Queen Mary Hospital has been performing liver transplants since the early 1990’s and perform around 60 per year. The majority of recipients of a transplanted liver have Hepatitis B related liver disease. Many of our cases involve living donors. Transplants are performed without assistance of veno-venous bypass. The survival rates are comparable to other major transplant centres around the world.

The Division of neuroanaesthesia is committed to providing high level perioperative care to patients undergoing neurosurgical and neuroendovascular procedures at Queen Mary Hospital, which is the tertiary neurosurgical referral centre providing a good volume of challenging cases. More than 700 neurosurgical procedures are performed annually including complex intracranial tumour excisions, skull base surgery, awake craniotomies, major neurovascular interventions, spine and pituitary surgery, functional neurosurgery, acute stroke care and interventional neuroradiological procedures.

Queen Mary Hospital is a tertiary referral centre for complicated pregnancies in the territory, and an assisted reproductive centre for the University of Hong Kong. We have around 4000 deliveries per year, of which 29% are by caesarean section. The Obstetric anaesthesia team at Queen Mary Hospital provides 24 hour cover to the labour ward to assist with labour analgesia and anaesthesia . We run joint drills with obstetricians and midwives in crisis management, and provide both in-patient consultations and out-patient screening for high risks pregnancies.

Multidisciplinary round table meetings plan high risk operative deliveries. Quality assurance activities, audits, and departmental CME activities are all mandatory in our operative risk management. Training of our theatre nurses and assistants and midwives are provided on a regular basis as well as to medical students. We are also an accredited training centre under the Hong Kong College of Anaesthesiologists. In the future we will continue to strive for excellence in a high standard of care matched with a growing delivery rate in HK, meeting the needs of evidence-based medicine, anaesthesia safety, public expectations, training potentials and research opportunities.

As one of the three designated neonatal surgical centres under the Hospital Authority and a major tertiary referral centre for paediatric surgery in Hong Kong, we provide anaesthesia to all paediatric operations performed at Queen Mary Hospital except cardiac surgery. These include:

• General paediatric surgery
• Thoracic surgery including VAT
• Urological operations
• Neonatal surgery including premature newborn
• Liver transplantation,
• Surgery for spinal or limbs deformity
• Correction of craniofacial abnormalities
• Plastic surgery
• Dental operations
• Neurosurgical or vascular operations
• Otolaryngology including laser surgery in infants
• Ophthalmic surgery
• EXIT procedure

 

Other services include:

• Paediatric acute pain management which is in collaboration with the Division of Pain Medicine.
• Procedural sedation to high risk children undergoing radiological or interventional procedures.

 

We anaesthetize over 1000 children aged less than six per year, among them about 100 are neonates of less than 45 weeks post conceptual age. Our team of paediatric anaesthetists provide 24 hours coverage of anaesthesia service to neonates and other high risks children undergoing major surgery.

Training in paediatric anaesthesia is provided to anaesthetic trainees and fellows in anaesthesia.

The Pre-Anaesthetic Clinic (PAC) of Queen Mary Hospital has been in service since 2008. It is located in the third floor of the S-Block (SOPD) of QMH, and consists of three consultation rooms. The aim of the PAC is to offer pre-anaesthetic assessment in an out-patient setting, so as to achieve a better preparation of patient for surgery, and at the same time a shorter pre-operative length of stay in the hospital. Currently the service is provided in afternoon, Monday to Friday. Since its establishment, over 10,000 patients have attended the clinic.

Currently we provide sedation to high risk patients, upon consultation. These include infants and children with special conditions and perhaps a history of difficult or failed sedation. A Sedation Task Force involving members from different specialties of Queen Mary Hospital, headed by Dr. Theresa Hui from Department of Anaesthesiology was set up in 2011 with an aim to improve the sedation service, educate clinicians on the practice of safe sedation, and identify high risk patients for sedation. The Department of Anaesthesiology plays a leading role in improving the quality and safety of the sedation service in Queen Mary Hospital. Our aim is to establish a regular sedation service for infants and children undergoing radiological imaging in CT and MRI suite.

Vascular anaesthesiologists in QMH work closely with surgeons for major and minor vascular surgery including thoracic and abdominal aortic repair and carotid endarterectomy. Anaesthetic approaches vary to cater for patient and surgical needs in the pre-operative, intra-operative and post-operative period.

Each year, more than 300 major arterial surgical procedures are performed in QMH. In 2011, there were 80 procedures for aortic diseases (aneurysm, dissection ), with 80% performed via endovascular approach. There were more than 100 peripheral endovascular procedures with the majority for lower limb arterial occlusive disease. In addition, there were more than 20 carotid artery procedures including stenting.

With the establishment of in-house high resolution multi-faceted X-ray machine in K11 operation theatre, there is a noticeable rising trend for endovascular surgery. Our anaesthetic approach has moved from traditional general anaesthesia towards regional anaesthesia and even sedation with monitored anaesthetic care (MAC) for many of the procedures.