CHOC Operating Rooms Integrate Tech for Better Outcomes

iSuite by Stryker

In the operating room of CHOC Children’s new Bill Holmes Tower, technology helps equipment work together to ensure the best outcomes for young patients.

Using the technology integration system iSuite by Stryker, CHOC is the first children’s hospital in the region to have a fully integrated operating room.  With more than 1,000 presets for individual doctors or disciplines, the system can also control the ambient lights, laproscopic camera and music.

The system anchors all camera and monitoring equipment to a boom overhead.  This eliminates the need for carts and cords, and frees staff to move with less risk of tripping.  The cameras give surgeons a better look at the operating field thanks to a variety of angle possibilities and zoom features.  These images can then be broadcasted on large, high-definition monitors placed inside the operating room.

From the system’s hub, a nurse can control the technology using a touch screen that is akin to an iPad.  The software is easy to use and similar to that of a desktop computer.

Stryker’s Connect Suite Video Conference System allows CHOC surgeons to connect with other experts outside the operating room.  This technology allows experts to give advice, direction and guidance without entering the sterile operating room.  The system can also connect from the operating room to a conference room, or even off site completely.

CHOC is the third facility in the nation – and the only in California – to have Stryker’s media management system, Studio 3.  This system collects still photographs and videos taken during surgery and automatically sends them to a patient’s file.  Doctors can more easily document their cases and follow a patient’s progress over time.  Physicians can use an iPad to show a patient’s family the video and still images captured from surgery.

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Celebrate Doctor’s Day – Dr. Michael Muhonen

In honor of Doctor’s Day – March 30th –  we’ve been highlighting some of our doctors throughout the month of March! Check out this video with Dr. Muhonen, Medical Director of the CHOC  Neuroscience Institute and Director of Neurosurgery, who shares what he is most excited about in The Bill Holmes Tower at CHOC.

Thank you Dr. Muhonen, and all of our CHOC doctors, for your dedication and commitment to the patients and families we serve!

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One For the Books


“Your baby has no kidneys.”  That’s what Nicola and Clifford Vazquez were told when a prenatal ultrasound showed an abnormal mass where their baby’s kidneys should be. Just halfway through the pregnancy, they were also told that their baby would die shortly after birth. they were devastated.  The Vazquezes decided to get a second opinion, which ultimately led them to CHOC children’s pediatric urologist Antoine Khoury, M.D.  He saw things differently.

When Madison Vazquez was born last November, Dr. Khoury and his team were ready and waiting. Dr. Khoury used tiny, minimally invasive instruments to drain accumulated fluid that appeared to explain the abnormal  images on the ultrasound. But he sensed there was more to the picture. He decided to look further.

ar-2012-one-for-the-books2What Dr. Khoury found was a structural abnormality that was undetectable by ultrasound. It explained everything.  No one in the operating room had ever seen anything like it. But Dr. Khoury and his team used a combination of reconstructive techniques to correct the newly discovered abnormality. Their ingenuity  in the operating room saved Madison from having a more extensive surgical procedure that very same day.

“The first condition was so glaringly abnormal that it masked the primary condition,” Dr. Khoury said.  “We’ve checked the literature and haven’t found reports of anyone else using the combination of techniques that we brainstormed that day. We are submitting it for publication in hopes it may save other children from having more extensive procedures.”

Looking back over their ordeal, Nicola and Clifford have already found a silver lining. “If we had not gotten the misdiagnosis before Madison was born, we would not have met Dr. Khoury when we did, and he saved her life,” Nicola said.

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Fully Wired for Patient Safety

All hospitals must take proactive steps to reduce the risk for possible human errors that lead to medical mistakes. But at CHOC Children’s, early investment in health information technology has undoubtedly improved patient care and saved lives.

The opening of our new South Tower next spring will further demonstrate the possibilities of health information technology. From seamless communication between hospital departments, to “plug and play” medical devices that automatically stream accurate, up-to-the-minute information into electronic medical records, these systems will promote better care while reducing the possibility of human error; hence, patient harm.  

Health Information Technology Enhances Patient Care
Although increasingly rare, medical errors are most likely to occur because humans are involved. Automating such manual tasks as calculating medication dosages or entering information into a patient’s chart reduces that risk.

Years ago, CHOC Children’s worked with the Cerner Corporation to automate the process of entering medical orders into electronic patient charts. Every CHOC physician participated in this project, and now the system we helped design is being adopted by hospitals throughout the country.

The opening of our South Tower will take our existing health information technology to the next level. For the first time in our hospital’s history, every patient service will be provided within a completely pediatric-focused environment. This includes the Julia and George Argyros Emergency Department, as well as surgical, radiology, laboratory and pathology services.

Building on the sophisticated infrastructure already in place, CHOC will connect all of those services into one system. This means from the moment a child enters our doors, sharing patient information across hospital departments will be greatly enhanced.

Our upgraded health information technology system features additional patient safety features:

• Surgery “Wall of Knowledge” — a large flat-screen monitor providing essential patient information for the surgery team, including the medical record, vital signs, lab results, images and an extensive safety check process. A sophisticated remote camera system will immediately display pathology results and images to waiting surgeons, as well.

• Emergency Department Patient Tracking System —  tracking each patient from the moment of arrival, enhancing communications and workflow through automated notifications.

• Bar Coded Blood Transfusions — automated to further ensure patient safety.

• Bedside Laboratory Specimen Labeling — portable computers that scan patient ID bands and print labels at the bedside, ensuring accurate specimen labeling.

• Computerized Medication Safety System — scanning patient ID bands at the bedside to ensure each patient receives the correct medication, and at the correct time.

• “Plug And Play” Medical Devices — including patient monitors and IV and medication pumps that stream patient information directly into the medical record.

Advanced Nurse Call System —that immediately connects patients and families to the nurse’s smartphone, as well as the nursing station.

And best of all, these upgrades are taking place throughout the CHOC Children’s campus. That’s because we know it’s about more than just having the right tools for the job — it’s also about leveraging those tools to the safest possible extent.

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Common Surgeries in Children – What Parents Should Know

Facing surgery can be a scary time for children and their parents. Dr. Ali Kavianian, M.D., surgeon-in-chief at CHOC Children’s explains what some of the most common surgeries in children are, and when to know when your child may need surgery.

Inguinal Hernia

An inguinal hernia is one of the most common conditions in infants and children, and it is usually more common in boys, according to Dr. Kavianian.

A hernia occurs when part of the abdominal organ pokes through a weak area of abdominal wall muscles. Dr. Kavianian says an inguinal hernia can be present from birth to adulthood and usually does not cause any symptoms except for a bulge in the groin or scrotum.

When the hernia content gets caught and can’t return to the abdomen, it is called incarcerated. If this happens, you should take your child to the emergency room immediately. Alarming signs include severe pain at the hernia site. Younger infants usually just cry.

If you discover a lump or bulge in or around the groin area, you should see your child’s pediatrician as soon as possible. A simple outpatient surgery by a pediatric surgeon can resolve the problem.


Appendicitis occurs when the appendix, a small tubular-shaped organ that is connected to the large intestine, becomes swollen and infected. Pain usually starts in the middle of the abdomen and then moves to the right side and lower part of the abdomen. The child may develop a fever and start vomiting.

If you think your child has appendicitis, take him or her to the pediatrician or emergency room without delay. If the operation is done before the appendix is ruptured, surgery is minor. A ruptured appendix usually requires five to seven days in the hospital.

Necrotizing Fasciitis

Necrotizing fasciitis is becoming more common so parents should be aware of this serious condition. It starts with a red pimple which can be seen around the buttocks or belly and can be mistaken for a diaper rash. But, within a very short time it becomes very red, swollen, and painful, and the child will develop a fever.

If you observe such a condition, take your child to the emergency room immediately. He or she will then likely be admitted to the hospital. Good hygiene, including frequent hand washing, can reduce the risk for this infection.

Learn more about surgery at CHOC by visiting