HOSPITALS Record Baby Born at Joondalup When Breanna Sykes went into labour doctors told her the baby would be big, but they had no idea just how big until the 5.9kg infant arrived. Ziad Kadic weighed in a whopping 5.9kgs at Joondalup Health Campus. 12 The Ramsay Way 2016 | 02 New Botox Treatment Developed to Improve Complex Hernia Surgery A newly developed technique introduced at Warringal Private Hospital, is set to enhance treatment outcomes for patients facing complex large abdominal wall hernia surgery. Large abdominal wall hernias are not an uncommon problem in general surgery. They can present significant difficulties for patients with pain and deformity and can affect physical and gut functioning. In addition, they may pose significant risks of obstruction and strangulation if left untreated. Despite advances in surgical techniques, such as the introduction of surgical mesh and facial release, large complex hernias still pose significant operative challenge for repair and risk of significant morbidity, due to complex operative conditions, intense post-operative pain, risk of respiratory compromise and lateral muscle traction predisposing patients to early recurrence. A new technique introduced by Mr Ahmad Aly, General Surgeon and Specialist Upper Gastrointestinal Surgeon at Warringal Private Hospital uses botulinum toxin A (BTA) injected under ultrasound control into the layers of the abdominal wall several weeks prior to surgery, inducing abdominal wall muscle relaxation and in turn muscle lengthening, allowing more ready closure with less tension and increased abdominal domain as well as improving pre and post-operative pain. Mr Aly reports that he first came across the technique at the RACS meeting 2015 where Dr. Nabil Ibrahim and associates from Macquarie University Hospital presented the early results of the technique in several patients. “I had a patient with a giant ventral hernia with at least 50% of the abdominal viscera outside the peritoneal cavity and very little abdominal domain (Figure 1). I had been considering various techniques for months and had consulted hernia experts in the USA. When I came across this technique, I was impressed with the imaging results demonstrating the muscle lengthening and I thought it might really help. Dr. Ibrahim’s team kindly shared the protocols with me and teaming up with radiologist Dr. Philip James at MIA – Warringal, we developed the technique for our patients at Warringal Private Hospital (Figure 2). The patient also commented that the pain from the hernia subsided almost immediately after injection.” Mr Aly has successfully treated a further two patients at Warringal Private Hospital using pre-operative BTA, finding it a useful adjunct to surgical repair of complex hernias. “This technique has real application for large hernia repair with the potential to reduce morbidity and in particular ICU stay from compartment syndrome. We will continue to prospectively monitor outcomes but I’m very excited about its potential.” Figure 1: Pre-operative appearance. Figure 2: Post-operative appearance. “It was a very big surprise,” the Carramar mum said from her hospital bed at Joondalup Health Campus. “The doctor would not induce me (at first) but then measured me on the table and said he thought my baby would be about eight or nine pounds. “When I woke up they told me I had a 13.2 pound (5.9kg) baby.” Not so little Ziad Kadic was born by caesarean section just after 7.15pm on Saturday weighing in at 5.9kg and measuring 57cm. His size was not just a shock for proud mum Breanna, but also for the medical staff at the hospital. While nothing has been confirmed, Ziad could be the biggest baby born in WA, possibly even Australia. “I have had 15 doctors come visit me when they found out how big he was,” Breanna explained. “Most have said he was the biggest newborn they have ever seen. “One of the doctors said to me he’s the biggest baby he has seen in his 15 years as a doctor. “My family are just shell shocked. They just can’t believe how big he is.” Find us on Facebook facebook.com/ramsayhealth World Class Breastfeeding Support at Westmead Westmead Private Hospital has received international recognition for its world-class breastfeeding support service recently receiving an International Board Certified Lactation Consultant (IBCLC) Care Award, one of only three which has been given out in Australia and the only one in NSW. Decalie Brown, President of International Lactation Consultants Association, presents Westmead with its prestigious IB. Decalie Brown, President of International Lactation Consultants Association visited the hospital recently to present the IBCLC Care Award to staff. This prestigious award recognises the hospital for the promotion, protection and support of breastfeeding. Families sing the praises of the support they received during their stay. Going home successfully breastfeeding is the goal of the majority of families, it is a privilege to be able to provide a service which is so supportive and achieves results. Families have access to antenatal consultation and breastfeeding education, a daily breastfeeding class for Mum’s as well as specialized class for partners and support people. Eligible women who have elective c/sections are offered skin to skin contact with their baby in recovery along with breastfeeding support. The postnatal ward offers a myriad of breastfeeding support from bedside assistance to our very popular Infant Feeding Support Centre. This provides a comfortable, woman only space with expert breastfeeding support around the clock. The support continues after discharge home with the Outpatient Clinic.
The Ramsay Way - 2016 Edition 2
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