Colorectal Surgery

Doctors

Support

No department can be managed effectively and successfully without numerous dedicated personnel. Secretaries, nurses, research personnel, and many others too numerous to list made our success possible. Full time permanent employees in the Department of Colorectal Surgery are listed below.

Residency Program

The Cleveland Clinic in Florida Department of Colorectal Surgery is one of only 35 training programs in colon and rectal surgery recognized by the Accreditation Council for Graduate Medical Education (ACGME). Our program has recently been reviewed by the ACGME and has received a full five year accreditation. We are extremely proud of this review. Our program has grown from initially one clinical resident to our current status of four clinical residents. Overall, these 35 programs train 63 surgeons each year; the residency training program participates in the National Resident Matching Program to fill these positions.

Our program also offers one of the four clinical residents an optional one year full time research fellowship. These funded residency and fellowship positions are highly sought after; typically close to 100 applications are received of whom 35-40 are granted interviews. Nineteen residents have been trained in the clinical training program, twelve of whom (*) also participated in the research fellowship during the year prior to or after their clinical fellowship.

All of our graduates limit their practices to colorectal surgery. A variety of practice types are chosen by the graduating residents although more than 75% practice in an academic or academic affiliated setting.

Resident		General Surgical Program		CCF		Practice and Location
John D. Cheape, MD(*)		University of Georgia, Augusta, GA		89-91		Academic affiliated, Augusta, GA
Olaf B. Johansen, MD		Massachusetts General, Boston, MA		91-92		Academic affiliated, Indianapolis, IN
Stephanie Schmitt, MD(*)		Mayo Clinic, Rochester, MN		91-93		Full time academic, University of South Florida, Tampa, FL
Sander Binderow, MD		Mt. Sinai Medical Center, New York, NY		92-93		Private practice, Atlanta, GA
Stephen Cohen, MD(*)		Boston University, Boston, MA		92-94		Private practice, Atlanta, GA
Eric G. Weiss, MD		Albert Einstein Medical Center, Philadelphia, PA		93-94		Full time academic, Cleveland Clinic Florida
Mitchell Bernstein, MD		University of Massachusetts, Worcester, MA		94-95		Full time academic, St. Luke’s-Roosevelt Hospital Center, New York, NY
Petachia Reissman, MD(*)		Hadassah University Hospital, Jerusalem, Israel		93-95		Full time academic, Hadassah University Hospital, Jerusalem, Israel
Marc E. Sher, MD		Long Island Jewish Medical Center, New Hyde Park, NY		95-96		Academic affiliated, Long Island Jewish Medical Center, New Hyde Park, NY
Laurence Sands, MD(*)		Albert Einstein Medical Center, Philadelphia, PA		95-96		Full time academic, University of Miami- Jackson Memorial Hospital, Miami, FL
Deborah DeMarta, MD(*)		SUNY Upstate Medical Center, Syracuse, NY		95-97		Private practice, Charleston, SC
Fabio Potenti, MD(*)		Brown University, Providence, RI		96-98		Full time academic, Brown University Hospital, Providence, RI
Jean-François Latulippe, MD (*)		University of Montreal, Montreal, Quebec, Canada		96-98		Full time academic, University of Montreal, Montreal, Quebec, Canada
Jay J. Singh, MD		Parkland Memorial Hospital, UTSWMC, Dallas, TX		97-98		Piedmont Surgical Associates, P.C. Atlanta, Georgia
Bruce Belin, MD(*)		University of Rochester, Rochester, NY		98-00		Full time academic, Lexington, KY
Jonathan Efron, MD (*)		Long Island Jewish Medical Center, New Hyde Park, NY		98-00		Full time academic, Cleveland Clinic Florida
Alon Pikarsky, MD (*)		Hadassah University Hospital, Jerusalem, Israel		98-00		Full time academic, Hadassah University, Jerusalem, Israel
Oded Zmora, MD (*)		Chaim Sheba Medical Center, Tel Hashomer, Israel		99-01		Sheba Medical Center Tel Hashomer, Israel
Jules Garbus, MD		North Shore University Hospital, Manhasset, NY		99-00		Private Practice, Great Neck, NY
Patrick H.D. Colquhoun, MD (*)		University of Saskatchewan, Saskatoon, Canada		00-02		University of Western Ontario, London, Ontario, Canada
Brooke H. Gurland, MD		Mt. Sinai School of Medinine, New York, NY		00-01		Maimonides Hospital, Brooklyn, NY
Joshua A. Katz, MD (*)		New York University Medical Center, New York, NY		00-02		George Washington University Washington, D.C.
Jorge Lagares-Garcia, MD		Temple University Philadelphia, PA		01-02		Rhode Island Colorectal Clinic, Providence, Rhode Island
Seth A. Rosen, MD		University of Chicago Hospitals Chicago, Illinois		01-02		Atlanta Colon & Rectal Surgeons Atlanta, Georgia
Dana R. Sands, MD		Jackson Memorial Hospital/University of Miami Miami FL		01-02		Cleveland Clinic Florida Weston, FL
M. Khurrum Baig, MD (*)		University of Karachi Pakistan		01-02		Greenacres Gorse Lane High Salvington, Worthing, UK
Maher A. Abbas, MD		Mayo Clinic Scottsdale, Arizona		02-03		Kaiser Permanente Los Angeles, CA
John J. DeBarros, MD		University of Connecticut Farmingdale, CT		02-03		Ft. Myers, Florida
Monica A. Hum, MD		St. Lukes Roosevelt Hospital Center New York, New York		02-03		Piedmont Surgical Associates, P.C. Atlanta, Georgia
Brian Valerian, MD		Albany Medical Center Albany NY		02-03		Albany Medical Center Albany NY
Susan M. Cera, MD		Carolinas Medical Center Charlotte, NC		03-04		Physicians Regional Medical Center Naples, FL
James M. Doty, MD		Medical College of Virginia Richmond, VA		03-04		Surgery Specialists of Broward, Inc Plantation, FL
T. Cristina Sardinha, MD		Long Island Jewish Medical Center New Hyde, NY		03-04		Progressive Surgical Care New Hyde, NY
Wael A. Solh, MD		St. Lukes Roosevelt Hospital New York, NY		03-04		Midwestern Surgical Associates, PC Michigan
Mari Anne Madsen, MD		Emory University Hospital Atlanta, GA		04-05		Cedars-Sinai Medical Center Los Angeles, CA
David Maron, M. D.		Thomas Jefferson University Hospital Philadelphia, PA		04-05		University of Pennsylvania Department of Colon & Rectal Surgery Presbyterian Medical Center Philadelphia, PA
John Migaly, MD		Temple University Philadelphia, PA		04-05		Temple University Hospital Philadelphia, PA
Bridget Sanders, MD		Indiana University Indianapolis, IN		04-05		Kendrick Regional Center Indianapolis, IN
Matthew Vrees, M.D		Brown University of Rhode Island Hospital Providence, RI		04-05		Rhode Island Colorectal Clinic Rhode Island
Farshad Abir, MD		Yale, New Haven Hospital New Haven, CT		05-06		Piedmont Surgical Associates, P.C. Atlanta, GA
Jill Genua, MD(*)		The Stanford Hospital / Columbia University College Stamford CT		05-06		Colon and Rectal Surgeons of CT Stamford, CT
Benjamin Person, MD(*)		Rambam Medical Center Haifa Israel		05-06		Rambam Medical Center Haifa Israel
Nathan Schneidereit, MD		Vancouver Hospital and Health Sciences Center Vancouver BC, Canada		05-06		British Columbia, Canada
Henry Talus, MD		Harlem Hospital Center New York, NY		05-06		Colon & Rectal Surgical Ctr. Of South Jersey Lumberton, NJ
Marat Khaikin, MD (*)		Sheba Medical Center Tel-Hashomer, Israel		06-07		Tel-Hashomer Hospital Israel
Amit Khanna, MD		University of Rochester Rochester, NY		06-07
Anne Lin, MD		Brown University, Rhode Island Hospital Providence, RI		06-07		Washington University St. Louis, MO
Dipen Maun, MD		Mt. Sinai Hospital New York, NY		06-07		Indianapolis, IN
Christina Seo, MD		University of Rochester Rochester, NY		06-07
Avraham Belizon, MD		North Shore Long Island Hospital New Hyde Park, NY		07-08		Minimally Invasive Colon Delray Beach, FL
Jared Frattini, MD		Yale-New Haven Hospital New Haven, CT		07-08		Tampa General Hospital Tampa, FL
Bashar Safar, MD		Indiana University Indianapolis, IN		07-08		St. Louis, MO
Elizabeth Mclemore, MD		Mayo Clinic Scottsdale, AZ		07-08		Pasadena Colon and Rectal Pasadena, CA
Ron Landman, MD		St. Luke’s-Roosevelt Hospital New York, NY		07-08		Mayo Clinic Jacksonville, FL
Paula Denoya, MD		Mount Sinai Hospital New York, NY		08-09		Stony Brook University Stony Brook, NY
Elie Schochet, MD		Lehigh Valley Hospital Allentown, PA		08-09		Holy Cross Hospital Ft. Lauderdale, Fl
Andrew Vorenberg, MD		University of Virginia Charlottesville, VA		08-09		St. Mary’s Hospital Richmond, VA
Joseph Mareno, MD		University of California San Diego, CA		08-09		ATL Colorectal Surgery Atlanta, GA
Nagesh Ravipati, MD		Mayo Clinic Phoenix, AZ		08-09		Colon and Rectal Surgery Associates St. Paul, MN
Cybil Corning, MD		University of Arizona Tucson, AZ		09-10		University of Illinois Chicago, IL
Giovanna Dasilva, MD		Maimonides Medical Center Tucson, AZ		09-10		Cleveland Clinic Florida Weston, FL
Yair Edden, MD		Hadassah Hebrew University Jerusalem, Israel		09-10		Hadassah Hebrew University Jerusalem, Israel
Thiru Lakshman, MD		Thomas Jefferson University Philadelphia, PA		09-10		Central Texas Colon & Rectal Austin, TX
Kimberly Matzie, MD		Brigham Women’s Hospital Boston, MA		09-10		Fairfax Colon & Rectal Surgery Fairfax, VA
Marylise Boutros, MD		McGill University Montreal, QC, can		10-11		Cleveland Clinic Florida Weston, FL
Assar Rather, MD		Mercy Catholic Medical Center Darby, PA		10-11		Dover, Delaware
Richard Schaller, MD		Albany Medical Center Albany, NY		10-11
Virgnia Shaffer, MD		Emory University Atlanta, GA		10-11		Emory Universtiy Atlanta, GA
Dana Hayden, MD		Rush University Medical Center Chicago, IL		10-11		Rush University Hospital Chicago, IL
Rafal Baczak, MD		University of Connecticut Farmington, CT		11-12		Hartfors Specialist Meriden, CT
Dan Enger-Ruiz, MD		New York Hospital Queens Flushing, NY		11-12		McDough District Hospital Macomb, IL
Yosef Nasseri, MD		Cedars Sinai Medical Center Los Angeles, CA		11-12		LA Surgical Assoc. Los Angeles, CA
Marc Osborne, MD		Hennepin County Medical Center Minneapolis, MN		11-12		University of Minnesota Edina, MN
E. Dawn Wietfeldt, MD		Southern Illinois University Springfield, IL		11-12		Springfield Clinic Springfield, IL
* Denotes research and clinical years § Denotes current residents

Research Residents

The Department of Colorectal Surgery at the Cleveland Clinic Florida has a world renowned reputation in education and research. Besides our ACGME accredited residency training program in colorectal surgery, we offer a variety of opportunities for international physicians and surgeons interested in colorectal surgery to develop and explore the specialty. In many countries throughout the world, colorectal surgery is not a recognized specialty and, therefore, advanced training is not possible. Physicians and surgeons from other countries visit the department on an almost daily basis and spend from several days to over one year in the department. Primarily, these individuals learn anorectal physiology; however, a wide array of clinical experience is offered to these physicians. Typically, these residents and fellows publish a myriad of chapters and manuscripts in relation to their work and research at the Cleveland Clinic Florida Department of Colorectal Surgery. It would be impossible to list everyone who has spent time in the department. However, those trainees who have spent more than two months from 1995 to 2007 are listed below as are their respective countries of origin.

Name		City, Country		Training Period
Hirokazu Okano, MD		Japan		1995 - 1996
Pedro Basilio, MD		Rio de Janeiro, Brazil		1995 - 1996
Armando Nessim, MD		Caracas, Venezuela		1996 - 1997
Augustine Iroatulam, MD		Siena, Italy		1996 - 1997
Euler Azaro Filho, MD		Salvador, Bahia, Brazil		1996
Cristina Sardinha, MD		São Paulo, Brazil-now Long Island, NY		1996 - 1998
Edelberto Vasquez Mulett, MD		Bogota, Colombia		1996
Helio Moreira, Jr., MD		Goiania, Goias, Brazil		1996 - 1997
Sandrasekeram Parameswaran, MD		Cleveland, UK		1996
Masato Kusunoki, MD		Hyogo, Japan		1996
Omer Alabaz, MD		Adana, Turkey		1996 - 1997
Hiroyoshi Matsuoka, MD		Tokyo, Japan		1996 - 1997
Tetsuro Nakamura, MD		Saitama, Japan		1996 - 1997
Hong Hwa Chen, MD		Taipei, Taiwan		1996 - 1997
Chi-Wai Lau, MD		Hong Kong		1996 - 1997
Christian Cock-Hernandez, MD		Medellin, Colombia		1996 - 1997
Cheng-Kiong Kum, MD		Singapore		1997
Constantinos Mavrantonis, MD		Athens, Greece		1997 - 1998
Oscar Tellez, MD		Mexico City, Mexico		1997
Gabriela Avella Zangari, MD		Buenos Aires, Argentina		1997
Takuya Yamaguchi, MD		Osaka, Japan		1997 - 1998
Mara Salum, MD		São Paulo, Brazil		1997 - 1998
Alexandre Freitas, MD		Curitiba, Parana, Brazil		1997
Miguel Pujadas Palumbo, MD		Tucuman, Argentina		1997 - 1998
Jeong Seok Choi, MD		Pusan, South Korea		1997 - 1998
Jin-Tung Liang, MD		Taipei, Taiwan		1997
Chengfang Yu, MD		Guangdon, P.R. China		1997 - 1998
Jorge Fajardo, MD		Bogota, Colombia		1998
Sergio Martinez, MD		Caracas, Venezuela		1998 - 1999
Carlos E. Vivas Espen, MD		Montevideo, Uruguay		1998
Isay Moscovitz, MD		Caracas, Venezuela		1998 - 1999
Yong Hee Hwang, MD		Seoul, Korea		1998 - 1999
Yoshihisa Saida, MD		Tokyo, Japan		1998
Ronghua Zhao, MD		Shanghai, P.R. China		1998 - 2000
Juliane Rocha Miranda, MD		Goiania, Goias, Brazil		1998 - 1999
Young-Soo Nam, MD		Seoul, Korea		1998 - 1999
William Chen, MD		Chang-Hua, Taiwan		1998
Christian Hamel, MD		Basel, Switzerland		1998 - 1999
Juan Carlos Patron Uriburu, MD		Buenos Aires, Argentina		1998 - 1999
Emin Engin Ovalioglu, MD		Cebeci, Turkey		1998
Mirza Khurrum Baig, MD		Portsmouth, UK		1998 - 1999
Eung-Jin Shin, MD		Chunnam, Korea		1998 - 1999
Hong Jo Choi, MD		Pusan, South Korea		1998 - 1999
Pascal Gervaz, MD		Lusanne, Switzerland		1999
David Lam, MD		Kowloon, Hong Kong		1999
Augusto Lauro, MD		Perugia, Italy		1999
Pasquale Esposito, MD		Naples, Italy		1999 - 2000
Anil Jain, MD		Nagda, India		1999
Naoto Saigusa, MD		Hamamatsu, Japan		1999 - 2000
Ho Tack Nam, MD		Puyo, Korea		1999 - 2000
Michele Pisano, MD		Cagliari, Italy		1999
Sung Won Chun, MD		Seoul, Korea		1999 - 2001
Goodluck Eze, MD		Parma, Italy		1999 - 2000
Xavier Gonzalez Argente, MD		Barcelona, Spain		1999
Nicolas Rotholtz, MD		Buenos Aires, Argentina		1999 - 2000
Seong Yeop You, MD		Kwangju, Korea		1999 - 2001
Chien-Yuh Yeh, MD		Taepei, Taiwan		1999 - 2000
John Oikonomakis, MD		Athens, Greece		1999 - 2000
Klaus Thaler, MD		Vienna, Austria		1999 - 2001
Jeong-do Moon, MD		Seoul, Korea		2000
Giovanna Marques da Silva		Belo Horizonte, Brazil		2000 - 2004
Pasquale Giordano, MD		London, England		2000 - 2001
Adolfo Renzi, MD		Napoli, Italy		2000
Nelly Mizrahi, MD		Caracas, Venezuela		2000 - 2001
Adam Dinnewitzer, MD		Salzburg, Austria		2000 - 2001
Taeseok Park, MD		Kwang-ju City		2000 - 2001
Turab Pishori, MD		Karachi, Pakistan		2000 - 2001
Kazuo Takeuchi, MD		Fukui, Japan		2000 - 2001
Luay Hajjar, MD		Dhahran, Saudi Arabia		2000 - 2001
Michael Oberwalder, MD		Innsbruck, Austria		2000 - 2001
Seong-do Moon, MD		Seoul, Korea		2000 - 2001
Sanhua Qing, MD		China		2000 - 2001
Nickos Kelessis, MD		Greece		2000 - 2001
Byung Kwn Ahn, MD		Korea		2001 - 2002
Abhijit Basu, MD		India		2001 - 2002
Hung-Chang Chang, MD		China		2001
Paolo Giamundo, MD		Naples, Italy		2001 - 2002
Sing Man Hui, MD		China		2001 - 2002
Ahmad Izadpanah, MD		Iran		2001 - 2002
Jong Kim, MD		Pusan, Korea		2001 - 2003
Yong-Soo Kim, MD		Pusan, Korea		2001 - 2003
Jong Lee, MD		Seoul, Korea		2001 - 2003
Neriman Sengul, MD		Turkey		2001 - 2002
Shih-Chang Chang, MD		China		2002 - 2003
Chong Chung, MD		Korea		2002
Long Cui, MD		China		2002
Kok-Sun Ho, MD		Singapore		2002 - 2003
Eunsoo Kim, MD		Seoul, Korea		2002 - 2004
Jorge Larach, MD		Santiago, Chile		2002
Jorge Rodriguez, MD		Bogotá, Columbia		2002
Mir Ramin Roohipour, MD		Iran		2002 - 2003
Shingo Tsujinaka, MD		Tokyo, Japan		2002 - 2004
Lars Borjesson, MD		Goteborg, Sweden		2003
Carlos De La Garza Hernandez, MD		Mexico		2003
Radosvet Gornev, MD		Bulgaria		2003
Jae-Kwan Hwang, MD		Korea		2003 - 2004
Dan Enger Ruiz, MD		Brazil		2003 - 2006
Rongua Zhao, MD		Shanghai, China		2003 - 2005
Moon-Kyung Seong, MD		Seoul, Korea		2003 - 2004
Moon-Kyung Schubert, MD		Seoul, Korea		2003
Myrian Oviedo, MD		Paraguay		2004 - 2007
Sang-Su Park, MD		Korea		2004-2005
Young-Jin Park, MD		Korea		2004
David Vivas, MD		Venezuela		2004 - 2007
Benjamin Person, MD		Israel		2004 - 2005, 2006 - 2007
Orit Kaidar-Person, MD		Israel		2005
Marat Khaikin, MD		Israel		2005 - 2006
Taehyung Kim, MD		Korea		2005 - 2006
Chenghua Luo, MD		China		2005 - 2006
Carlos Torres, MD		Venezuela		2005
Woo Seo Ahn, MD		Korea		2005 - 2006
Jorge Bracho, MD		Venezuela		2005 - 2006
Chae Gibong, MD		Korea		2005 - 2006
Luca Moraldi, MD		Italy		2006
Badma Bashankaev, MD		Russia		2006
Soon-Sup Chung, MD		Seoul, Korea		2006
Min-Geun, Kwak, MD		Seoul, Korea		2006
Sanjay Jobanputra, MD		United States		2006 - 2007
Daniel Melero, MD		Spain		2006 - 2007
Bashar Safar, MD		London		2006 - 2007
Sherief Shawki, MD		Egypt		2006 - 2007
Bianca Santoni, MD		Brazil		2006 - 2009
Deok Won Hwang, MD		Korea		2007 - 2009
Paula Denoya, MD		USA		2007 - 2008
Kazuwhiro Narito, MD		Japan		2008 - 2009
Rodrigo Pinto, MD		Brazil		2008 - 2009
Sthela Regadas, MD		Brazil		2008 - 2009
Sergio Regadas, MD		Brazil		2008 - 2009
Raul Almenara, MD		Spain		2009
Federica Cadeddu, MD		Italy		2009
Seung Hyn Lee, MD		Korea		2009
Feng Fan Chiang, MD		Taiwan		2010
Rodrick Babakhanlou, MD		Germany		2010
Mehdi Fesharakizadeh, MD		Iran		2010
Yoon Suk Lee, MD		Korea		2010
Abraham Testa, MD		Peru		2010
Neriman Sengul, MD		Turkey		2011
Jianhua Ding, MD		China		2011
Richard Schaller, MD		USA		2011
Art Hiranyakas, MD		Thailand		2011
Ricardo Mentz, MD		Argentina		2011
Hao Liqiang, MD		China		2011
Junlin Liang, MD		China		2011
Rejeesh Selvaganesan, MD		India		2011
Rejeesh Selvaganesan, MD		USA		2011
XingRong Lu, MD		China		2011
Nobuhiro Ito, MD		Japan		2011
JiYeon Kim, MD		Korea		2012
Georgia Dedemadi, MD		Greece		2012
Antonio Maya, MD		Argentina		2012
Seth Wollman, MD		USA		2012
Mohamed El Messiry, MD		Egypt		2012
Kwang Dae Hong, MD		Korea		2012
Fulin Lin, MD		China		2012

Clinical Fellows

Melissa Alvarez, MD

Hayer Al-Azzawi, MD

Lisa Hayder, MD

Rahul Narang, MD

Julie Vankoughnett, MD

Research Fellows

Gifty Abraham, MD

Mohammed Al-Qadasi, MD

Karla Arancibia, MD

Yin Hoong Chong, MD

Sudhir Kalaskar, MD

Fulin Lin, MD

Aleksandra Murawska, MD

Shota Takano, MD

Qingming Wang, MD

Xiaofeng Wang, MD

Visiting Professors

Each year we share with our residents, students, and support staff the chance to be taught by internationally acclaimed visiting experts. The following is a list of our previous Visiting Professors and the institutions at which they teach.

Herand Abcarian, MD
University of Illinois School of
Medicine/Cook County
Chicago, Illinois

H. Randolph Bailey, MD
University of Texas Affiliated
Hospitals/Baylor Medical School
Houston, Texas

Robert W. Beart, Jr., MD
University of Southern California
Los Angeles, California

David E. Beck, MD
Ochsner Clinic
New Orleans, Louisiana

Richard Billingham, MD
Northwest Colon and Rectal Clinic Program

Ronald Bleday, MD
Brigham & Women’s Hospital

Zane Cohen, MD

Marvin C. Corman, MD
Sansum Medical Clinic
Santa Barbara, California

Thomas H. Dailey, MD
Columbia University College of
Physicians and Surgeons/
The Roosevelt Hospital
New York, New York

James W. Fleshman, MD
Washington University
St. Louis, Missouri

Robert D. Fry
Thomas Jefferson University
Philadelphia, Pennsylvania

Stanley M. Goldberg, MD, FACS,
FASCRS, FRCS (Hon), FRACS (Hon)
University of Minnesota
Minneapolis, Minnesota

Philip H. Gordon, MD
Jewish Genereal Hospital

Lester Gottesman, MD
St. Luke’s-Roosevelt Hospital Center
New York, New York

Frederick Greene, MD

R.J. Heald, MD
The Pelican Centre, North Hampshire

Terry C. Hicks, MD
Ochsner Clnic
New Orleans, Louisiana

Neil Hyman, MD
Western Pennsylvania Hospital

Indru T. Khubchandani, MD
University of Pennsylvania,
Hahnemann University
Philadelphia, Pennsylvania

Ira J. Kodner, MD
Washington University
St. Louis, Missouri

Ann Lowry, MD
University of Minnesota Hospitals

Robert D. Madoff, MD
University of Minnesota

Peter Marcello, MD
Lahey Clinic

Jorge E. Marcet, MD
University of South Florida

Frank Opelka, MD
Ochsner Clinic
New Orleans

John Pemberton, MD
Mayo Clinic
Rochester, Minnesota

Thomas Read, MD
Western Pennsylvania Hospital

Patricia L. Roberts, MD
Lahey Clinic
Burlington, Massachusetts

David A. Rothenberger, MD
University of Minnesota

David J. Schoetz, MD,
FACS, FASCRS
Lahey Clinic
Burlington, Massachusetts

Anthony Senagore, MD
Medical University of Ohio

Cliff Simmang
UT Southwestern University

Lee E. Smith, MD
Washington Hospital Center
Washington, D.C.

Michael J. Stamos, MD
UCLA School of Medicine

Steven Stryker, MD
Northwestern University
Chicago, Illinois

Alan G. Thorson, MD
Creighton University
Omaha, Nebraska

Anthony M. Vernava, III, MD
St. Louis University
St. Louis, Missouri

R. Lawrence Whelan, MD
Columbia Presbyterian

Bruce G. Wolff, MD
Mayo Clinic
Rochester, Minnesota

Douglas Wong, MD
Memorial Sloan-Kettering Cancer Center
New York, New York

Alumni Association

The Department of Colorectal Surgery has graduated 59 clinical residents and dozens of research residents and fellows from our training program. Alumni are spread out throughout the world in a variety of practice settings.

In an effort to continue contact and give alumni a central site to communicate through, the Alumni Association has been created. The Alumni Association will hopefully allow collaborative or multi-institutional trials involving members of the association to participate. In addition, a website will be developed and will have a separate area for alumni to read about and hear of activities of alumni. Any one of the alumni will attest to the “family” in the Department of Colorectal Surgery.

Applications may be obtained through Marisol Quintana, 954.659.5240, fax 954.659.5757, or email quintam@ccf.org.

Colorectal Surgery Overview

The Department of Colorectal Surgery is the epitomy of the growth. The department is internationally renowned for patient care, research and education, teaching, and training.

As we enter our 21st year in Florida, we owe a debt of gratitude to our patients, peers, residents and fellows, philanthropists, and corporate supporters. The collective trust which you have placed in us has allowed us to grow from four members of our department in 1988 to more than 50 in 2008.

As you peruse the information contained within the text to follow this introduction, you will note that tens of thousands of patient visits have resulted in the opportunity for our staff to assist through consultations and interventional procedures thousands of patients from throughout the world. In addition to directly improving the outcome for these individuals, we have indirectly touched the lives of many thousands more patients by training their physicians and surgeons when they have visited us from throughout the world.

Moreover, hundreds of medical students, residents, and fellows have spent periods ranging from one month to three years in our department to further their education and learn the methodology and techniques of evaluation and management of colorectal diseases at Cleveland Clinic in Florida.

Although these individuals were here to learn, they also helped to teach our staff by researching methods of improving outcomes. Specifically, they have helped us conduct prospective and prospective randomized trials as well as database and retrospectively review our results. By these labors, they have helped us to continually improve and expedite methods of diagnosis, reduce the adverse side effects of treatment, improve the curability of our therapeutic modalities, reduce recurrence rates, and improve the quality of life of patients throughout the world.

The fruits of these labors have yielded as an average one published manuscript per month in the medical literature over the last 20 years along with an average of one book chapter every three months during this same time period. Moreover, over the last several years, we have published approximately one textbook per year. All of these discoveries and innovations have enabled our staff and many of our former residents to become recognized as leaders within the field of colorectal surgery.

All of our staff and many of our former trainees have been asked to serve on important committees in regional, national, and international professional societies. They have been bestowed with honorary memberships and fellowships and have been recruited to travel throughout the world teaching the methodology developed and utilized in our department so that patients in other lands may benefit.

Sometimes one’s expertise is only recognized far from home; in proximity local politics and jealousies often sadly preclude utilizing the resources of even an internationally acclaimed individual. We are proud that in our local community our colleagues in colorectal surgery as well as in the allied fields of general surgery and gastroenterology have continually called upon our staff, both as a referral resource for their patients as well as an academic asset to further their education.

Our staff have been asked to organize the educational sessions for the South Florida Chapter of the American College of Surgeons, the Florida Chapter of the American College of Surgeons, the Florida Gastroenterologic Society, the Northeastern Society of Colon and Rectal Surgeons, the Welsh Surgical Society, and the Royal Society of Medicine Section of Coloproctology, as well as many other similarly prestigious societies.

Our doctors are recognized by our peers as “the best” in publications including The Best Doctors in America (national editions, 1994-2008), The Best Doctors in America (southeast edition, 1997-1998), Town and Country (1990), South Florida (1991), American Health (1996), Good Housekeeping (1999), Miami Metro (2000), Where to Find the Best Doctors (2000), America’s Top Doctors (2002-2007), and America’s Top Cancer Doctors (2005-2007).

From late 1987 through the opening of Cleveland Clinic in Florida on February 28, 1998 until July 2, 2001, Cleveland Clinic in Florida was split between two campuses.The hospital was located on A1A just south of Oakland Park Boulevard in Fort Lauderdale while the outpatient clinic facility was in a series of three buildings on West Cypress Creek Road and NW 31st Avenue in northwestern most Fort Lauderdale.

Through a variety of steps undertaken by our former CEO, Harry K. Moon, MD, Cleveland Clinic in Florida successfully relocated to a 68-acre unified campus in Weston, Florida. Weston is the geographic epicenter amongst Palm Beach, Broward, Miami-Dade, Lee, and Collier Counties.

This imminently convenient 500,000 square foot location includes the multi-million dollar interactive David G. Jagelman, MD Conference Center. Most of the 153 beds are in private rooms. Both the physical plant and level of service are far more akin to a five star hotel than to a conditional hospital.

The hospital has become a destination for both health care providers and patients from around the world. In fact, over 80% of the patients seeking surgery in the Department of Colorectal Surgery live outside of the five-county area of Monroe, Miami-Dade, Broward, Palm Beach, and Martin Counties. Despite the small size of the hospital, the colorectal service generally occupies 25% to 35% of the hospital census. On most days, 2 to 3 colorectal operating rooms are in session from 7:30 a.m. until some time in the evening serving an ever-increasing number of patients.

None of these accomplishments would have been possible without the efforts and visions of our founding late chairman, David G. Jagelman, MD Although more than five years have elapsed since David’s untimely passing, on August 9, 1993, his teachings are imparted to our residents and students on a daily basis. His energy and enthusiasm for our specialty continues to be transmitted and his name will live on forever.

Although he is not here with us in a corporeal sense, he continues to be our guiding light as we follow the path which he outlined to success. We are delighted that the multimillion dollar interactive conference facility in Weston is named “The David G. Jagelman, MD Conference Center.” It is a fitting tribute to a man who made so many innovations and touched in a positive way so many lives throughout the world.

None of the accomplishments in this department would have been possible without the participation of our patients by allowing us the privilege of serving their health care needs. We could not have treated these patients had our colleagues from communities throughout the world not relied upon us as a referral resource for these problems.

We could not have learned how to better treat the patients of these physicians had our clinical and research residents, fellows, and students not been here to continually stimulate us to work at our best and to mercilessly, and in a brutally honest fashion, scrutinize our results. These results could not have been properly analyzed, presented, and published without the financial support of our philanthropic patients and corporate donors.

Unfortunately, funding for research and education is increasingly difficult to secure. We must rely upon such altruism to continue our activities.

As you peruse the sections that follow this introduction, I ask you to think about the impact made on the quality of life for patients throughout the world by the advances made in our department. I would like you to reflect upon the importance of continuing to teach current and future generations of surgeons how to evaluate and manage these problems. Lastly, I would like you to volunteer to help us as best you can to perpetuate Dr. Jagelman’s legacy in providing the finest possible care for diseases of the colon, rectum, and anus.

In the acknowledgements section, you will find a list of our major donors to date. I hope to see your name on the next iteration of this list. I thank you in advance for your anticipated generosity.

Steven D. Wexner, MD, FACS, FRCSEd, FASCRS, FACG

Chief Academic Officer
Emeritus Chief of Staff
Chairman, Division of Research and Education
Chairman, Department of Colorectal Surgery
Professor of Surgery, The Cleveland Clinic Foundation Health Sciences Center of The Ohio State University
Clinical Professor, Department of Surgery, University of South Florida
Research Professor of Biomedical Science, Florida Atlantic University
21st Century Oncology Chair in Colorectal Surgery

History of the Cleveland Clinic Foundation

In 1921, the Cleveland Clinic Foundation was established by four physicians, Drs. George Crile, Frank Bunts, William Lower, and John Phillips. At that time, the group practice model was rare, only being found at the Mayo Clinic and in military units. Their mission was to establish a medical facility dedicated to quality patient care, education, and research into the diseases of the patients they treated. This mission culminated in the formation of the Cleveland Clinic.

Seventy years and two million patients later, that mission statement remains a guiding principle for the Cleveland Clinic Foundation, a not-for-profit group practice in which clinical care, research, and education are inextricably linked in order to provide each patient with the best possible care. Through the years, the Clinic has changed and grown and now is one of the world’s foremost leaders in healthcare.

Similarly, in 1988, Cleveland Clinic in Florida was established to provide similar care in a region where academic medicine and group practices were rare. Since 1988, Cleveland Clinic in Florida has grown in all aspects and is internationally recognized as a healthcare leader.

The Department of Colorectal Surgery is the epitomy of the growth. The department is internationally renowned for patient care, research and education, teaching, and training. Moreover, numerous publications and presentations as well as new and innovative techniques makes the department one of the most well respected academic colorectal units in the world.

History of the Department

As in all successful endeavors, an initial development person is usually behind that success. The case is no different in the Department of Colorectal Surgery at Cleveland Clinic in Florida.

Dr. David G. Jagelman

The late Dr. David G. Jagelman (1939-1993) was the driving force in the department. Dr. Jagelman was born in England where he received all of his undergraduate and graduate education. He trained at such prestigious institutions as Westminster Medical College, the Metropolitan Hospital, and St. Mark’s Hospital. Dr. Jagelman then trained as a fellow in colorectal surgery at the Cleveland Clinic Foundation in Ohio in 1974-1975 and remained on staff in the department. In 1987, he was recruited to begin to build the Department of Colorectal Surgery in Fort Lauderdale.

Dr. Jagelman was one of the founding fathers and Chairman of both the Department of Colorectal Surgery and the Division of Surgery. His world famous reputation and expertise in rectal cancer, inflammatory bowel disease and familial adenomatous polyposis (FAP) allowed the department to quickly blossom.

In Cleveland, Dr. Jagelman had established the polyposis registry which became one of the largest and most respected registries in the world. After entering 240 families into the registry, Dr. Jagelman set up an identical registry in Florida. Between 1988 and 1993, he entered 33 new families into the Florida registry. Dr. Jagelman remained chairman until his untimely death at the age of 53 in 1993.

In 1987, prior to Dr. Jagelman leaving Cleveland, he recruited Steven D. Wexner, MD, from the University of Minnesota, to help begin the vision of a world-class department. A native of New York, Dr. Wexner received his undergraduate education at Columbia University, his medical schooling at Cornell University, and his surgical training at The Roosevelt Hospital in New York.

In early 1988, when Cleveland Clinic in Florida opened, Dr. Wexner established the Anorectal Physiology Lab. At the time of its inception, the physiology lab was one of the first comprehensive interdisciplinary testing facilities in North America. Since that time, it has become one of the premier physiology laboratories in the world, evaluating hundreds of patients and training dozens of physicians each year.

In 1988, Drs. Jagelman and Wexner were among the first surgeons in the world to perform and disseminate the benefits of a new type of ileal pouch anal anastomosis called the double stapled technique. This exciting new modification to the pouch procedure revolutionized surgery for mucosal ulcerative colitis. It has been applied to almost 1000 patients in our department and has been adopted by countless surgeons worldwide, thereby benefiting many thousands of patients.

In 1991, Drs. Jagelman and Wexner began to pioneer laparoscopic colorectal surgery. That program has now developed into one of the most extensive of its type in the world. Thousands of surgeons from throughout the world have come to receive training while over 1000 patients at Cleveland Clinic in Florida and hundreds of thousands more worldwide have now undergone this impressive new technique. Other new and innovative procedures pioneered in total or in part at Cleveland Clinic in Florida in the Department of Colorectal Surgery include:

• sacral nerve stimulation for fecal incontinence
• stimulated graciloplasty for fecal incontinence
• the artificial bowel sphincter for fecal incontinence
• the use of sodium hyaluronate/carboxymethylcellulose bioresorbable membrane for prevention of postoperative adhesions
• a new technique of multilayered sphincter repair for fecal incontinence
• management of sigmoidoceles for chronic constipation
• graciloplasty for rectourethral and rectovaginal fistulas
• scoring systems for both fecal incontinence and chronic constipation developed at Cleveland Clinic im Florida have become the most commonly used validated scoring systems.

Dr. Steven Wexner

Since 1993, Dr. Wexner has been the Chairman of the Department of Colorectal Surgery as well as serving as Director of the Residency Program from 1989 to the present. He served as Vice-Chairman of the Division of Surgery until 1995 when he was appointed as Chairman of the Division of Research and Education.

He chaired the Institutional Review Board and the Continuing Medical Education Committee until November 1997 when he resigned from those positions to accept the appointment as Chief of Staff. His duties as Chief of Staff include Cleveland Clinic in Florida, and Cleveland Clinic Hospital, and currently include the additional responsibilities of Chairman of the Medical Executive Committee, and 21st Century Oncology Chair in Colorectal Surgery.

Dr. Wexner was also appointed Professor of Surgery at The Cleveland Clinic Foundation Health Sciences Center of The Ohio State University, Research Professor of Biomedical Science at Florida Atlantic University, and Clinical Professor in the Department of Surgery at the University of South Florida as well as honorary professor at the University of Siena in Siena, Italy, the University of Nanjing, China, University of Belgrade, Serbia, and Tokyo University, Japan.

Dr. Wexner is also a Visiting Professor at Hadassah University Medical Center in Jerusalem, Israel. He has also received fellowships from the Royal College of Surgeons in London and the Royal College of Surgeons in Edinburgh. Dr. Wexner has been president of numerous professional societies including the South Florida Chapter of the American College of Surgeons, the Florida Gastroenterologic Society, and the Section of Colon and Rectal Surgery of the Southern Medical Association.

From 2006-2007, Dr. Wexner was President of SAGES, the largest general surgery association in the USA with over 6000 surgeon-members. Other leadership roles have included the residency review committee for Colon and Rectal Surgery of the ACGME, the American Board of Colon and Rectal Surgeons, the executive council of the ASCRS, and a governor of the American College of Surgeons.

Dr. Wexner is on 19 editorial boards, has delivered thousands of lectures on 6 continents. He has authored or coauthored 26 books, 191 book chapters, 1025 abstracts, and 476 manuscripts.

Dr. Juan J. Nogueras

In 1991, Dr. Juan J. Nogueras was recruited from colorectal surgery training at the University of Minnesota. Born in Puerto Rico, Dr. Nogueras moved to New Jersey at the age of ten years. His undergraduate training was at Princeton University, and he attended medical school at Jefferson Medical College in Philadelphia, Pennsylvania. He completed his surgical residency training at Columbia-Presbyterian Medical Center of Columbia University in New York.

Dr. Nogueras is in charge of the Cleveland Clinic in Florida David G. Jagelman, MD Inherited Colorectal Cancer Registry as well as the surgical registries in the Department of Colorectal Surgery. Dr. Nogueras has significant interest in genetics and in familial colorectal cancer syndromes. Dr. Nogueras is one of the world experts in endoanal ultrasonography and has pioneered some of its current uses in benign diseases such as fistulas, incontinence, and anorectal pain.

Dr. Nogueras served as Chairman of the Medical Advisory Committee of the Gold Coast Chapter of the Crohn’s and Colitis Foundation of America. He chaired the Medical Student Education Committee and was the interim co-chair for the Cancer Center at Cleveland Clinic Florida. In addition, he has served on many important national committees including the Program Committee for the American Society of Colon and Rectal Surgeons. In addition, he is an honorary member in seven international surgical societies.

In January 1999, Dr. Nogueras was appointed as the Vice-Chairman of the Department of Colorectal Surgery and was also appointed as Associate Professor of Surgery of The Cleveland Clinic Foundation Health Sciences Center of the Ohio State University. Since 2000, Dr. Nogueras has served as Chairman of the Department of Surgery. His other leadership roles have included Secretary-treasurer of the South Florida Chapter of the American College of Surgeons.

Dr. Nogueras has delivered 233 lectures at 93 meetings in 16 countries on 3 continents. He has authored 23 book chapters, 150 abstracts, and 97 manuscripts.

Dr. Eric G. Weiss

In 1994, Dr. Eric G. Weiss was recruited after completing fellowship training in the Department of Colorectal Surgery at Cleveland Clinic Florida. Dr. Weiss, a New Mexico native, received his undergraduate education at Pennsylvania State University, his medical education at Temple University, and surgical training at the Albert Einstein Medical Center in Philadelphia.

As the first alumnus member of the department, Dr. Weiss is integrally important to the residency training program. He has interests in laparoscopy, endoanal ultrasonography, colonoscopy, colorectal cancer, and inflammatory bowel disease, in addition to other facets of colorectal surgery.

Dr. Weiss has chaired the Patient Education Committee at Cleveland Clinic Florida since its inception. He also plays important roles in many national societies including as a member of the Young Surgeons Committee of the American Society of Colon and Rectal Surgeons.

In 1998, Dr. Weiss was appointed as Associate Program Director of the Residency Training Program in the Department of Colorectal Surgery at Cleveland Clinic Florida, and in 2004 became the Residency Program Director. Since 1998, Dr. Weiss has also served as Chairman of the Graduate Medical Education committee.

Dr. Weiss served on many regional committees for several professional societies including SAGES and ASCRS. He was the representative from both these prestigious societies to the CPT coding panel of the American Medical Association and is a member of the residency review committee in colon and rectal surgery of the ACGME. Dr. Weiss is also a member of the executive council of the Program Directors Association in Colon and Rectal Surgery.

Dr. Weiss was also appointed as Assistant Professor of Surgery of The Cleveland Clinic Foundation Health Sciences Center of the Ohio State University. He has delivered 178 lectures worldwide. He has authored or co-authored 550 abstracts, 1 book, 36 book chapters, and 225 manuscripts.

Dr. Dana Sands

In 2002, Dr. Dana Sands joined the department after completing the Colorectal Surgery fellowship here at Cleveland Clinic Florida. Prior to coming to Cleveland Clinic Florida, she received her undergraduate education at Renssalear Polytechnical Institute in Troy, NY. She attended the Hahnemman University School of Medicine in Philadelphia, PA and completed general surgery residency training at Jackson Memorial Hospital in Miami, FL.

Since joining the department, she became director of the Colorectal Physiology Center in 2002, and has expertise in benign anorectal diseases, pelvic floor dysfunction, fecal incontinence, constipation, inflammatory bowel disease, and colorectal cancer. Dr. Sands has an extensive experience with transanal endoscopic microsurgery(TEMs).

Dr. Fabio Potenti

During 2006, Dr. Fabio Potenti was recruited as a member of the Faculty for the Residency Program. Dr. Potenti completed his general surgery training at Brown University and after two years on Faculty at Brown came to Florida where he successfully completed both a research and clinical year in the Department of Colorectal Surgery.

After serving on the Faculty at Brown University for an additional five years, Dr. Potenti returned to South Florida and established practice in Broward County. Because of his abilities, results, and enthusiasm for teaching, Dr. Potenti was invited to join the medical staff in the Department of Colorectal Surgery at Cleveland Clinic in Florida. He has become an invaluable resource for the residents and has his operative and “on call” schedules completely integrated with the other members of the Department.

In addition to the full time faculty and Dr. Potenti, since 1998, a variety of Clinical Associates have helped maintain the high volume of patients and of complex cases. These individuals have included Drs. Jay Singh, Josh Katz, Jonathon Efron, Susan Cera, Jenny Speranza, Jill Genua, and Christina Seo.

Dr. Susan Cera

Dr. Susan Cera (Clinical Associate from July 2004 to June 2005) attended medical school at Georgetown University and then completed her general surgery residency at the Carolinas Medical Center. After her Clinical Associate year, Dr. Cera replaced Dr. Efron at Cleveland Clinic in Florida Naples.

Since that facility has become Physicians Regional Medical Center, Dr. Cera has remained not only as a world-renowned surgeon but as an excellent and highly contributing member of the Faculty in the Department of Colorectal Surgery at Cleveland Clinic in Florida.

Dr. Lestor Rosen

Dr. Sowsan Rasheid

Acknowledgements

Our rise from our inception during 1987 to our birth early 1988 to the present day has been dramatic.Our international acclaim is due to the efforts of far more individuals than the Staff and Clinical Associates listed on the website.Numerous other individuals play an important role on a daily basis, including our clinical coordinators, Clinic and Hospital nurses and physician assistants, publications manager, clinical research coordinators, data managers, intra-stomal therapists, and our allied health care providers.

All of our laudations from patients and peers relative to direct patient interaction are in large measure due to the expert assistance of all of these individuals. Many visiting professors have taken time from their busy schedules to help teach our residents and each year over 40 internationally renowned top level surgeons from around the world come help us teach at our annual international colorectal disease symposium.

This symposium has be held each year since 1990, and has become the largest international colorectal surgeon gathering in the United States. We certainly owe a debt of gratitude to both the visiting professors and the faculty of our annual course, as well as the surgeons who take time from their daily practices and spend considerable sums money to register for and participate in our annual international colorectal disease symposium.

In addition, we must our thank our referring physicians and their patients whose trust and respect for us, the best barometer of our abilities, and the chief reason for our sustained growth. Lastly, none of our education and research efforts would be possible without the humanitarian altruistic assistance of our benefactors.

Our benefactors are listed by category below.

Patient Information

Colon and Rectal Diseases and Their Treatments

The nature of the practice of the Department of Colorectal Surgery is extremely diverse and the types of procedures performed are significantly different from the “average” colorectal surgeon’s practice. Inflammatory bowel disease, including mucosal ulcerative colitis and Crohn’s disease are some of the most common conditions managed in our department.

In addition, the most challenging cancers, specifically those tumors located in the mid and lower thirds of the rectum, are another mainstay of our workload. Also, other complex problems such as fecal incontinence refractory to surgery, recurrent inflammatory bowel disease, recurrent carcinoma, and complex anorectal surgery are conditions that we frequently manage.

The staff continuously strives to introduce new ideas, techniques, and technology into the armamentarium available to colorectal and general surgeons and gastroenterologists and therefore patients throughout the world.

Diagnostic Techniques

Pelvic Floor Physiology Laboratory

Since 1989, the Pelvic Floor Physiology Laboratory has included anal ultrasonography, anal sphincter electromyography and pudendal nerve motor latency assessment, defecography, manometry, and small bowel and colonic transit studies. This composite of tests offered by the department draws numerous patients with challenging disorders who cannot be properly cared for without this technology.

These studies are crucial to the appropriate management of patients with constipation, incontinence, rectal prolapse, rectal cancer, mucosal ulcerative colitis, and numerous other disorders. The number of patients evaluated in our lab is among the largest in the world.

Under the direction of Dr. Dana Sands, the Pelvic Floor Physiology Laboratory works in close conjunction with the Urogynecology and Female Urology sections at Cleveland Clinic in Florida.

Endoscopy

Endoscopic procedures are a significant component of a colorectal surgery practice. Colonoscopy performed on an outpatient basis is performed twice weekly by three of four members of the department. Therapeutic endoscopy with either biopsy or polypectomy is performed in almost two-thirds of cases with only one-third being purely diagnostic.

Several studies attesting to surgical endoscopists’ expertise in performing colonoscopy have been performed in the department as part of multi-institutional trials. In addition, we have participated in several bowel prep trials leading to major advances in bowel cleansing regimens.

Endoscopy

Endoscopic procedures are a significant component of a colorectal surgery practice. Colonoscopy performed on an outpatient basis is performed twice weekly by three of four members of the department. Therapeutic endoscopy with either biopsy or polypectomy is performed in almost two-thirds of cases with only one-third being purely diagnostic. Several studies attesting to surgical endoscopists’ expertise in performing colonoscopy have been performed in the department as part of multi-institutional trials. In addition, we have participated in several bowel prep trials leading to major advances in bowel cleansing regimens.

Enterostomal Care

An integral part of the Department of Colorectal Surgery is enterostomal care. Two full-time enterostomal therapists provide care for patients with stomas and wound problems.

The enterostomal therapists provide both inpatient and outpatient care for patients with all types of stomas including ileostomies, continent ileostomies, colostomies, urostomies, and continent urostomies. They provide preoperative information, consultation, stoma marking, and postoperative care. They are also active in facilitating support groups for patients with stomas. Many enterostomal therapists and ET students spend study periods benefiting from the expertise of our stoma therapists.

Enterostomal Therapy Nursing: Helping You To Recover

The Role of the Enterostomal Therapy (E.T.) Nurse

People with ostomies, fistulas, pressure ulcers and incontinence have very special needs. Recognizing these needs and the concerns you may have about them, Cleveland Clinic Florida employs an E.T. nurse devoted specifically to helping you overcome any initial anxiety or insecurity you may feel.

Credentials

The E.T. nurse is board certified by her professional organization and has received special training. She keeps abreast of state-of-the-art equipment and treatment programs and quickly makes such innovations available to patients.

Experience

Each day at Cleveland Clinic in Florida, our E.T. nurse cares for people with ostomies and fistulas. As part of the Skin Care Team, she works with people who have skin problems related to pressure or incontinence. Each year, she provides counseling during outpatient visits. She cares for children, adolescents, and adults.

How the E.T. Nurse Can Help You

While your E.T. nurse does not function as your primary nurse, the E.T. nurse’s goal is to help ensure a smooth recovery and to return you to normal daily life as rapidly as possible.

Your E.T. nurse is available to provide individualized care and instruction at the bedside before surgery and after, in the outpatient clinics, and by phone even when you are at home.

If you have a urinary or fecal diversion (ostomy) or fistulas...

Nearly one million people in North America have ostomies. People learn to lead very normal lives with temporary and permanent ostomies of all kinds. They work, have children, eat well, travel and lead active lives. E.T. nurses offer preoperative counseling, working individually with patients to help them prepare for surgery and to inform them about what to expect after surgery.

E.T. nurses play an important role in stoma siting, or finding the best spot on the abdomen for the surgeon to create the stoma, or opening. They try to identify a spot which will help ensure both comfort and a reliable seal with the ostomy pouch.

After surgery, E.T. nurses provide instruction on the techniques, appliances and equipment necessary to care for an ostomy, and ways to protect the skin with low-profile, odor-proof pouching systems. The E.T. nursing staff cares for patients with colostomies, conventional and continent ileostomies, urostomies and fistulas.

If you have pressure ulcer problems...

The E.T. nurse, as part of the Hospital Skin Care Team, consults with staff nurses about preventing and treating pressure ulcers (bed sores).

If you are incontinent...

The E.T. nurse helps patients with skin care and odor management. Your E.T. nurse will help identify the best collection or absorption device and skin care products for you, and will instruct you in their proper use.

Enterostomal Therapy Nursing and Cleveland Clinic

Rupert B. Turnbull, Jr., MD, a pioneer in colorectal surgery at The Cleveland Clinic, developed the concept of enterostomal therapy.

In 1958, Dr. Turnbull offered Norma Gill, an ostomy patient herself, a position as the world’s first enterostomal therapist. The two established the first enterostomal therapy training program, later named the R.B. Turnbull Jr., MD, School of Enterostomal Therapy Nursing.

Since then, the school has graduated more than 600 of the approximately 2,000 E.T. nurse specialists practicing in this country, the Orient, Europe and South America.

If You Have Questions

Please ask questions of your E.T. nurse. Any question you have is important; none is too difficult or too trivial. If you have a question, you can reach an E.T. nurse by calling: 954.659.5251, 8 a.m. to 5 p.m., Monday through Friday.

For a Consultation

To make an appointment with an E.T. nurse, call 954.659.5251

For hospital consultations: Ask your physician to write an order for an E.T. nursing consultation.

Insurance Coverage

Some medical insurers cover E.T. nursing services. Check with your insurer to find out about your specific coverage.

Familial Adenomatous Polyposis

Familial adenomatous polyposis (also know as FAP) is an inherited condition of the colon in which polyps may develop into cancer if not detected and removed early enough. It is an autosomal dominant inherited condition, so children of affected patients have a 50% chance of developing the disease.

FAP continues to be a condition that generates a significant number of patient visits annually. Although relatively few patients undergo surgery for the disease, these patients require frequent screening for cancer via colonoscopy. Surgical treatment of this condition is most commonly a total colectomy with an ileal J pouch with pouch anal anastomosis (also know as an ileal J pouch, restorative proctocolectomy, or pullthrough), with good outcomes seen in the majority of patients.

The ileal J pouch was first developed simultaneously in England and in Japan during the 1970s. The technique was then modified by our staff in 1989 to a safer method with better outcomes. That modification, simultaneously introduced in England and at Cleveland Clinic in Florida has now become the “gold standard” throughout the world. Surgeons at Cleveland Clinic in Florida have one of the largest experiences in the world with this technique. The ileal J pouch allows removal of the cancerous and/or precancerous tissue with reconstruction of a new rectum to avoid the need for a permanent bag (stoma).

The number of colectomies with J-pouch reconstruction performed yearly for FAP is shown in the graph below.

Fecal Incontinence

The diagnosis and treatment of fecal incontinence and pelvic floor dysfunction is led by Dr. Dana Sands and is conducted in conjunction with the Women’s Center for Pelvic Disorders to offer women comprehensive evaluation of pelvic problems. Our specialists work as a team and are constantly investigating new treatment alternatives for these patients.

Patients with fecal incontinence generally will undergo or have had sphincter repairs performed in the past. In addition, more advanced reconstructive procedures are available for more complex or reoperative cases, and surgeons are assisting in the development of other investigational methods of repair, such as neosphincter procedures, stimulated graciloplasty, sacral nerve stimulation, artificial bowel sphincter, the use of radiofrequency, and injectable materials.

These innovative techniques are offered to patients who would otherwise be relegated to a permanent colostomy. This department is one of only a few centers in the world offer all five of these procedures in high volumes.

The graph below shows the number of procedures for fecal incontinence performed in our department.

Inflammatory Bowel Disease

Crohn’s disease and mucosal ulcerative colitis comprise a large proportion of the surgical cases and patients treated in this department, making us one of the premier centers in the United States and around the world for the treatment of inflammatory bowel disease. In addition to innovative surgical techniques, reoperative surgical management of both abdominal and anorectal problems associated with inflammatory bowel disease are a forte in our department.

Patients who suffer from Crohn’s disease and mucosal ulcerative colitis are treated by gastroenterologists as well as colorectal surgeons at Cleveland Clinic in Florida. These two specialties work as a team to diagnose and identify the optimal approach to the management of these patients.

Innovative therapies – many pioneered by Cleveland Clinic in Florida physicians and surgeons – allow patients to lead higher quality lives.This department receives worldwide referrals, particularly for complex and severely affected patients, due to its participation in clinical trials and its excellent outcome of surgical cases.

The number of surgeries performed for Crohn’s Disease and Ulcerative Colitis is shown in the graph below.

Laparoscopic Colorectal Surgery

Surgeons in this department have been involved since 1991 in research studies to assess the safety and efficacy of laparoscopic colorectal surgery. Based upon the results of the published data produced in part by pioneering surgeons at Cleveland Clinic in Florida, the technique has gained worldwide acceptance.

Laparoscopy has significant proven benefits for the treatment of a wide array of benign and malignant disorders, including less pain, shorter hospitalization, quicker return to full activities, and less scarring. Fifteen years of experience has shown that the approach can be at least as safe as traditional surgical methods, when performed by a surgical team with special training and extensive experience. Laparoscopic surgery offers the patient an identical operation, performed through an incision that is often 5cm or less in length.

Our surgeons were among the first in the world to gain international acclaim for their expertise in laparoscopic colorectal surgery. In fact, our staff members have performed laparoscopic colorectal surgery procedures for cancer and other disorders of the colon and rectum longer than the faculty in virtually any other training program.

Eligible patients may include individuals with Crohn’s disease, diverticulitis, endoscopically irretrievable polyps, rectal prolapse, mucosal ulcerative colitis, and colon and rectal cancer.

Outpatient Visits

The nature of the practice of the Department of Colorectal Surgery is extremely diverse and the types of procedures performed are significantly different from the "average" colorectal surgeon’s practice. Inflammatory bowel disease, including mucosal ulcerative colitis and Crohn’s disease are some of the most common conditions managed in our department.

In addition, the most challenging cancers, specifically those tumors located in the mid and lower thirds of the rectum, are another mainstay of our workload. Also, other complex problems such as fecal incontinence refractory to surgery, recurrent inflammatory bowel disease, recurrent carcinoma, and complex anorectal surgery are conditions that we frequently manage.

The staff continuously strives to introduce new ideas, techniques, and technology into the armamentarium available to colorectal and general surgeons and gastroenterologists and therefore patients throughout the world.

Rectal Cancer

Surgeons in our department have extensive experience treating rectal cancer and treat among one of the highest volume of patients in the United States with this condition.

One of the factors that set us apart is the number of treatment options available to save the sphincter and avoid the need for colostomy. These options include transanal excision and radical surgery with anastomosis of the colon to the anus, and more recently, incorporating a colonic J pouch reconstruction or coloplasty procedure. Using these techniques, our surgeons can avoid the need for a permanent colostomy in over the majority of cases while still achieving some of the lowest recurrence rates in the world.

The number of patients with rectal cancer operated on by our department is shown in the graph below.

Transanal Endoscopic Microsurgery (TEM)

Dr. Dana Sands, one of our staff surgeons, has become expert in transanal endoscopic microsurgery, a minimally invasive technique used to treat selected rectal tumors. The technique allows removal of benign and certain malignant tumors of the rectum without needing an abdominal operation.

Rectal Prolapse

Rectal prolapse occurs when the rectum protrudes through the anus, usually as a consequence of weak or injured pelvic floor muscles.Surgical repair for rectal prolapse is generally advised. This repair can be undertaken using an abdominal operation or an anal operation, with the exact approach being tailored to each individual patient.

Surgeons in this department have performed these procedures in high volume for the past 14 years, as shown in the graph below.

Referral

Patients have been referred to the Department of Colorectal Surgery from over 3,000 physicians from almost all of the 50 United States and the Canadian provinces. In addition, numerous international patients have been referred from Europe, the Middle East, South and Central America, and the Caribbean. Due to Dr. Nogueras’ expertise and fluency in Spanish, a significant increase in patients from Puerto Rico has added to our referrals.

Despite the fact that many patients are referred because of complex, chronic, or recurrent problems, some patients refer themselves to the department. Physician referral is not mandatory; similarly, the staff will routinely treat “simple” as well as complex problems.

Surgical Procedures

The nature of the practice is extremely diverse and the types of procedures performed are significantly different from the “routine” colorectal surgeon’s practice. Functional disorders requiring surgery as well as complex anorectal surgery, cancer, and inflammatory bowel disease form the nucleus of the cases performed.

Functional disorders include constipation, rectal prolapse, incontinence, and several other less common problems. Those patients with incontinence generally had sphincter repairs performed but in addition, 23 patients have undergone a stimulated gracilis neosphincter procedure and 9 patients have undergone the implantation of an artificial bowel sphincter. Both of these “neosphincter” procedures offer the latest technology to those patients who would otherwise be relegated to a permanent stoma. Our Department is one of only a few in the world to offer both procedures. Moreover, we have one of the largest experiences with both of these procedures of any institution.

Rectal prolapse is a relatively common disorder seen and treated in the department. The vast majority of patients are treated via a perineal approach which offers significant decreases in hospitalization and shorter recovery. Several recent publications attest to the excellent results derived from our Department. Constipation and sphincter repair are amongst the disorders for which we have become an international tertiary referral center and our data remain among the largest published experiences in these areas in the world.

Colon and rectal carcinoma comprise almost one-fifth of all major abdominal operations performed in the department. Rectal ultrasonography, performed by Drs. Nogueras and Weiss, allows precise preoperative evaluation of tumor size and depth of penetration as well as lymph node involvement. A newer technology recently acquired by the institution, a rectal MRI coil, may allow even better imaging of the tumor and nodes and will be routinely employed in the evaluation of rectal cancer. The availability of this technology at Cleveland Clinic Florida allows optimal management in all cases. Multiple means for caring for patients with rectal cancer are available and include transanal excisions, low anterior resections, abdominoperineal resections, and most recently and now routinely used the colonic J-pouch reconstruction. Several years ago, colonic J-pouch reconstruction was studied as a means of reconstruction after rectal cancer surgery. Our landmark prospective randomized study clearly demonstrated the superiority of this technique. Since that time, a follow-up study has shown continued superiority in even more patients over a longer time. Other studies from outside Cleveland Clinic Florida have substantiated our results and, in part as a result of our work, this technique is employed worldwide. Similarly, laparoscopy can now be applied for cure of colon carcinoma within the confines of a multi-institutional trial sponsored by the National Institutes of Health. Cleveland Clinic Florida is among a few centers in the Southeast United States at which this exciting technology can be offered within the safety of the national trial. Our overall laparoscopic experience remains one of the most extensive in the world.