Steven D. Wexner is an American surgeon and physician who developed clinical scoring systems used in colorectal surgery.[2] He is the Physician Executive Director and System Chair for Colorectal Surgery at MedStar Health and Professor of Surgery at Georgetown University School of Medicine, having previously served as Director of the Ellen Leifer Shulman and Steven Shulman Digestive Disease Center at Cleveland Clinic Florida from 2022-2025 and as chair of the Department of Colorectal Surgery at Cleveland Clinic Florida from 1993 to 2024, and many other leadership roles at Cleveland Clinic Florida between 1988-2025.[3][4][5]
His scoring systems—including the Wexner Incontinence Score, Wexner Constipation Score, and Pikarsky-Wexner Perianal Crohn's Score—are used for patient assessment and treatment planning. Wexner specializes in fecal incontinence and has contributed to surgical techniques and quality of life assessments for this condition. He has received 44 regional, national, and international research awards.[6] Through his academic appointments, Wexner trains 15-20 surgeons annually and participates in medical conferences and lectures.[7] He serves as a referral resource for complex colorectal cases.[8] In 2020, he was elected vice-chair of the Board of Regents of the American College of Surgeons for a one-year term.[9] Since 1990, he has served as Symposium Director of the Cleveland Clinic Annual International Colorectal Disease Symposium. The Symposium was held in Fort Lauderdale or Boca Raton every year from 1990 to 2019. Since 2020, the Symposium has expanded to include host locations outside of the US with interruptions during the pandemic years of 2021–2022.[2] Wexner was recognized as one of America's Leading Doctors 2025 by Newsweek and Statista.[10]
Early life and education
Steven Wexner is the son of Judge Ira Howard Wexner (1929–2007), who served as a Justice of the Supreme Court of the State of New York and Supervising Judge of the Nassau District and County Courts,[11] and Arlene.[1] His decision to pursue medicine was influenced by two childhood experiences: his grandmother's fatal heart attack and his sister's emergency hospitalization.[12]
Wexner received his bachelor's degree from Columbia University in 1978. He earned his MD in 1982 from Weill Cornell Medicine.Saulnier, Beth (January 2013). "Best of Both Worlds"(PDF). Impact: The Magazine of Weill Cornell Medicine. 15 (1). Weill Cornell Medicine: 26–30. Retrieved 27 June 2025. He completed a general surgery residency in 1987 at Roosevelt Hospital (now Mount Sinai West).[13] In 1988 he completed a fellowship in colon and rectal surgery at the University of Minnesota Medical School in Minneapolis, MN.
Career
In 1993, Wexner was named chairman of the Department of Colorectal Surgery at Cleveland Clinic Florida, a position he held until 2024 when he became Emeritus Chair. While at Cleveland Clinic he also served as Chairman of the Division of Research and Education from 1995 to 2012, as well as Chief of Staff from 1997 to 2008. He served as Chief Academic Officer from 2008 to 2012. In 2012 He was appointed the Director of the Digestive Diseases Center.[14] In November 2025, Wexner was appointed Executive Director and System Chair for Colorectal Surgery at MedStar Health, covering 10 hospitals in the Washington, D.C. region.[15] He concurrently serves as Professor of Surgery and Vice Chair for Professional Development in the Department of Surgery at Georgetown University School of Medicine.
Wexner has focused on research related to fecal incontinence treatment. His 1993 paper with Marcio Jorge on the etiology and management of fecal incontinence is among the most cited works in the field and contributed to current treatment approaches.[22]
Wexner has worked on the development and refinement of surgical techniques for fecal incontinence, including sphincteroplasty, sacral nerve stimulation, and artificial bowel sphincter implantation. He has published on the outcomes of these procedures and contributed to treatment algorithms used in clinical practice.
His research has included quality of life assessments for patients with fecal incontinence. His work has emphasized multidisciplinary approaches involving colorectal surgeons, gastroenterologists, pelvic floor physical therapists, and other specialists.
In 2022, Cleveland Clinic Florida received a $5 million gift to fund Wexner's research. In recognition of their generous contribution, Cleveland Clinic Weston recognized the Shulmans by naming the Digestive Disease Center the Ellen Leifer Shulman and Steven Shulman Digestive Disease Center.[4]
In an interview with Local 10, Wexner shared that he has been seeing a higher frequency of colorectal cancer in younger patients, due to genetic drift as well as environmental and dietary factors.[23] This is often misdiagnosed until the disease has become advanced, and so Wexner recommends beginning regular colonoscopy screenings earlier than guidelines currently advise.
Clinical scoring systems
Wexner has developed clinical scoring systems used in colorectal surgery and gastroenterology. These scoring systems are used for patient assessment, treatment planning, and outcome evaluation.
Wexner Incontinence Score
The Wexner Incontinence Score, also known as the Cleveland Clinic Incontinence Score, is a scoring system for assessing fecal incontinence severity.[22] Developed with J. Marcio N. Jorge, MD, this scoring system evaluates five parameters: type of incontinence (solid, liquid, gas, pad wearing, and lifestyle alteration), with each scored from 0 (never) to 4 (always), yielding a total score of 0-20. The score has been validated in multiple languages and is used for pre- and post-operative assessment of anal incontinence treatment outcomes.
Wexner Constipation Score
The Wexner Constipation Score, also known as the Cleveland Clinic Constipation Score or Agachan-Wexner Score, is used for assessment of constipation severity.[24] The score evaluates eight parameters including frequency of bowel movements, difficulty of evacuation, completeness of evacuation, abdominal pain, time spent on toilet, type of assistance required, unsuccessful attempts per 24 hours, and duration of constipation. Each parameter is scored 0-4, with a maximum score of 30. This scoring system is used in clinical practice for constipation assessment and treatment planning.
Pikarsky-Wexner Perianal Crohn's Disease Score
In 2002, Wexner and colleagues developed a scoring system specifically for perianal Crohn's disease to predict surgical outcomes.[25] This scoring system incorporates patient history and physical examination findings to assess disease activity and predict the likelihood of successful surgical intervention. Prior to its development, clinicians lacked reliable indices for evaluating perianal Crohn's disease severity and prognostic implications.
Impact on clinical practice
These scoring systems have been adopted in multiple countries and translated into various languages. They are incorporated into clinical guidelines, research protocols, and electronic medical records. The development of these standardized assessment tools has contributed to the ability to measure treatment outcomes and compare results across institutions.
In recent years, Wexner's scoring systems have been integrated into digital platforms, including the CareScore application, which provides medical professionals with access to colorectal scoring systems and classification metrics for diagnostic and treatment purposes.
J-pouch procedures
Wexner's work has focused on surgical techniques for the avoidance of permanent stomas in patients with colorectal cancer, ulcerative colitis, and fecal incontinence. He introduced a modification to the technique for creating an ileo-anal pouch, or j-pouch for ulcerative colitis, in which double stapling is used in place of sutures.[26] He also worked on the colonic j-pouch for patients with rectal cancer.[27] The J-pouch is an alternative to a permanent ileostomy or colostomy, allowing patients who have had their colons removed to continue to have bowel movements without an ostomy bag. This is now part of standard care for patients with rectal carcinoma.[14]
Minimally invasive surgery
Wexner established a laparoscopic colorectal surgery program at Cleveland Clinic Florida in 1991.[28] He has utilized fluorescence imaging and indocyanine green (ICG) during colorectal surgery, and contributed to FDA-approved protocols for bowel perfusion assessment.[29] He has worked on transanal total mesorectal excision (TaTME) techniques and has collaborated with Karl Storz GmbH and Intuitive Surgical on surgical instrument development.[30]
Patents
Wexner has been granted six patents and has licensed intellectual property:[31]
USpatent 20090281560A1,Wexner, Steven D.&Regadas, Francisco Sergio Pinheiro,"Method for anastomosis surgery using zip-ties",published 2009-11-12
WOpatent 2010030707A1,Regadas, Francisco Sergio Pinheiro&Wexner, Steven D.,"Surgical string applicator for anastomosis surgery and method of use",published 2010-03-18
USpatent 7954251B2,Wexner, Steven D.; Nunes, Rogean R.& Regadas, Francisco Sergio Pinheiro,"Multifunctional airway evaluator for orotracheal intubation",published 2011-06-07
USpatent 8211129B2,Regadas, Francisco Sergio Pinheiro&Wexner, Steven D.,"Method for anastomosis surgery using zip-ties",published 2012-07-03
USpatent D682425S1,Wexner, Steven D.; Nunes, Rogean R.& Regadas, Francisco Sergio Pinheiro,"Airway evaluator for orotracheal intubation",published 2013-05-14
USpatent 9526502B2,Regadas, Francisco Sergio Pinheiro&Wexner, Steven D.,"Surgical string applicator for anastomosis surgery",published 2016-12-27
USpatent 20170056020A1,Regadas, Francisco Sergio Pinheiro&Wexner, Steven D.,"Surgical string applicator for anastomosis surgery and method of use",published 2017-03-02
He holds honorary memberships in surgical societies of 15 countries, including Israel, Peru, Argentina, Brazil, Italy, Hong Kong, Wales, Chile, South Africa, Central America, Singapore, the German Surgical Society (2008), the European Surgical Association (2015), European Society of Coloproctology (2015), the Association of Coloproctology of Great Britain and Ireland (2008), and the Colorectal Society of Australia and New Zealand (2011). In 2024, he was elected as an Honorary Fellow of The Society of Black Academic Surgeons.[32][33]
In 2025, Wexner was recognized as one of America's Leading Doctors by Newsweek and Statista. The listing was based on analysis of doctor performance data from Medicare Fee-for-Service claims and commercial data, recommendations and quality assessments from medical professionals, and certifications from American medical and surgical certification boards.[10][36]
Wexner has received 4% national, international, and regional awards for his research.
Professional memberships and positions
Wexner is an active member of 43 learned societies and has held more than 70 appointed or elected offices in these societies.[31]
As of October 2020, Wexner is vice-chair of the Board of Regents of the American College of Surgeons.[9] Through this position he also serves as vice-chair of the executive committee of the Board of Regents, the vice-chair of the Finance Committee of the ACS, and the Regental Liaison to the ACS Board of Governors.[37]
Wexner has served as the president of other professional organizations, including the American Society of Colon and Rectal Surgeons Research Foundation (2014-2016), the Florida Gastroenterologic Society (2004-2005), and South Florida Chapter of the American College of Surgeons (2000-2004, two terms).[7] He served for six years as a governor to the ACS, was past chair of the ACS advisory council for colon and rectal surgery from 2001-2005, and was a member of the Accreditation Council for Graduate Medical Education residency review committee for colon and rectal surgery from 1999-2004.[31] In addition to being licensed in multiple states in the United States, Wexner is licensed in the United Kingdom with the General Medical Council and he is listed as a colorectal surgeon on the specialist register.[48]
Publications
Wexner is the co-editor-in-chief of Surgery.[49] He has served on the editorial team for textbooks and has published textbook chapters. He is a reviewer for 31 journals and is on 33 editorial boards.
As of 2025, Wexner has authored 1,112 peer-reviewed publications with an h-index of 101 and 41,216 citations.[31] According to Elsevier's 2024 analysis of the Scopus database, he ranks 34th among surgeons in all specialties, 11th among all GI surgeons, and is the most cited living colorectal surgeon in the world.[50] Among all scientists in all fields, he ranks #1,500 in the USA and #2,614 in the world with a D index of 121. He was named a 2024 Highly Ranked Scholar by ScholarGPS. He has edited 44 books and authored 274 textbook chapters and 215 editorials and/or invited commentaries.[31]
In 2019, the Journal of Coloproctology published an analysis of the top 100 cited papers in benign anorectal disease which listed Wexner as the second most cited author, with 5 papers authored or co-authored by him among the top 100. His 1993 paper with Marcio Jorge, "Etiology and Management of Fecal Incontinence," was ranked as the most cited paper on benign anorectal disease.[51] This paper established the Wexner Incontinence Score and treatment algorithms used in clinical practice.
Wexner also published studies which resulted in the eponymous Wexner Incontinence Score and the Wexner Constipation Score, as well as the Pikarsky Wexner Perianal Crohn's Score:
S.R. Steele, J.A. Maykel, S.D. Wexner (Eds.), (2020). Clinical Decision Making in Colorectal Surgery, 2nd ed. Springer Nature Switzerland. ISBN978-3-319-65942-8
David E. Beck (Author), Steven D. Wexner (Author), Janice F. Rafferty (Author) (2019). Gordon and Nivatvongs' Principles and Practice of Surgery for the Colon, Rectum, and Anus, 4th ed. Thieme. ISBN1626234299
David E. Beck, Scott R. Steele, Steven D. Wexner (2019). Fundamentals of Anorectal Surgery, 3rd ed. Springer Nature Switzerland. ISBN3319659650
Steven D. Wexner (Author), James W. Fleshman (Author) (2019). Colon and Rectal Surgery: Abdominal Operations (Master Techniques in Surgery), 2nd ed. Wolters Kluwer. ISBN1496347234
Steven D. Wexner (Author), James W. Fleshman (Author) (2019). Colon and Rectal Surgery: Anorectal Operations (Master Techniques in Surgery), 2nd ed. Wolters Kluwer. ISBN1496348575
David E. Beck, Steven D. Wexner, et al. (2014). The ASCRS Manual of Colon and Rectal Surgery, 2nd ed. Springer New York.
Andrew P. Zbar, Robert D. Madoff, Steven D. Wexner (2013). Reconstructive Surgery of the Rectum, Anus and Perineum. Springer. ISBN1848824122
Steven D. Wexner, Andrew P. Zbar, Mario Pescatori (2010). Complex Anorectal Disorders: Investigation and Management. Springer. ISBN1849968969
Andrew P. Zbar, Steven D. Wexner (2010). Coloproctology (Springer Specialist Surgery Series). Springer. ISBN1848827555
N. Stollman, Steven D. Wexner (2007). Disease of the Colon, 1st ed. Informa Healthcare. ISBN0824729994
Steven D. Wexner, Graeme S. Duthrie (2006). Constipation: Etiology, Evaluation and Management. Springer. ISBN1849968969
G. Davila, G. Ghoneim G, Steven D. Wexner (2006). Pelvic Floor Dysfunction, 1st ed. Springer. ISBN1852337303
Steven D. Wexner et al. (2006). Diverticular Disease: Emerging Evidence in Common Conditions, 1st ed. Springer. ISBN1849968969
Steven D. Wexner, Andrew P. Zbar, Mario Pescatori (2005). Complex Anorectal Disorders. Investigation and Management, 1st ed. Springer. ISBN185233-6900
Steven D. Wexner (Section Ed.), B. MacFadyen (Section Ed.) (2004). Laparoscopic Surgery of the Abdomen. Springer-Verlag. ISBN978-0-387-98468-1
P. Boulos, Steven D. Wexner (2000). Current Challenges in Colorectal Surgery, 1st ed. W. B. Saunders. ISBN0-7020-2559-3
Steven D. Wexner, (1999). Protocols in General Surgery: Laparoscopic Colorectal Surgery. ISBN0471240303
Selected articles
Wexner has published articles in scientific journals and books, including over 780 manuscripts and 26 editorials or commentaries in the last twenty years.[52][53] He has co-authored articles on COVID-19 response, contributions of women to colorectal surgery, and racial disparities in colorectal surgery outcomes:
Wexner, Steven D.; Opelka, Frank; Bailey, Patrick V.; Cortés-Guiral, Deila (September 2020). "The American College of Surgeons Response to the COVID-19 Pandemic (Part II): Advocacy and Public Policy". The American Surgeon. 86 (7): 757–761. doi:10.1177/0003134820936614. PMID32916074. S2CID221636992.
Wexner, Steven D.; Hoyt, David B.; Cortes-Guiral, Delia (September 2020). "The American College of Surgeons Response to the COVID-19 Pandemic (Part III): Leadership in a Time of Crisis". The American Surgeon. 86 (7): 762–765. doi:10.1177/0003134820940772. PMID32916069. S2CID221636398.
Keller, Deborah S.; Berho, Mariana; Brown, Gina; Hull, Tracy; Moeslein, Gabriela; Wexner, Steven D. (July 2020). "A narrative celebrating the recent contributions of women to colorectal surgery". Surgery. 168 (3): 355–362. doi:10.1016/j.surg.2020.06.024. PMID32741622. S2CID220942775.
Emile, SH; Horesh, N; Garoufalia, Z; Gefen, R; Zhou, P; Strassman, V; Wexner, SD (April 2023). "Robotic and laparoscopic colectomy: propensity score-matched outcomes from a national cancer database". British Journal of Surgery. 110 (6): 717–726. doi:10.1093/bjs/znad096. PMID37075480.
Emile, SH; Garoufalia, Z; Barsom, S; Horesh, N; Gefen, R; Zhou, P; Wexner, SD (April 2023). "Systematic review and meta-analysis of randomized clinical trials on the treatment of low anterior resection syndrome". Surgery. 173 (6): 1352–1358. doi:10.1016/j.surg.2023.02.010. PMID37012144. S2CID257905660.
Freund, M; Horesh, N; Emile, SH; Garoufalia, Z; Gefen, R; Wexner, SD (March 2023). "Predictors and outcomes of positive surgical margins after local excision of clinical T1 rectal cancer: A National Cancer Database analysis". Surgery. 173 (6): 1359–1366. doi:10.1016/j.surg.2023.02.012. PMID36959073. S2CID257680731.
Freund, M; Emile, SH; Horesh, N; Gefen, R; Wexner, SD (March 2023). "The importance of surgical resection in the management of rectal sarcoma: A national cancer database analysis of 133 cases". European Journal of Oncology. 49 (3): 647–654. doi:10.1016/j.ejso.2022.10.014. PMID36756950. S2CID253058786.
Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (January 2023). "Treatment and outcome trends and predictors of overall survival of rectal melanoma: Analysis of the National Cancer Database". European Journal of Oncology. 49 (7): 1275–1282. doi:10.1016/j.ejso.2023.01.021. PMID36732208. S2CID256301182.
Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (February 2023). "A National Cancer Database analysis of the predictors of unplanned 30-day readmission after proctectomy for rectal adenocarcinoma: The CCF RETURN-30 Score". Surgery. 173 (2): 342–349. doi:10.1016/j.surg.2022.10.034. PMID36473745. S2CID254348327.
Emile, SH; Horesh, N; Freund, M; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Dasilva, G; Wexner, SD (January 2023). "Outcomes of laparoscopic versus robotic-assisted resection of T4 rectal cancer: propensity score-matched analysis of a national cancer database". British Journal of Surgery. 110 (2): 242–250. doi:10.1093/bjs/znac396. PMID36471483.
Dip, F; Lo Menzo, E; Bouvet, M; Schols, RM; Sherwinter, D; Wexner, SD; White, KP; Rosenthal, RJ (December 2022). "Intraoperative fluorescence imaging in different surgical fields: Consensus among 140 intercontinental experts". Surgery. 172 (6S): S54 –S59. doi:10.1016/j.surg.2022.07.025. PMID36427931. S2CID253827695.
Dip, F; Lo Menzo, E; Bouvet, M; Schols, RM; Sherwinter, D; Wexner, SD; White, KP; Rosenthal, RJ (December 2022). "Intraoperative fluorescence imaging in different surgical fields: First step to consensus guidelines". Surgery. 172 (6S): S3 –S5. doi:10.1016/j.surg.2022.04.017. PMID36427928. S2CID253833292.
Freund, M; Emile, SH; Horesh, N; Garoufalia, Z; Gefen, R; Perets, M; Wexner, SD (December 2022). "Redo ileocolic resection for recurrent Crohn's disease: A review and meta-analysis of surgical outcomes". Surgery. 172 (6): 1614–1621. doi:10.1016/j.surg.2022.09.003. PMID36270822. S2CID253037408.
Emile, SH; Silva-Alvarenga, E; Horesh, N; Freund, M; Garoufalia, Z; Wexner, SD (February 2023). "Concordance between clinical and pathologic assessment of T and N stages of rectal adenocarcinoma patients who underwent surgery without neoadjuvant therapy: A National Cancer Database analysis". European Journal of Surgical Oncology. 49 (2): 426–432. doi:10.1016/j.ejso.2022.09.014. PMID36257901. S2CID252676451.
Emile, SH; Freund, M; Horesh, N; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Wexner, SD (February 2023). "Risk factors and predictors of 30-day complications and conversion to open surgery after repeat ileocolic resection of Crohn's disease". Surgical Endoscopy. 37 (2): 941–949. doi:10.1007/s00464-022-09557-4. PMID36068385. S2CID252092903.
Emile, SH; Horesh, N; Freund, M; Parlade, A; Nagarajan, A; Garoufalia, Z; Gefen, R; Silva-Alvarenga, E; Dasilva, G; Wexner, SD (October 2022). "Assessment of mesorectal fascia status in MRI compared with circumferential resection margin after total mesorectal excision and predictors of involved margins". Surgery. 172 (4): 1085–1092. doi:10.1016/j.surg.2022.06.005. PMID35970606. S2CID251557312.
AIS Channel
Wexner is a contributor for the AIS (Advances in Surgery) Channel, an educational platform for surgical training.[54] Since 2014, AIS has provided audiovisual recordings and broadcasts of procedures, techniques, and new developments in surgery. AIS works with hospitals and surgical societies. Wexner has participated in broadcasts covering topics including robotic colorectal surgery techniques and healthcare diversity issues.[54]
Educational contributions
Since 1990, Wexner has served as Symposium Director of the Cleveland Clinic Annual International Colorectal Disease Symposium. The symposium was held annually in Fort Lauderdale or Boca Raton from 1990 to 2019 for over 35 years, and has since included international locations.[55]
Wexner contributes to the AIS (Advances in Surgery) Channel, an educational platform for surgeons. Since 2014, he has participated in broadcasts covering robotic colorectal surgery techniques and healthcare diversity topics.[54] He has delivered over 2,292 scientific lectures, held over 80 visiting professorships, and trains 15-20 surgeons annually through fellowship programs. He has served as an educator to surgeons internationally and maintains an active social media presence.[31][56]
During the COVID-19 pandemic, Wexner created the "A Surgeon's Voice" video series as ACS Regent, conducting over 100 interviews with surgeons globally about pandemic experiences, which received over 300,000 views.[57] This series included an interview with Johnson & Johnson CEO Alex Gorsky on the development of their COVID-19 vaccine.[58]
Personal life
Wexner's father was Judge Ira Wexner, who presided in New York for over twenty years and lived part time in West Boca.[59] Wexner's spouse, Mariana Berho, M.D., was the Chief of Staff at Cleveland Clinic Weston and served on the Board of Governors and Board of Trustees at the parent organization, Cleveland Clinic. She is a colorectal pathologist and served as Chair of Pathology from 2004-2023.[60]
↑ Wexner, Steven D. (June 26, 2009). "Trials and tribulations in the history of surgical innovation: SAGES 2007 presidential address". Surgical Endoscopy. 23 (6): 1171–1179. doi:10.1007/s00464-009-0472-9. PMID19412629. S2CID8761960.
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