Radical Surgery Saves Life of Young Mom, California First
Liver Removed, Reconstructed, Re-Implanted
A team led by Alan Hemming, MD, transplant surgeon at UC San Diego Health System, has successfully performed the west coast’s first ex-vivo liver resection, a radical procedure to completely remove and reconstruct a diseased liver and re-implant it without any tumors. The procedure saved the life of a 27-year old mother whose liver had been invaded by a painful tumor that crushed the organ and entangled its blood supply.
“During a 9-hour surgery the team was able to remove the basketball-sized tumor,” said Hemming, professor and surgical director of the Center for Hepatobiliary Disease and Abdominal Transplantation (CHAT) at UC San Diego Health System. “This is a surgery that carries a 15 to 20 percent risk of mortality. In this case, the patient would not have survived if she did not have surgery. This was the only way we could save her liver and her life.”
Robotic Surgery with One Small Incision, U.S. First
On Tuesday, December 20th, Santiago Horgan, MD, chief of minimally invasive surgery at UC San Diego Health System was the first surgeon in the United States to remove a diseased gallbladder through a patient’s belly button with the aid of a new FDA-approved da Vinci Si Surgical System. With one incision, Horgan removed the gallbladder in 60 minutes. The patient returned home five hours after the groundbreaking surgery and reported minimal pain.
“Our goal is to offer surgery options that reduce discomfort, shorten hospital stays and minimize scarring,” said Horgan, a robotic surgery expert and director of the UC San Diego Center for the Future of Surgery. “With the aid of this robotic system, we can accomplish all three. This is a significant advancement for the 750,000 patients who need gallbladder removal each year.”
Intuitive Surgical, Inc. received FDA-approval on the new operating platform specifically for cholecystectomy procedures, the surgical removal of the gallbladder. The system enables surgeons to reduce the traditional number of incisions from 4-6 down to one incision that is less than an inch in length.
UC San Diego Health System Honored with Magnet® Status
On December 12, 2011, UC San Diego Health System was bestowed Magnet® status by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program® recognizes health care organizations for quality patient care, nursing excellence and innovations in nursing practice. UC San Diego Health System is one of 25 health systems in California to achieve this prestigious recognition.
“Today we celebrate Magnet status, an incredible accomplishment for UC San Diego Health System,” said Margarita Baggett, MSN, RN, chief nursing officer and interim chief operating officer at UC San Diego Health System. “I wish to personally thank all of our nurses, physicians, residents, researchers, pharmacists, and staff for their contributions in making this goal a reality.”
UC San Diego Health System Receives Leapfrog Group’s Top Hospitals Award for its Commitment to High Quality Care
The Leapfrog Group’s annual class of top hospitals – 65 from a field of nearly 1200 – was announced December 6th in Washington, D.C. and included UC San Diego Health System in San Diego, California for the first time. The 2011 list includes university and other teaching hospitals, children’s hospitals and community hospitals in rural, suburban and urban settings. The selection is based on the results of the Leapfrog Group’s national survey that measures hospitals’ performance in crucial areas of patient safety and quality.
“UC San Diego Health System’s faculty and staff are the heroes whose commitment to quality and patient safety has lead to this recognition,” said Tom McAfee, MD, interim chief executive officer and dean of Clinical Affairs for UC San Diego Health Sciences.
The survey, which launched in 2001, focuses on four critical areas of patient safety: 1) the use of computer physician order entry (CPOE) to prevent medication errors; 2) standards for doing high-risk procedures; 3) protocols and policies to reduce medical errors and other safe practices recommended by the National Quality Forum; and 4) adequate nurse and physician staffing. In addition, hospitals are measured on their progress in preventing infections and other hospital-acquired conditions and adopting policies on the handling of serious medical errors, among other things.
UCSD doctor helps women suffering from obstetric fistula
With developed maternal health care, c-sections and timely interventions, obstetric fistula is almost unheard of in the US. In the developing world, however, this debilitating condition affects as many as three and a half million women every year.
“Fistula is a complication of several days of prolonged labour,” said Anna Kirby, MD, OB/GYN and fellow in The Female Pelvic Medicine and Reconstructive Surgery Program at UC San Diego Health System. “Without medical intervention, the pressure from the fetal head trapped in the birth canal destroys tissues separating a woman’s vagina from her bladder or rectum.”
The consequences are devastating. Not only do women usually lose their babies, they also sustain injuries which cause them to steadily leak urine and sometimes feces. Traumatized, often abandoned by husbands and isolated from communities, they are forced to live on the edges of villages in horrific conditions. Some decide to end their despair by suicide.
This year Kirby joined Andy Norman, MD, gynecologist at Vanderbilt University Medical Center, who previously spent 13 years working and teaching family medical practice to residents in Nigeria. Norman and Kirby traveled to Somaliand in Africa to train physicians and perform surgeries on women who suffered from obstetric fistulas.
The health of the people of Somaliland is among the worst in Africa, with one of the highest maternal and infant mortality rates in the world. According to the available statistics, one in every eight babies dies in infancy and nearly 4000 Somali women die in childbirth every year. These numbers can be attributed in large part to the long civil war which brought about the death or departure of nearly all of the region’s trained healthcare professionals.
However, with proper medical attention, the lives of many Somaliland woman can be saved. “In the case of fistulas, reconstructive surgery can return not only women’s health, but also their dignity and their place in society. Success rates are as high as 90 percent for uncomplicated cases,” said Kirby.
In Somaliland, Kirby and Norman worked at the Edna Adan Maternity Hospital in Hargesia. Edna Adan, the hospital founder, is a remarkable woman who is bringing desperately needed health care to local women. She was featured in the widely acclaimed book by the Pulitzer Prize winning authors Nicholas Kristof and Sheryl WuDunn Half the Sky: Turning Oppression into Opportunity for Women Worldwide - also the basis for an upcoming PBS documentary. Adan is the first qualified nurse-midwife in Somalia, the first Somali girl to study in the UK, and the first Somali woman to drive. After working with the World Health Organization in the region, she dedicated her pension and life savings to build the first teaching hospital in Hargesia, in a plot donated to her by the regional government - a site formerly used as a garbage dump. The hospital started with 25 maternity beds. Now it can serve 69 patients, including newborn babies.
Center for Future of Surgery Opens at UC San Diego School of Medicine
Largest Surgical Training Site in U.S. Advances Safety and Innovation in OR
Every year, millions of patients undergo lifesaving surgeries. The outcome of each procedure is driven by dynamic factors such as the patient’s health, drugs and instruments used, team communication, and the wisdom of the surgeon’s hand. To advance safety and innovation in today’s operating rooms, the School of Medicine at the University of California, San Diego has unveiled the Center for the Future of Surgery (CFoS) ─ the largest state-of-the art facility in the nation dedicated to catalyzing novel surgical technologies, techniques and teaching methods.
“The Center for the Future of Surgery is developing revolutionary surgical techniques that will change the way surgery is performed in the next decade,” said Santiago Horgan, MD, professor of surgery and CFoS director. “Teaching these techniques is core to our mission along with developing the tools needed to perform next-generation procedures. As a global training center, our ultimate goal is to develop safe methods that will result in better outcomes, less pain and faster recoveries for every patient.”
Building Sustainable Surgical Systems, November 9-11
4th Annual Alliance for Surgery and Anesthesia Presence Conference
Today, around the world, more than two billion world citizens do not have access to emergency and essential surgical care. The results are devastating, leading to more than 500,000 maternal deaths and more than 5 million fatalities associated with everyday injuries such as road traffic accidents and burns. This lack of surgical care is arguably a top killer around the world but mostly ignored by organizations that can affect positive change.
To address strategies for improving surgical care in low-income countries, the UC San Diego School of Medicine and Rady Children’s Hospital will host a joint Alliance for Surgery and Anesthesia (ASAP) and World Health Organization Global Initiative for Emergency and Essential Surgical Care (GIEESC) meeting November 9-11, 2011, in San Diego. The conference “Building Sustainable Surgical Systems” will bring together global leaders in surgery and anesthesia, health economists, and public policy experts to discuss how surgical care might be improved in settings of limited resources.
Domino Liver Transplant Treats Two Rare Diseases, World First
For the first time ever, a surgical team led by Alan Hemming, MD, has successfully performed a domino transplant using a liver with a rare genetic disorder called methylmalonic acidemia (MMA).
“This extraordinary procedure allowed us to use one donated liver to save two lives,” said Hemming, professor and co-director of the Center for Hepatobiliary Disease and Abdominal Transplantation (CHAT) at UC San Diego Health System. “This procedure is technically more difficult but allows us to expand the number of patients who can benefit from this lifesaving surgery.”
The first transplant recipient, Rafael Bolanos, 28, suffered from MMA, a metabolic disease that causes a toxic build up of amino acids in the body. He faced coma and irreversible neurologic damage. The second patient, James Ogara, 62, was diagnosed with primary sclerosing cholangitis, a chronic liver disease caused by scarring of the bile ducts.
UC San Diego Health System Opens Comprehensive Liver Clinic in Nevada
Patients in Nevada seeking care for liver disease may now access the university-level expertise of UC San Diego Health System’s Center for Hepatobiliary Disease and Abdominal Transplantation (CHAT). Led by Robert Gish, MD, world-renowned hepatologist, patients may benefit by having access to a full spectrum of liver care, from diagnostics and testing to novel therapies and clinical trials not found anywhere else in the state. Located at 3033 W. Horizon Ridge Parkway, Suite 101, in the city of Henderson, patients may make appointments by calling toll free 1-855-LV LIVER (1-855-585-4837) or 1-702-331-6303.
“I am so grateful to be able to return to the Las Vegas community to practice advanced liver care and to provide local and regional tertiary care for the patients in this region,” said Gish. “Even if you have been told that your liver disease is untreatable, there is hope for you through UC San Diego Health System experts who will come here to care for you.”
New Technique to Remove Large Colon Polyps, California First
For the first time in the western United States, a surgical team lead by Elisabeth McLemore, MD, has used a novel operating platform to perform the scarless removal of rectal tumors. Called Trans-Anal Minimally Invasive Surgery (TAMIS), the technique allows surgeons to excise large polyps and masses that cannot be completely removed during a routine colonoscopy.
“With the use of this new surgical platform, we can now offer patients an innovative, less invasive procedure to remove advanced polyps with significantly less pain and scarring compared to the standard surgical procedure,” said McLemore, colorectal surgeon at UC San Diego Moores Cancer Center and the third surgeon in the world to perform the procedure. “Instead of a major abdominal operation with removal and reconstruction of the colon and rectum, we can remove the growth by operating through an existing natural body opening.”
