Since its inception as a six-bed charity hospital 150 years ago, the Royal Children’s Hospital has been a place of many firsts and medical breakthroughs.
The hospital has taken on tricky surgical cases that no other centre would or could. It has forged a reputation for not being satisfied with current cure or recovery rates and instead leading research into better ways, improving the lot of our smallest patients. And it has bucked the stereotype of Grey’s Anatomy-style turf wars to bring together disparate departments to solve complex cases.
“There isn’t a department that isn’t looking at pushing the edges,” Mike O’Brien, RCH chief of surgery, says.
The first two cases were performed 10 weeks apart at the RCH in 1975: first, Yew Sun and Yew Tze Foo from Singapore, and then Melbourne brothers Grant and Andrew Priestly. More than 30 years later, Bangladeshi orphans Trishna and Krishna, who were joined at the head, were separated in 2009 in a 27-hour surgery involving 16 surgeons.
A 35-strong surgical team took on the case of Nima and Dawa in 2018, disconnecting the 15-month-olds at the torso and liver, and rebuilding the fronts of their bodies. The toddlers have returned home to Bhutan, where they are free to walk and grow normally.
“These surgeries are successful, not because we’re the only place that does them — lots of places do twins — but because we pulled together teams from many different disciplines,” says O’Brien.
It is a radical concept, to remove part of a child’s brain so they are healthier than before. But that’s just what epilepsy surgery at the RCH gives children with uncontrollable seizures. If the seizure hotspot can be found through complex brain scans, the team, led by neurosurgeon Wirginia Maixner and neurologist Simon Harvey, works to remove that part of the brain, while aiming not to compromise the child’s basic functions. In some cases these surgeries are even performed while the young person is awake, when the area of the brain being removed is perilously close to those that control movement or speech.
Research is ongoing to devise better imaging methods to find the still “invisible” regions in the brain triggering seizures, and to more accurately map the brain’s communication connections.
Childhood cancer survivors have a 15-times higher chance of heart failure. It is a heartbreaking statistic, and one that a world-first study at the RCH and Murdoch Children’s Research Institute is working to reverse.
The team plans to track every Australian child and teenager with cancer to determine what treatments are damaging their hearts, develop a way to detect what patients are at greater risk, and look for safer treatment options.
The latest weapon in the fight against blood cancer lives inside the patient’s own immune system. CAR T-cell therapy involves removing and reprogramming immune-fighting cells, and reinfusing them back into the patient so it can then see the cancer cells and attack them.