Columbia University Medical Center

The Resurgence of Surgical Science at P&S

Not many surgery departments have a division full of basic scientists, but Columbia University has been committed to the concept for years.

“We always need a better understanding of what causes diseases, how we can prevent diseases from happening, and how we can treat them better. Those are questions that will be in a surgery department,” says Donna Farber, PhD, the George H. Humphreys II Professor of Surgical Sciences. Dr. Farber was recently appointed chief of the Division of Surgical Sciences in the Department of Surgery.

“In order to move forward, you need to do research,” she says. “Sometimes that’s research looking at better ways to do a surgery, or better devices. Other times, such as in transplantation, we want to better understand the immune system so we can tweak it to promote organ and transplant survival.” Dr. Farber’s own work, which focuses on immunological memory and tissue immunity, is a prime example of these efforts.

Dr. Farber was sole occupant of the division when she joined the P&S faculty in 2010. Previous researchers had moved, but the chair of surgery, Craig Smith, MD, has worked over several years to recruit a cadre of new scientists.

“It is historically challenging for clinical departments, but particularly procedural clinical departments like surgery, to maintain active, basic science research because that’s not what we do every day. But it’s extremely important to the future of what we do,” says Dr. Smith. “The fact that Donna Farber is now taking over the Division of Surgical Sciences is a signal of the real rebirth of that important division that began about 15 years ago.”

The research by the division’s full-time scientists covers a wide spectrum of topics that all connect to surgical ideas. For example, Nigel Bunnett, PhD, is uncovering the way chronic pain is transmitted through nerve cells; David Sachs, MD, is developing a pig colony whose organs are more compatible for transplantation in humans; and Giovanni Ferrari, PhD, is investigating how cardiovascular diseases affect the physiology of heart valves and vascular cells. This breadth means that collaboration across departments and centers of the University is common, particularly with the Columbia Center for Translational Immunology, which Dr. Farber and Dr. Sachs also belong to.

The division also gives surgeons, who have less time to maintain their own labs, the opportunity to pursue their research questions. “People at Columbia all have interest in research to some degree. That’s why they’re here,” says Dr. Smith. “It’s not enough for them on average to do an operation and go home. They have a desire to come up with new ideas, to push new procedures, to explore the physiological underpinnings of the procedures we already do, or develop a better understanding of the physiology of the body.

“Without a division like Surgical Sciences, their options are limited to collaborations with basic scientists in other parts of the University, which poses geographic, time, and resource constraints. To have those resources within the department makes that research that much easier.”

Residents and fellows are also enlisted into fundamental and translational research.

Dr. Farber plans to organize a training program in surgical sciences for residents and fellows and apply for NIH training grants. Dr. Bunnett, the department’s vice chair for research, expects to replicate a program he established a decade ago at UCSF that provides two or more years of funded research for each surgical resident.

Bringing together investigators and connecting them with resources is another priority for Dr. Farber. She has already set up—and maintained for six years—a research resource through the organ procurement organization Live On New York, through which she has been able to collect tissues from consenting donors for her immunology research. She hopes to further develop it into a biobank for the research community. The Division of Surgical Sciences also has core facilities that researchers in the department can use and offers instruction in grant writing and statistical science.

By reestablishing the division, Dr. Smith says, “Columbia Surgery is declaring that science, innovation, research, and investigation are all very important parts of the practice of surgery. Although it’s hard to do, it’s extremely important, and we’re going to show that it’s possible.”