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UCLA Ronald ReaganMedical Center

The Division of General Surgery, under the direction of O. Joe Hines, M.D., includes the Sections of Bariatric/Minimally Invasive Surgery, Colorectal Surgery, Endocrine Surgery, Gastrointestinal Surgery, Surgical Critical Care and Trauma. Faculty of the Division of General Surgery practice at UCLA Medical Center and Santa Monica-UCLA Medical Center, as well as three affiliated hospitals: Harbor/UCLA, West LA Veterans Administration Medical Center, and Olive View Medical Center.

The section of Gastrointestinal Surgery, led by Howard A. Reber, M.D. provides an extraordinary operative experience with hepatic and bile duct tumors, pancreatic and other periampullary neoplasms, acute and chronic pancreatitis, inflammatory and neoplastic bowel disease, colorectal surgery, gastrointestinal fistulas, gastric cancer and a variety of other complicated gastrointestinal problems. The Program in Pancreatic Diseases is one of the largest in the world, with approximately 100 pancreatic resections performed annually.

An active laparoscopic practice provides experience with surgery for reflux esophagitis, abdominal wall hernias, benign and malignant large bowel disease, adrenal tumors, pancreatic and splenic diseases, and cholelithiasis, as well as morbid obesity.

The weekly service conference features active participation of colleagues from gastroenterology, gastrointestinal radiology, gastrointestinal pathology, medical and radiation oncology, and Minimally Invasive Surgery. All new patients are presented and discussed by the group, and management is enhanced by the multidisciplinary perspective.

In collaboration with the Division of Gastroenterology of the Department of Medicine, the Gastrointestinal Surgery section supports the activities of the UCLA Digestive Disease Center, a comprehensive multidisciplinary center that brings together surgeons, gastroenterologists, radiologists, and oncologists to provide contemporary, comprehensive care for patients with benign and malignant gastrointestinal disease.

Research activities within the section encompass a variety of clinical and basic projects. The former include studies in patients with pancreatic cancer to determine more effective methods for surgical cure and palliation, updated reviews of the large bile duct cancer patient population, and studies of postoperative pathophysiology in patients who have undergone surgery for inflammatory bowel disease. Basic laboratory projects are exploring molecular and cellular mechanisms of small bowel fluid and electrolyte transport, the pathophysiology of acute and chronic pancreatitis, control mechanisms of pancreatic islet cell insulin secretion, endocrine management of pancreatic cancer, and a variety of problems related to nutrition in gastrointestinal disease. These projects are supported by funding from the National Institutes of Health, the Veterans Administration Merit Review Program, industry, and various private sources. They provide numerous research opportunities for residents and students.

The Colorectal Surgery Program performs a wide variety of procedures in all areas of the discipline, with a focus on laparoscopic techniques. There also is a basic research program under the direction of James Yoo, M.D.

The section of Minimally Invasive Surgery and Bariatric Surgery has performed hundreds of advanced laparoscopic procedures over the past five years. Advanced procedures include minimally invasive techniques for gastroesophageal reflux disease, motility disorders of the esophagus, benign and malignant diseases of the stomach and intestines, disorders of the spleen and adrenal glands, abdominal pain, liver resections, and staging or biopsy techniques. In addition, routine laparoscopic procedures including gallbladder removal, appendectomy, and hernia repair.

The Bariatric Surgery Program is designed to assist patients in improving their health and the quality of their lives by using surgical intervention for weight reduction. The National Institutes of Health Consensus Development Conference of 1991 determined that patients with a body mass index of over 40 who cannot achieve sustained weight-loss by dietary measures alone are candidates for bariatric surgery. UCLA is an NIH-designated Center for the Study and Treatment of Obesity. UCLA's program uses advanced minimally invasive technology. The procedures performed are Roux-en-Y gastric bypass, removal of adjustable bands, sleeve gastrectomy and revisional bariatric surgery on a case by case basis.

There is a busy program in Endocrine Surgery under the direction of Dr. Yeh with a multidisciplinary team and a broad experience with diseases of the thyroid, parathyroid, and adrenal glands.

The Lichtenstein Hernia Institute is now located at our Santa Monica campus.

The Trauma and Emergency Surgery section, under the direction of H. Gill Cryer, M.D. continues to grow, with over 1200 admissions and 250 consults over the last academic year. The mechanisms of injury included blunt trauma in 75% and penetrating trauma in 25% of cases. A large number of these patients were multiply injured and required general surgical, neurosurgical, and orthopedic operations. Over 300 emergency general surgical procedures were performed in the section during the last academic year. Multidisciplinary educational and quality assurance programs in conjunction with Emergency Medicine, Neurosurgery, Orthopedic Surgery, Plastic and Reconstructive Surgery, Head and Neck Surgery, and Cardiothoracic Surgery are conducted on a regular basis.

Research activities include participation in several multi-institutional trials including IL1 receptor antagonist for septic syndrome, fluconazole prophylaxis, a brain injury study, and a study on resuscitation responses to hemorrhagic shock, with the Division of Neurosurgery. Basic science evaluations include macrophage biology in response to infection and shock.

Residency Program

The UCLA General Surgery Residency is a seven-year training program designed for residents with a a career interest in academic surgery. The program includes five years of clinical training and two years of research experience.

The clinical experience is remarkable both in the diversity of training institutions and the variety of cases. The principles of graduated responsibility and early opportunities for independent decision-making are emphasized throughout the duration of training.

The research training is offered between the second and third years of clinical training. This hiatus from clinical training is an opportunity for residents to gain experience in the design, implementation and analysis of scientific investigations. Though many residents continue to participate in basic science research, others have been successful in clincal outcomes research and healthcare management studies.

The overall emphasis of the program is to provide our trainees with the opportunity to become excellent clinical surgeons, experienced teachers, and accomplished scientific investigators.

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