University of California, Irvine Medical Center

History

The Division of Colon & Rectal Surgery is actively engaged in teaching and training medical students, residents and fellows.

Our program is located at a single hospital (the University of California Irvine Medical Center) and is designed to prepare the trainee for an advanced practice in Colon and Rectal Surgery.

We have a nationally recognized faculty that is highly interested in the training of our fellow. Access to faculty and the program director is emphasized. During the year, assessment frequently occurs to evaluate how we can tailor the educational experience to the trainee’s ongoing needs. Significant educational resources are in place to assist in training including office space, free textbooks, an iPad, computers and electronic journal access through the University of California system. We have a structured series of lectures, conferences and journal clubs throughout the year. We emphasize maintaining a good balance between educational experience and clinical service. Duty hours are strictly monitored.

Our practice emphasizes advanced surgical techniques in all aspects of Colon and Rectal Surgery. Our group is very active in evaluating and adopting new surgical approaches and technology, and we participate in (and often lead) clinical trials. In the area of colon and rectal cancer, the trainee will become proficient in robotic surgery, laparoscopic surgery and the approach to recurrent colon and rectal cancer. The trainee will learn advanced techniques such as laparoscopic intracorporeal anastomosis and transanal specimen extraction. Transanal Endoscopic Microsurgery (TEM) is utilized and “Reverse” (transanal) TME is performed. Minimally invasive approaches to recurrent cancer are also applied when appropriate and intraoperative radiation therapy is utilized in specific cases. The trainee will learn the multidisciplinary approach to colon and rectal cancer through participation in tumor board and lectures from nationally recognized experts at our NCI-designated Comprehensive Cancer Center. Our faculty performs Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with peritoneal cytoreduction in select cases.

We also have a busy practice in Inflammatory Bowel Disease (IBD) and benefit from being associated with an active Gastroenterology practice in IBD at our institution. We emphasize minimally invasive approaches to IBD treatment and a collaborative approach with our colleagues in Gastroenterology. Our fellows routinely exceed the required case numbers for ileal pouch surgery and leave the program comfortable performing totally laparoscopic restorative proctocolectomy.

In terms of pelvic floor surgery, we offer endoanal ultrasound, anal manometry, pelvic floor physical therapy and excellent collaboration with our colleagues in Urogynecology. Fellows will become facile at Sacral Nerve Stimulation therapy, clinic-based Peripheral Nerve Evaluations, injection of bulking agents and overlapping sphincter repair. Fellows finish the program able to perform standard and advanced techniques in rectal prolapse surgery such as robotic ventral mesh rectopexy.

During the year, the trainee is expected to participate in a research project. For that project, we have resources including a statistician, SAS/SPSS programs, clinical databases (Nationwide Inpatient Sample, National Surgical Quality Improvement Project, California Cancer Registry, University Health Consortium), and collaborative research fellows. We also provide financial support for travel to academic meetings to present research. Faculty will assist throughout the year in research design and publication. This can serve as an excellent springboard to an academic surgical practice if the trainee desires.

After training at our program, fellows have gone on to busy academic and private practice environments. Our goal is for trainees to leave the program ready to launch into a highly successful career.

Faculty Listing

Joseph Carmichael, MD, FACS, FASCRS
Chief, Division of Colon and Rectal Surgery

Mehraneh Dorna Jafari, MD
Assistant Clinical Professor

Steven Mills, MD, FACS, FASCRS
Program Director, Colon and Rectal Surgery Residency
Core Clerkship Director, Medical Student Education

Alessio Pigazzi, MD, PhD, FASCRS
Vice-Chair, Research and Clinical Operations
Chief, Division of Surgical Oncology

Michael Stamos, MD, FACS, FASCRS
Dean, School of Medicine

Recent Fellow Placement

2013-2014: University Hospitals of Cleveland
2014-2015: Private Practice, Bakersfield, CA
2015-2016: Virginia Mason Seattle, WA
2016-2017: MetroHealth Cleveland, OH
2017-2018: University of California Irvine
2018 -2019: Naples, Italy
2019-2020: MD Anderson Cancer Center

Recent Fellow Publications

Bosio RM, Pigazzi A. Emerging and Evolving Technology in Colon and Rectal Surgery. Clin Colon Rectal Surg. 2015 Sep;28(3):152-7. doi: 10.1055/s-0035-1558823. Review. PMID: 26491407

Brady MT, Patts GJ, Rosen A, Kasotakis G, Siracuse JJ, Sachs T, Kuhnen A, Kunitake H. Postoperative Venous Thromboembolism in Patients Undergoing Abdominal Surgery for IBD: A Common but Rarely Addressed Problem. Dis Colon Rectum. 2017 Jan;60(1):61-67. PMID: 27926558

Steven Mills, MD, FACS, FASCRS
Staci Reichenecker, BS
333 City Blvd West
Suite 1600
Orange, CA 92868
reichens@uci.edu
(714) 456-5532
(714) 456-6027

Number of Positions Offered:

  • Clinical: 1
  • Research: None

Accreditation Status
1

Next Scheduled (Self-Study) Visit

Case Numbers – Past Five Years

Abdominal Procedure 15/16 16/17 17/18 18/19 19/20
Segmental Colectomy 59 74 96 85 71
Laparoscopic Resection 107 127 175 138 116
Low Anterior Resection 34 28 33 39 42
Abdominoperineal Resection 11 8 19 9 20
Proctocolectomy Total 2 1 9 9 20
Proctocolectomy w/Ileostomy 9 12 11
Proctocolectomy w/Ileoanal Reservoir 9 12 11
Prolapse Repair Total 19 9 15
Prolapse Repair Abdominal 15 4 12
Prolapse Repair Perineal 4 5 3
Stomas Total 64 65 107 87 73
Stomas Complications 5 8 8 7 10
Pelvic Dissections 61 49 72 67
Abdominal Procedure Total 188 198 272 238 211
Endoscopy/Pelvic Floor 15/16 16/17 17/18 18/19 19/20
Proctoscopy/Anoscopy 30 66 49 37 28
Colonoscopy Total 141 147 144 148 140
Colonoscopy Diagnostic 84 97 97 94 95
Colonoscopy w/Intervention 57 50 47 54 47
Pelvic Floor Evaluation 15 20 16 15 15
Endoscopy/Pelvic Floor Total 206 259 237 216 197
Anorectoal Procedure 15/16 16/17 17/18 18/19 19/20
Hemorrhoidectomy 22 29 25 22 20
Fistulotomy 20 21 25 34 13
Endorectal Advancement Flap 1 3 2 30 16
Fecal Incontinence Procedures 3 6 7 5 5
Internal Sphincterotomy 2 2 4 4 2
Transanal Excision 22 13 22 20 13
Anorectoal Procedure Total 95 113 147 139 78