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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. We have been a leader in th3 use of radial artery conduits and have
outstanding published results. 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 were one of the first in New York City to use
the da Vinci robot for the minimally invasive approach to cardiac surgery and we
continue this MIS commitment to this day.Surgical residents rotate on the
Cardiac Surgical Service at the PGY3 year level and receive a robust exposure to
cardio thoracic surgery. 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
benign conditions such as inflammatory bowel disease. 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 is recognized for his minimally invasive
approach to treating benign and malignant diseases of the colon and rectum.
Resident have also been taught by Dr. Warren
Enker, MD, an internationally recognized authority in surgery for rectal
cancer. He is the former Chief of the Colorectal Service at the Memorial
Sloan-Kettering Cancer Center. Dr. Enker is also the current leader of the
Gastrointestinal Oncology Service line across all Continuum hospitals.
Dr. Kurt Melstrom has recently joined the
Division after completing his Colorectal fellowship at Cornell University
Medical Center. Dr. Melstrom completed his general surgery training at
Loyola University Medical Center. He brings to the division additional
expertise and training in advanced minimally invasive surgical treatment
of colorectal diseases.
The members of the division are focused on
achieving the best outcomes for our patients utilizing the most advanced
techniques and modalities. The recent introduction of the Da Vinci Robot
and its application to colon and rectal surgery has expanded the minimally
invasive options that are provided.
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Endocrine Surgery
The Surgical Oncology division includes the
discipline of endocrine surgery, focused on the treatment of benign and
malignant disorders of the thyroid, parathyroid, and adrenal glands. A
multi-disciplinary approach with endocrinology, radiology, nuclear
medicine, and pathology is employed in patient care. Operations include
thyroidectomy, minimally invasive parathyroidectomy, modified radical neck
dissection, and laparoscopic adrenalectomy. Minimally invasive techniques
are used for parathyroid surgery, performed under regional anesthesia on
an outpatient basis. Cooperative research on endocrine neoplasia is
performed with the Division of Endocrinology, Department of Medicine, and
the Albert Einstein College of Medicine. Dr. Moses Nussbaum (former
Chairman of the Department of Surgery) led the Division of Head and Neck
Surgery for many years before his passing. Dr Jennifer Marti who received
her Endocrine Surgery Fellowship training at Yale University after
completing her general surgical residency at NYU will continue this
program. top
Pediatric Surgery
The Division of Pediatric Surgery performs surgical
procedures on patients ranging from premature infants to teenagers. Our practice
encompasses newborn surgery for congenital anomalies, cancer surgery, advanced
laparoscopy, hernia surgery, thoracic surgery, head and neck surgery, and some
urologic surgery. All operations are performed at the Petrie campus. Service is
provided 24 hours per day, seven days per week.
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Plastic and Reconstructive Surgery
The Division of Plastic and Reconstructive Surgery at Beth
Israel has one of the busiest Microsurgery services in the New York City
with approximately 100-150 free tissue transfers performed annually. All
members of the full-time faculty are fellowship-trained in Microsurgery.
The division also has multidisciplinary specialty programs in facial
reanimation, oncoplastic surgery, cancer reconstruction, lymphatic
reconstruction, and craniofacial surgery. General surgery residents are
active in divisional research and have presented their work nationally and
internationally. top
Surgical Endoscopy
The discovery and implementation of modern flexible
endoscopy is intimately associated with Beth Israel Medical Center. Beth Israel
was one of the first hospitals to introduce and pioneer endoscopy and
colonoscopy in the United States led by Dr William Wolff and Dr Hiromi Shinya.
There is a continuing surgical expertise and research into new applications of
endoscopic 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. With this technology they are able to perform endoscopic suturing
and plications for patients with gastro-esophageal reflux disease. top
Minimally Invasive Surgery/Advanced Medical Technology Institute
The majority of our surgeons utilize minimally invasive
surgical techniques to treat a wide variety of basic and complex surgical
diseases. With in the Frank Netter simulation and skills center the residents
have the opportunity to practice skills and procedures prior to scrubbing in the
operating room. The da Vinci robot has added a new dimension to laparoscopic
surgery on our Thoracic and Colorectal services. Some of the diseases treated
with a minimally invasive approach include:
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 neoplasm
13. Achalasia
14. Thoracic Surgery. top
Bariatric
Surgery
The department of surgery offers a
multidisciplinary approach to the treatment of morbid obesity. Laparoscopic
Band surgery, gastric bypass surgery and sleeve gastrectomy surgery are
performed at the St Lukes campus. While endoscopic procedures are performed
at the Petrie campus. There is a tri-monthly; multi-disciplinary meeting
teleconferenced between the multiple Continuum sites to discuss Bariatric
surgery. 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. top
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 top
Vascular Surgery
The Division of Vascular Surgery continues to treat the
full spectrum of vascular disease states. A newly equipped, non-invasive
vascular laboratory located on the Petrie Campus in Feirman Hall is available to
diagnose and treat ambulatory patients who require arterial or venous
evaluation. Studies include lower extremity, renal, carotid, dialysis access and
aortic duplex ultrasonography, as well as venous vascular evaluations. 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 state of the art technology for the minimally invasive treatment of complex
aortic, carotid and peripheral vascular interventions. Dr. Thomas Bernik MD,
FACS has been recently recruited to lead the Division of Vascular Surgery. top
Surgical Intensive Care Unit
The Surgical ICU service at Beth Israel Medical Center
cares for approximately 1800 patients per year in our 12 bed SICU and 12 bed
stepdown units. Approximately half the SICU patients are general surgery,
gastrointestinal oncology, or vascular, one fifth are otolaryngologic/reconstructive,
with 10% orthopedic/spine, 10% neurosurgery, 5% urologic and 5% gynecologic. All
patients consulted to the service have a comprehensive consultation and an
attending-intensivist-led plan of care. Daily rounds consist of a 14 system
review of each patient, together with radiology review and bedside rounds by
residents, physician assistants, nurses and board-certified surgical
intensivists.
The educational underpinning of the PGY-1
rotation is the Fundamentals of Critical Care Support Course of the
Society of Critical Care Medicine and the Advanced Trauma Life Support
Course of the American College of Surgeons. The division also supports a
beyond FCCS attending-led lecture series and journal club on the
pathophysiology and therapy of critical surgical illness and acute care
surgery. Care in the unit is protocolized and team-driven, with an
emphasis on best practices and clinical guidelines as promulgated by the
major specialty organizations. top
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