbreaking research that can’t be done elsewhere,” Messner said. “We have the potential to become a national research hub that drives how children with these conditions are cared for, both now and in the future.”

Messner comes to Texas Children’s from Stanford University Medical Center, where she served as professor of Otolaryngology and Pediatrics and vice chair of the Department of Otolaryngology. She was also previously the Chief of Pediatric Otolaryngology at Lucile Packard Children’s Hospital Stanford and program director for the Otolaryngology Residency at Stanford University Medical School.

A nationally recognized leader in Pediatric Otolaryngology, Messner is president-elect of the American Society of Pediatric Otolaryngology (ASPO). She is also a member of the ACGME Otolaryngology Residency Review Committee and has been a guest examiner for the American Board of Otolaryngology Oral Exams.

Messner is a graduate of Wake Forest University School of Medicine, where she also completed her residency and internship. She completed an otolaryngology fellowship at the Hospital for Sick Children in Toronto.

She will begin her new role on January 14, 2019.

About Otolaryngology at Texas Children’s
Texas Children’s is home to largest pediatric otolaryngology program in the United States, providing advanced surgical and medical care for the entire spectrum of ear, nose, throat, and head and neck diseases and disorders. We are distinguished by wide range of clinical expertise across specialty areas including:

  • Cleft lip and palate
  • Cochlear implantation
  • Complex airway surgery
  • Down syndrome
  • Head and neck surgery
  • Laryngology
  • Microtia and atresia
  • Otology and neurotology
  • Rhinology
  • Sleep medicine
  • Tracheostomy care
  • Vascular anomalies

Our team of surgeons and advanced practice providers offers a comprehensive range of services at all three Texas Children’s Hospital locations, as well as five other Texas Children’s Specialty Care locations in the Houston metropolitan area. We see approximately 40,000 patients in clinic and perform more than 10,000 surgeries each year – and we’re still growing.

Learn more about Texas Children’s Division of Otolaryngology.

November 12, 2018

Eighteen-year-old Angeles Vasquez was anxious and scared. For months, a painful wound had lingered on her right ankle. No matter what remedy she and her family tried, it just wouldn’t heal. Unable to find answers or relief elsewhere, they turned to Texas Children’s Hospital and our new pediatric Wound Care Clinic, a new initiative spearheaded by Chief of Plastic Surgery Dr. Edward Buchanan and Director of Surgical Advanced Practice Providers Ryan Krasnosky.

“Dr. Buchanan and Ryan were awesome,” Vasquez said “They gave me the medications I needed and taught me how to properly clean and care for the wound. It’s finally healing and they’re still checking in with me all the time to make sure I’m okay.”

The new Texas Children’s Wound Care Clinic – one of only a few in the country, and the first and only one of its kind in Texas – is a comprehensive center where patients can have a variety of wounds evaluated and treated by an experienced, multidisciplinary team of dedicated medical, surgical, nursing and advanced practice providers.

The team uses evidence-based, standardized treatment protocols – which are under constant scientific scrutiny – to develop individualized treatment plans for each patient. These care plans take into account factors such as wound origin and location, as well as patient and family lifestyle, to determine the best approach to maintenance and to prevent future wounds. Additionally, data from each case is carefully analyzed with the dual goals of improving clinical processes and ensuring care protocols provide the best possible outcomes.

“There is a huge need for this kind of care in Houston and across the United States,” said Buchanan. “We want to lead the way in pediatric wound care on the national level, developing scientifically supported protocols that become the standard of pediatric wound care. With our clinical volume and our dedication to treating these patients, we’re strategically positioned to accomplish this goal.”

Experts in the Wound Care Clinic currently see patients from across the Texas Children’s system at our Texas Medical Center campus, providing high-quality care for a wide range of conditions, including:

  • Animal bites
  • Chronic wounds
  • Deep pressure wounds and ulcers
  • Fragile skin and other skin issues
  • Gastrostomy or other tube issues
  • Soft tissue infections
  • Thermal skin injuries (that do not meet criteria for burn transfer)
  • Trauma
  • Wounds in babies with congenital anomalies

“These wounds are often complex and can take quite some time to heal,” said Surgeon-in-Chief Dr. Larry Hollier. “It’s wonderful for a patient to be able to see a team that has all the expertise and products available to heal these wounds in a timely fashion. Additionally, we have the ability to perform minor procedures to speed along the healing and are also able to directly schedule surgeries from the clinic if necessary.”

Still in its beginning phase, the clinic is currently held one day a week. However, in the months since the clinic’s opening, there has been a rapid increase in patient volume, and preliminary plans are already being made for expansion to West Campus and The Woodlands.

“The growth in volume is a testament to the high-quality care our patients are receiving,” Krasnosky said. “Families have been extremely pleased with the care we’re providing and they’ve voiced their appreciation for having a consistent ‘home’ for wound care.”

As the clinic grows, teams will continue to analyze data and lessons learned in order to further standardize clinical processes and care protocols. Long-term goals include the introduction of same-day surgical interventions, for wounds that require more invasive treatment. There are also plans for the integration of a comprehensive research component, with a basic science emphasis on wound healing and clinical research efforts focused on developing evidence-based wound care guidelines, as well as the creation of novel wound treatments and care assessment tools.

In the meantime, clinic care teams are laser-focused on providing the best possible wound care and improving outcomes for every patient who comes to us.

“The Wound Care Clinic is open to any and all wounds that practitioners need assistance with,” Buchanan said. “We hope to get involved early in the care of pediatric wounds within the Texas Children’s system, so as to decrease the time to healing and improve the quality of life of our patients. As our clinic expands, our capacity will expand, and we will be able to provide services to all patient populations. No wound is too trivial or small for an evaluation.”

November 6, 2018

A team of Texas Children’s surgeons, anesthesiologists and perioperative staff recently traveled to Malawi and Uganda to provide surgical care for children with cancer and congenital anomalies as part of Texas Children’s Cancer and Hematology Centers’ Global HOPE program. This was one of the first coordinated trips under the new Division of Global Surgery.

Dr. Jed Nuchtern, chief of Global Surgery, Dr. Bindi Naik-Mathuria, pediatric surgeon and Trauma medical director, Dr. Titi Aina, pediatric anesthesiologist, and operating room nurse Anita Hadley worked alongside local surgical teams to provide much-needed surgical care for area children, many of whom had been waiting months for experienced doctors and nurses who could treat their conditions. The team helped complete more than 30 operations, including 10 nephrectomies for Wilm’s tumor, the most common form of pediatric kidney cancer, effectively providing a cure for these children.

“I am so proud to be able to share the talents of our surgical teams by going abroad,” said Nuchtern. “Not only are we able to treat these children who are in great need of surgery, but we are also able to educate the doctors and surgical teams from these countries. The collaborative efforts of Surgery, Anesthesia and the Cancer Center continue, as future trips have already been planned, and we will add to our traveling surgical teams as the Division of Global Surgery grows.”

The Division of Global Surgery, created this past August, expands Texas Children’s ability to help children and women across the globe in low-resource countries and offers pediatric surgery education by providing hands-on instruction and necessary supplies. To build capacity, preliminary Global Surgery efforts are focused on surgical care for pediatric cancer patients and leverage resources, infrastructure and successful global medical programs already in place in sub-Saharan. These include Baylor International Pediatric AIDS Initiative (BIPAI) Network, Global HOPE and existing efforts by Texas Children’s Department of Ob/Gyn. Long-term goals for the division include a surgical facility for women and children in Lilongwe, Malawi; expansion of care capacity in Central America; and, ultimately, recognition for Texas Children’s as a leader in global surgical outreach.