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SURGICAL
RESIDENCY PROGRAM
CLINICAL DIVISIONS
The Department of Surgery consists of ten clinical divisions (noted below) and a
surgical intensive care unit and two ancillary departments.
Beth Israel Medical Center also has active departments of gynecology,
urology, orthopedics, neurosurgery, neurology and ENT.
Cardiac Surgery
The Cardiac
Surgery program, began at the Medical Center in 1989 and offers a full range of
cardiac surgery other than transplantation and complex congenital pediatric
surgical repairs. The program has consistently achieved outstanding results in
the New York State annual reporting system with the best risk three-year
aggregate adjusted coronary bypass mortality rate in New York City for each of
the years from 1991 to 2008. In the most recent three-year aggregate reporting
for individual surgeons, Robert Tranbaugh, MD, had one of the best records in
the state. Both on-pump and beating heart options are used. All vein and radial
artery harvests are performed minimally invasively, reducing pain and
complications dramatically. Full ranges of valve repair and replacement
surgeries are undertaken. There is a program of minimally invasive thoracic
aortic surgery. Particular expertise covers the area of arrhythmia management
with outstanding results pacemaker and AICD (defibrillator) implantation.
Radiofrequency ablation for atrial fibrillation is performed as an adjunct to
open heart surgery or as a stand-alone procedure via a minimally invasive
approach. We obtained and used one of the first DiVinci robots in New York City
or the minimally invasive approach to the treatment of cardiac disease. The
program is a leader in surgical implantation of biventricular devices and new
investigational devices for the therapy of heart failure. The cardiac surgery
suite consists of two fully equipped operating rooms, an adjacent 10-bed cardiac
surgery intensive care unit, and a dedicated step down unit. Surgical residents
rotate on the Cardiac Surgical Service at the PGY3 year level. The service is
run by attending cardiothoracic surgeons, cardiologists, physician assistants
and nurse practitioners.
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Colorectal Surgery
The Division of Colorectal
Surgery, started in 1995, is both a clinical and investigative division in the
department. Special attention is given to colorectal neoplasms and their
multi-modality treatment, as well as anal incontinence. The Division of
Colorectal Surgery is led by Dr. Joseph Martz (Division Chief, a well-known
minimally invasive colorectal surgeon, trained at Beth Israel Medical Center and
at the Lahey Clinic. Dr. Joseph Martz has become recognized for his minimally
invasive approach to treating benign and malignant diseases of the colon and
rectum
Warren Enker, MD, is
an internationally recognized authority in surgery for rectal cancer, and
the former Chief of the Colorectal Service at the Memorial Sloan-Kettering
Cancer Center. Dr. Enker is also leader of the Gastrointestinal Oncology
Service line across all Continuum hospitals.
The Division of
Colorectal Surgery performs a wide variety of endoscopic evaluations and
treatments. top
Oncological
Surgery
The division works and
collaborates closely with Medical Oncology and Radiation Oncology to ensure
a multidisciplinary approach that optimizes care of patients with complex
gastrointestinal, soft tissue, liver, biliary
and pancreatic malignancies. Continnum Cancer Canter has its headquarters at
the Beth Israel Phillips Ambulatory Care Center and is an American College
of Surgeons designated cancer center.
The division of
surgical oncology performs major hepatic resection,
biliary reconstruction, pancreatic resections, radiofrequency
ablation, and the placement of intra-arterial hepatic pumps. Alternatives
including alcohol injection, embolization,
chemoembolization, etc. are available and
offered to appropriate patients. Weekly multi-disciplinary conferences are
held to review new and experimental treatment options for complex cancer
patients via a televised meeting at Beth Israel Medical Center and St.
Luke’s and Roosevelt Hospitals. Individual cases are reviewed with experts
in radiology, pathology, and medical, surgical and radiation oncology.
Antonio Picon, MD, a graduate of Beth Israel Medical Center’s surgical
residency has obtained additional expertise in surgical oncology during
additional training at Memorial Sloan Cancer Center and The National
Hospital of Japan in Tokyo.
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Head and Neck Surgery
The Head and
Neck Division is engaged in cooperative studies with the Departments of
Otolaryngology, Radiation Oncology and the Oncology Division of the Department
of Medicine. Current research protocols address the management of patients with
head and neck cancer in both early and advanced stages. Surgeons routinely
perform extensive head and neck surgery with major soft tissue transfer and
reconstruction. Dr. Moses Nussbaum (former Chairman of the Department of
Surgery) leads the Division of Head and Neck Surgery. top
Pediatric Surgery
The Division
of Pediatric Surgery continues to perform an array of surgical procedures,
ranging from hernia repairs and appendectomies to rectal atresias, T-E fistulas
and tumor resections. Laparoscopic surgery for intra-abdominal diseases is
performed at the Petrie campus. The division provides 24-hour,
seven-day-a-week coverage for pediatric surgical emergencies.
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Plastic and Reconstructive Surgery
The Division
of Plastic and Reconstructive Surgery has a caseload consisting of general
plastic surgical cases, cosmetic, general reconstructive, post-mastectomy
reconstruction, facial and hand trauma and pediatric cases. The division also is
involved in multi-specialty cases with other surgical subspecialists, offers a
laser program, runs a cleft palate center and has an active pediatric plastic
surgery service. Innovative therapies for reconstruction following ablative
surgery for malignancy is an area of expertise.
Surgeons at Beth Israel Medical Center have provided state-of-the-art
reconstruction of patients following radical head and neck surgery, breast
cancer surgery, and resection of soft tissue neoplasms of the extremities and
trunk. top
Surgical Endoscopy
The discovery
and implementation of modern flexible endoscopy is
tied to Beth Israel Medical Center. Beth Israel was one of the first hospitals
to introduce endoscopy and colonoscopy in the United States and is renowned for
its pioneering efforts in the development of endoscopy and its continuing
expertise and research into new applications of this technology. Most endoscopic
procedures performed at the Medical Center are on an outpatient basis. A full
array of diagnostic and therapeutic procedures is performed. The procedures
included upper and lower endoscopy, gastrostomy tube insertion, ERCP, stent
placement, percutaneous gastrostomy, endoscopic feeding tube placement, laser
procedures, endoscopic ultrasound and biopsy, and balloon dilatations.
Surgeons at Beth
Israel have also pioneered new totally endoscopic surgical procedures for
the revision of the gastric pouch for patients who have regained weight
following gastric bypass surgery and for patients with gastro-esophageal
reflux disease.
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Minimally Invasive Surgery/Advanced Medical Technology Institute
The Division of Minimally
Invasive Surgery at the Beth Israel Medical Center was started in 2002 with the
recruitment of James “Butch” Rosser, MD, the former head of Yale laparoscopy;
Dr. Rosser is an internationally renowned laparoscopic surgeon and surgical
educator. Dr. Rosser introduced novel educational modules to enhance residency
education in the field of minimally invasive surgery and has educated hundreds
of practicing surgeons in advanced laparoscopic techniques. We have the latest
high-definition, state of the art equipment and continue to provide the most
innovative minimally invasive options for surgical treatment to our patients.
A wide variety of
basic and complex minimally invasive surgical procedures are performed at
Beth Israel. This includes:
1. Cholecystectomy
2. Appendectomy
3.Inguinal hernia
repair
4. Ventral and
Incisional repair
5. Diaphragmatic
hernia repair
6. Hiatus hernia
repair for gastro-esophageal reflux disease.
7. Intestinal
resection
8. Splenectomy
9. Pancreatectomy
10. Adrenalectomy
11. Cancer staging
12. Combined endoscopic and laparoscopic surgery for gastrointestinal
neoplasms.
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Bariatric
Surgery
The department of surgery offers a multidisciplinary approach to the
treatment of morbid obesity. Laparoscopic band surgery and gastric bypass
surgery are performed at the Petrie campus. There are short and long-term
clinical outcome research studies being performed by Drs. Elliot Goodman,
Michael Leitman and John L. Holup, who have had as much as 18 years
experience in the surgical treatment of morbid obesity. There is a
twice-monthly multi-disciplinary meeting to discuss the Beth Israel Center
for Obesity Surgery (BICOS). Each patient is reviewed by a panel of
bariatric surgeons, anesthesiologist, internists, surgical intensivist,
endocrinologist, psychiatrist, nurses, and social workers prior to surgery.
A monthly Obesity Support Group Meeting is held for past and prospective
patients and is open to the public.
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Thoracic Surgery
The caseload
of the Division of Thoracic Surgery consists primarily of lung, esophageal and
hyperhidrosis cases. The David B. Kriser Lung Cancer Center, established in
1987, is staffed with a multidisciplinary team that provides a comprehensive
approach to the treatment of lung cancer. This division currently has several
research projects in progress in the areas of lung cancer, post-operative chest
pain and brachytherapy techniques. The Division of Thoracic Surgery is under the
leadership of Drs. Cliff Connery, and Angelo Reyes
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Vascular Surgery
The Division
of Vascular Surgery continues to treat a broad spectrum of peripheral vascular
lesions. A newly equipped, non-invasive vascular laboratory treats both
inpatients and ambulatory patients. Studies include arterial, carotid and venous
vascular evaluations, as well as evaluation of vascular impotence. A full array
of endovascular treatment options is available to patients, and Beth Israel
Medical Center is an internationally recognized leader in the utilization of
these techniques. Dr. Jonathan Deitch has been recently recruited to lead the
Division of Vascular Surgery. top
Surgical Intensive Care Unit
Full-time intensivists certified in surgical critical care direct the Surgical
Intensive Care Unit. This medical leadership is combined with a critical care
nursing coordinator and a critical care nurse specialist, both of whom are
critical care certified. The majority of registered nurses assigned to the SICU
are also certified in critical care. There is a fully monitored 9 bed step-down
unit.
Each year the SICU admits
approximately 886 patients from the various surgical divisions.
Multidisciplinary critical care daily rounds include a comprehensive nursing
review of the patient's prior 24-hour ICU course, followed by input from the
critical care attending, resident intern, pulmonary medicine fellow and
nutrition specialist. This information is incorporated into the clinical
plan established by the patient's surgical attending and medical
consultants.
The SICU's academic activities include publications and national lectures by
the attending intensivists, as well as research activities initiated by
nursing specialists. The SICU also has a critical care database/quality
assurance software program for analysis of SICU care. Dr. Marvin McMillen in
the current chief of the SICU. top
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