Department of Surgery
Craig R. Smith, MD
Over the past twenty years the Department of Surgery has evolved from a loose federation of private practices to a sophisticated network of creative alliances. Collaboration with medical and scientific experts at Columbia University and globally, as well as with the biotech industry, has resulted in many "firsts" and enhanced our reputation for providing the highest quality patient care.
With the university's new dedication to translational research, we are able to move promising new advances from the laboratory bench to the patient's bedside with greater speed. We then use our clinical observations to fine-tune these treatments and monitor their acceptance into mainstream practice. In short, we are involved in every aspect of the innovation process.
Sponsored research in the Department of Surgery has more than doubled in the last three years to over $19 million, allowing us to have a substantial impact on national healthcare policy. Seven of our eight divisions now have at least one investigator funded by the National Institutes of Health. With our robust culture of clinical trials and our expertise in tracking long-term outcomes, we are setting new national benchmarks.
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In 2004 our Center for Innovation and Outcomes Research completed a $9 million NIH grant to study the LVAD, or left-ventricular assist device, for the treatment of end-stage heart failure. This resulted in FDA approval of the mechanical heart and reimbursement from the Centers for Medicare and Medicaid Services for LVAD implantation.
As the premier site for circulatory assist devices, we have trained over 250 surgeons at 100 centers worldwide. We recently participated in the prestigious Gordon Research Conference, assessing second and third generation devices.
Working hand-in-hand with industry we have made significant advances in mitral valve repair and the treatment of atrial fibrillation. Our department has led national clinical trials of robotically assisted surgery for the repair of atrial septal defects and mitral valves, as well as coronary bypass surgery.
We have also spearheaded the use of new minimally invasive techniques for the treatment of obesity, diseases of the colon, gallbladder and biliary tract, esophageal reflux and hernias. Our joint program in minimal access surgery at NewYork- Presbyterian/Weill Cornell was launched in 2002 with a $10 million industry grant.
The department has contributed to our understanding of the RAGE molecule (Receptors for Advanced Glycation Endproducts) and its role in heart disease, diabetes, Alzheimer's disease, colon cancer, breast cancer and arthritis. We are now collaborating with a biotechnology company to create novel treatments based on RAGE blockade. Two of these drugs are now in Phase II clinical trials and have the potential to help millions of patients live longer, fuller lives.
Our interest in interventional biology extends to cancer vaccines that may prevent recurrence after surgery. Surgical oncologists are testing a new vaccine for kidney cancer and exploring the link between bowel inflammation and cancer. They have also developed the first drug to treat solid childhood tumors.
Our reputation for innovation and the very best patient care has resulted in a burgeoning caseload. The Department of Surgery now performs more than 12,000 operations annually, and our clinical revenue has risen from $27 million to $45 million in the past five years.
Over the last decade we have created over 20 multidisciplinary centers and clinical programs. We have established a strong regional referral base for our melanoma program at the Center for Innovative Cancer Management. Our Wound Healing Program at the Allen Pavilion is under the leadership of Felix Ramond Ortega, MD.
The Plastic Surgery Division is increasingly addressing complex chest wounds and performing reconstruction after openheart surgery. It has advanced craniofacial repair and body contouring after bariatric surgery. As a result, its caseload is at an all-time high.
The Vascular Surgery Division has made dramatic progress in the repair of abdominal aortic aneurysms, innovative peripheral atherectomy and carotid stenting.
The Transplant Institute, operated by NewYork-Presbyterian Hospital, is now one of the largest and most respected in the country. In addition to our leadership in heart transplantation and circulatory assist devices, we are national experts in pediatric and adult liver transplants. We have nearly doubled our program of living donor kidney transplants under the guidance of Lloyd Ratner, MD, who pioneered the two-way kidney swap and has brought that capacity to our department, performing several paired exchanges in 2005.
Our Pediatric Surgery Division has a new home in the Morgan Stanley Children's Hospital at NewYork-Presbyterian/Columbia. The environment is as warm and welcoming as it is technologically dazzling, and it houses one of the country's most active programs in extracorporeal membrane oxygenation (ECMO).