1. family and parenting
2. children

INSIDE SURGERY at
Texas Children’s Hospital
Fall 2012
In the News
Dear colleagues,
I am very pleased to share
some highlights of recent
exciting achievements in the
Department of Surgery at
Texas Children’s Hospital. Our
surgical teams have made the
headlines in numerous major
news organizations, testimony to the tremendous
work being done here.
The Department of Surgery is committed to improving
the lives of children through focused research,
education of surgical residents and fellows, responsible
outcomes analysis and exemplary patient care. We
have been busy this year and are currently on track
to complete more than 24,000 operating room cases
and over 95,000 outpatient clinic visits. It is our
privilege to help children who need surgical care.
New comprehensive Sports
Medicine Program
Ultimate Katy | January 2012
Texas Children’s Hospital West Campus – Houston’s first
community hospital designed, built and equipped exclusively
for children – announced the expansion of patient services to
include a new Sports Medicine Program dedicated to treating
children for all types of sports-related injuries and disorders.
This new program provides comprehensive and convenient
sports medicine care to the West Houston community and
utilizes an interdisciplinary approach for the diagnosis,
evaluation and treatment of children and adolescents
from the physically active individual to the pediatric and
adolescent athlete.
The multidisciplinary team consists of primary care sports
medicine physicians, pediatric orthopaedic surgeons, pediatric
and musculoskeletal radiologists, and sports-focused physical
therapists, all of whom have specialized training in pediatric
and adolescent sports conditions. Patients of the new
program also have access to other medical services needed
to appropriately care for a sports injury including pediatric
emergency medicine, pediatric cardiology, pediatric neurology,
pediatric pulmonary medicine and pediatric anesthesia.
Thank you for taking the time to review these news
stories. To find out more about our department,
visit texaschildrens.org/surgery. We hope you will
find the information here – and online – valuable
and informative.
While the Sports Medicine Program places a large emphasis
on wellness and injury prevention, athletic injuries – whether
minor or serious – are unfortunately inevitable. This program
sees patients with any type of athletic-related injury including
but not limited to the joints, knees, ankles, elbows or shoulders.
Additionally, concussions, exercise-induced asthma and
conditions affecting sports performance are treated.
Respectfully,
For more information, please visit
texaschildrens.org/sports-medicine.
Charles D. Fraser, Jr., M.D.
Surgeon-in-Chief, Texas Children’s Hospital
Donovan Chair and Chief of Congenital Heart Surgery,
Texas Children’s Hospital
Susan V. Clayton Chair in Surgery, Baylor College of Medicine
Professor of Surgery and Pediatrics, Baylor College of Medicine
The power of medicine saves a newborn’s sight in the
nick of time
ABC World News | October 2011
When a baby girl in Louisiana was born with a cloudy film
covering her eyes, physicians were unsure what they were
looking at until a pediatric ophthalmologist diagnosed the
problem as Peter’s Anomaly, a rare disorder that occurs in
three in 100,000 babies. In the condition, the cornea and
lens fuse to each other.
A corneal transplant was necessary to save the baby’s sight,
and doctors told her young parents that time was precious.
She was referred to Texas Childrens Hospital, where she
received corneal transplants at 9 days old.
“There is a small window of time, about six weeks, before a
baby’s eyes and brain start to work together, and it takes a
while for the brain to really learn how to use the eye,” said
Bowes Hamill, M.D., Ophthalmologic Surgeon at Texas Children’s.
“The clock starts ticking from hour one, so our staff needed to
complete surgery immediately.”
The surgery was a success and restored the baby’s sight.
“It was like a light switch,” her mother said. “When they
took the patch off, she couldn’t stop looking around.”
For more information on the Ophthalmology Division at Texas
Children’s, please visit texaschildrens.org/ophthalmology.
Texas Children’s Fetal Center performs successful fetal
surgery to treat spina bifida
FOX 26 KRIV | February 2012
A multidisciplinary team led by Texas Children’s Fetal Center
surgeons performed the hospital’s first in utero surgery to
treat myelomeningocele, or spina bifida. Nearly 11 weeks
after the fetal closure was performed, the baby’s mother
went into labor and delivered via cesarean section. Mother
and baby are doing well.
The standard of care for spina bifida is neurosurgical closure
of the defect in the first days of life. However, prenatal surgery
gives significant benefits to the growing fetus. “Closure of the
spinal defect before birth reduces the risk of hydrocephalus
and may improve motor function in select patients,” said
Robert Bollo, M.D., Pediatric Neurosurgeon at Texas Children’s
Hospital and Assistant Professor of Neurosurgery at Baylor
College of Medicine. “Fetal surgery is an exciting new tool in
our multidisciplinary commitment to lifelong care of patients
with spina bifida.”
Recently, a NICHD-funded study entitled, “The Management
of Myelomeningocele Study (MOMS)” published in the New
England Journal of Medicine reported similar findings. It
2
texaschildrens.org/surgery
demonstrated a significant decrease in the risk of hydrocephalus
for select patients undergoing fetal closure of the spine as
well as possible improvement in lower extremity function
compared to patients who underwent standard closure
after birth.
“The confirmation that fetal surgery may decrease the physical
challenges some of these babies face is not only a ray of hope
for families, it is also a significant achievement for fetal medicine,”
said Darrell Cass, M.D., Co-Director of Texas Children’s Fetal
Center and Associate Professor, Departments of Surgery,
Pediatrics and Obstetrics and Gynecology at Baylor College
of Medicine. “Breakthrough studies like the MOMS trial are
exciting and reaffirm our commitment to advancing fetal
medicine and giving babies with complications and anomalies
the healthiest possible start to life.”
The Fetal Center at Texas Children’s Hospital has developed
extensive screening and diagnostic algorithms for pregnancies
with fetal spina bifida and other fetal diagnoses. To learn
more, visit women.texaschildrens.org/fetalcenter.
Couple makes decision to get cochlear implant
for 3-year-old son
Lufkin Daily News | November 2011
When toddler Jaxon had delays in speech and showed no
response to sound, local pediatricians and his parents blamed
chronic ear infections. But after insertion of ear tubes, the
problems showed no improvement. Jaxon was referred to
Texas Children’s Hospital, where an auditory brainstem
response test revealed he was deaf. A subsequent blood
test showed his deafness was caused by recessive gene
Connexin 26.
He was fitted for hearing aids, which seemed to work for
several months, but then his progress plateaued and physicians
in the Otolaryngology Division at Texas Children’s recommended
a cochlear implant. His parents were hesitant at first because
cochlear implants often are frowned upon in deaf culture. But
after tests and counseling, they decided it was the best choice
for their child.
The internal mechanism was placed in October 2011, and
Jaxon returned to Texas Children’s the next month to have
the implant activated. Jaxon’s progress with the cochlear
implant will be evaluated before the decision is made to
surgically insert another.
For more information on cochlear implants and the
Otolaryngology Division, visit texaschildrens.org/otolaryngology.
Spotlight on Charles D. Fraser, Jr., M.D.
Garden & Gun Magazine | February/March 2012
Surgeon-in-Chief Charles D. Fraser, Jr., M.D., was recently
featured alongside notable Houstonians Marilyn Oshman and
George H. W. and Barbara Bush in Garden & Gun Magazine’s
feature entitled “Houston: The Locals.” The article highlighted
Dr. Fraser’s upbringing in Midland, Texas, his marriage to
Helen, the daughter of legendary heart surgeon Denton
Cooley and his plan to live out his career at the Cleveland
Clinic. That is, until he was offered an unparalleled opportunity
to build a program at Texas Children’s, now the largest pediatric
hospital in the United States.
Today, Texas Children’s Heart Center performs more than 800
heart surgeries a year, has developed the nation’s largest
pediatric lung transplant program and has surgical outcomes
among the best in the nation. “I view myself as a surgeon
first,” said Fraser, who operates at least three days a week.
“When you’re operating on little babies, the outcome of the
operation is viewed in terms of decades of life. That keeps
you coming back.”
Ventricular Assist Device offers hope for youngest
heart patients
ABCNews.com | August 2012
Hundreds of children in the United States are born each year
with cardiomyopathy, or failing hearts, and often the only
hope is transplantation. Unfortunately, many are not able to
survive long enough to find a suitable donor heart. Not too
long ago, extra-corporeal membrane oxygenation (ECMO)
was many patients’ only option. To Charles D. Fraser, Jr., M.D.,
Surgeon-in-Chief at Texas Children’s Hospital, this was a huge
problem. In turn, he became the national principal investigator
for the Berlin Heart EXCOR® Pediatric Ventricular Assist Device
(VAD) study. “My interest [in this project] was related to my
clinical frustration,” Fraser said. The trial’s goal was to conduct
the first prospective, multicenter study of a device that had
not been used yet in children.
Largely because of this trial, children with failing hearts have
been able to take advantage of a technology that at one time
was only available to adults – Ventricular Assist Devices, or
VADs. There had been no FDA-approved VAD devices for children
prior to the Berlin Heart study.
The study, published in the New England Journal of Medicine,
compared the outcomes of 48 children who received the
Berlin Heart EXCOR® Pediatric VAD to those of children who
received ECMO in the past. The study divided the patients
into groups based on size and showed all children with VADs
did better. Smaller patients had a 13 percent increased success
rate and larger patients a 25 percent increased success rate.
For more information, please visit texaschildrens.org/berlinheart.
texaschildrens.org/surgery
3
Multidisciplinary case to treat child attacked by dog
NBC 2 KPRC | February 2012
Physicians from several subspecialties at Texas Children’s
Hospital worked together on a complex surgery to repair a
2-year-old girl’s extensive facial injuries resulting from a dog
attack. The multidisciplinary team, which included physicians
from pediatric general surgery, radiology, plastic surgery,
anesthesia and otolaryngology, completed what will be the
first of several surgeries to reconstruct the child’s face.
This case is one example of many; dog attacks are more common
than many people realize. According to the Texas Department
of State Health Services, nearly 400,000 people are bitten by
dogs every year, and sixty percent of those bitten are children.
The Emergency Center at Texas Children’s Hospital has seen
high numbers of dog bites as well. In the past year alone,
the Emergency Center saw more than 230 children sustaining
dog-related injuries, and about ten percent of them were
severe enough to require hospitalization.
“What we typically see in smaller kids is bites to the face
because kids tend to explore with their head first, looking
at the dog,” said Texas Children’s Plastic Surgeon Larry
Hollier, M.D.
Nurse practitioner Jaimee Westfall has seen some of the
worst dog attacks that have been treated at Texas Children’s
Hospital. She said almost any breed of dog can turn on a
child. “You’ll hear from parents over and over the same
story every time – I never thought my dog would do this.”
3D reconstruction of patient on
day of injury
3D reconstruction of patient nearly
one year later
Keeping kids safe this summer with protective gear
NBC 2 KPRC | June 2012
Texas Children’s Pediatric Surgeon Mark
Mazziotti, M.D. “We see a lot of head
injuries in the summer, and concussions
are common,” Mazziotti said. “It’s also
an active time for blunt abdominal
injuries caused by falls off bikes and
other moving vehicles.”
Last year, more than 400 patients were
admitted to Texas Childrens Hospital
with head injuries. Thirty-one of these
were accidents that happened while
children were riding bicycles, dirt bikes,
ATVs, skateboards, scooters or skates.
Twenty-seven of these children were
not wearing helmets, and one sustained
fatal injuries.
Every year, about 300,000 children
across the nation land in emergency
rooms because of head injuries from
falling off bicycles. Prevention often is as
simple as wearing a helmet. “Definitely
wear a helmet if you’re going to be driving
or riding anything that has wheels,” said
provided 1,275 bicycle helmets to
low-income children and educated more
than 10,000 children and parents on
outdoor safety, including bicycle,
pedestrian and water safety. For more
information, visit texaschildrens.org/
injury-prevention.
Mazziotti said summer is also a busy
time for fractures. Because children fall
with outstretched arms, wrist and arm
fractures are common. Some also get
run over or caught under vehicles. He
advised physicians and parents to
convince children to wear:
• Properly fitted helmets
• Long sleeves and long pants
• Elbow pads and knee pads
To help educate parents and prevent
injuries, Texas Children’s Hospital created
the Center for Childhood Injury Prevention,
which receives more than $500,000 in
grants each year to teach parents how
to keep their children safe in the car,
outdoors and at home. In 2011, the
Center for Childhood Injury Prevention
Texas Children’s
Department of Surgery
West Tower, 3rd Floor
6621 Fannin St.
Houston, Texas 77030
832-826-5779
surgeoninchief@texaschildrens.org
texaschildrens.org/surgery
texaschildrens.org/surgery
4
Texas Children’s ranks 4th among nation’s best
pediatric institutions by U.S.News and World Report
USA Today | June 2012
Texas Children’s Hospital once again was named a national
leader among pediatric hospitals in U.S.News & World
Report’s 2012 - 2013 edition of Best Children’s Hospitals.
Ranked 4th among children’s hospitals nationally, Texas
Children’s was one of only 12 hospitals in the nation to
achieve the Best Children’s Hospitals Honor Roll designation.
The hospital is the only one in Texas – and the entire southern
region of the United States – awarded this distinction.
Additionally, Texas Children’s was ranked in all 10 subspecialties
and in the top 10 for eight out of the 10 categories.
#2 Neonatology
#3 Cardiology & Heart Surgery
#3 Pulmonology
#4 Cancer
#4 Gastroenterology
#5 Nephrology
#5 Neurology & Neurosurgery
#7 Urology
#14 Diabetes & Endocrinology
#33 Orthopedics
“Together with our academic partner Baylor College of
Medicine [BCM], we continue to pioneer advancements
in pediatric health care,” said Charles D. Fraser, Jr., M.D.,
Surgeon-in-Chief of Texas Children’s Hospital. “Texas
Children’s Department of Surgery is a pre-eminent surgical
program nationally, and these rankings signify the strength
of both the department and hospital.”
The rankings are a result of a methodology that weighs
a combination of reputation, outcome and care-related
measures such as nursing care, advanced technology and
credentialing, among other factors. The hospitals also were
judged based on a combination of opinions from pediatric
specialists about the hospitals they would recommend for
the sickest children and data gathered in an extensive survey
of the hospitals themselves.
“Texas Children’s notable ranking, in the midst of other
exemplary pediatric institutions, is truly outstanding,” said
Mark Kline, M.D., Physician-in-Chief of Texas Children’s
Hospital and Chair of the Department of Pediatrics at BCM.
“It’s a reflection of the outstanding commitment by our
physicians, clinicians, researchers and all employees to the
highest standard of care for our patients.”
“While we are pleased our hospital ranks among the best in
the nation, we consistently strive to improve our patient
outcomes, satisfaction levels and medical advancements,”
said Fraser. “We have ongoing efforts to examine our
programs, be transparent with our activities and continue
to improve the quality of care we provide to our patients.”
A new mother’s intuition likely saved her daughter’s life
NBC 2 KPRC, MSNBC.com | May 2012
When her newborn daughter lost seven ounces shortly after
birth and stayed at that weight for several weeks, a Houston
mother sensed something was wrong and took the baby
to Texas Children’s Hospital. The baby was diagnosed with
hepatoblastoma, a rare malignant liver tumor. Only 150
cases are diagnosed each year in the United States.
a bold move in a child just 11 weeks old, the tumor was
surgically removed intact, with minimal damage to the liver.
Two cycles of chemotherapy followed. “You couldn’t ask
for better results in terms of surgery,” said Texas Children’s
Pediatric Oncologist Patrick Thompson, M.D. “I’m extremely
hopeful, and I think her prognosis is excellent.”
“In a child who's 6 weeks old, this is very unusual. Most of the
children are a couple of years old,” said Eugene Kim, M.D.,
Pediatric Surgeon at Texas Children’s. Kim also was struck by
the size of the tumor, which was a large as grapefruit. “It
clearly looked like at least two-thirds of her abdomen was
taken up by the tumor,” he said. Physicians aren’t certain
if the tumor developed in utero or after birth.
Thompson said the baby will undergo two cycles of
chemotherapy and should be just fine. Kim added, “[Her
mother] did what she could to get that extra level of care,
get that extra level of diagnosis, and it really made a huge
difference here.” Now, the baby has regained her appetite,
a welcome sign thanks to a mother’s intuition.
Specialists in Texas Children’s Liver Tumor Center first tried a
round of chemotherapy, but the tumor didn't respond. So in
5
texaschildrens.org/surgery
For more information on the Pediatric General Surgery
Division, please visit texaschildrens.org/pediatric-surgery.
Texas teen loses more than 150 pounds with gastric bypass
ABC Nightline | June 2012
Prior to the surgery, the 16-year-old from Baytown, Texas
weighed 403 pounds, was pre-diabetic and had sleep apnea,
liver damage and joint pain due to his weight. He consumed
about 7,000 calories a day, about three times the recommended
caloric intake for an adult man. The majority of his diet was
fast food.
food in his diet. Plus, he gained a girlfriend, whom he took to
the prom.
Gastric bypass surgery at Texas Children’s Hospital is one part
of the multidisciplinary bariatric team, which is comprised of
pediatric specialists in gastroenterology, pulmonary medicine,
cardiology, endocrinology, psychology, nutrition, gynecology,
anesthesia and more. To learn more, please visit
texaschildrens.org/bariatric.
Texas Children’s surgeons performed laparoscopic Roux-en-Y
Gastric Bypass surgery, which has shown reliable results,
improved health and a higher success rate in maintaining
weight loss than other bypass surgeries. In two hours,
surgeons completely rewired the teen’s digestive system and
shrunk his stomach from the size of a toaster to the size of an
egg. “Our outcomes have been overwhelmingly positive since
we began performing the procedure in 2004,” said Mary
Brandt, M.D., Pediatric Surgeon at Texas Children’s Hospital.
Six months after the surgery, the patient’s weight had fallen to
247 pounds, and he had adopted some healthier ways of life.
Not only had he joined his school’s swim and water polo teams,
he also dramatically decreased the level of calories and junk
Fold Line
© 2012 Texas Children’s Hospital. All rights reserved.PedSur044_100312r1
Texas Children’s Hospital surgeons performed a complex gastric
bypass to help an obese teen with several life-threatening
co-morbidities lose more than 150 pounds.
ADDreSS ServiCe requeSTeD
Texas Children’s Hospital
1919 S. Braeswood Blvd., Ste. 6226
Houston, TX 77030