Episodes

20h ago

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

1d ago

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

2d ago

Welcome back for our series on AI for the clinician. This episode is a discussion about the ethical challenges and questions of AI in surgery, and there are often more questions than answers. Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. Ruchi Thanawala, MD: @Ruchi_TJ Ruchi Thanawala is an Associate Professor of Thoracic Surgery and Faculty in the Informatics Division at Oregon Health and Science University (tOHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU. Phillip Jenkins, MD: @PhilJenkinsMD Phil Jenkins is a general surgery PGY-4 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics. Steven Bedrick, PhD: @stevenbedrick Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Division of Informatics, Clinical Epidemiology, and Translational Data Science. His research is focused on biomedical applications for speech and language technologies, with particular emphases on facilitating secondary use of electronic health record data and on supporting the diagnosis and management of language and communication disorders. Ryan Antiel, MD: @RyanAntiel Ryan Antiel is an Associate Professor of Pediatric Surgery at Duke Hospital and an associate director of the Trent Center for Bioethics, Humanities, and History of Medicine. His research addresses ethical challenges surrounding the care of seriously ill fetuses and neonates. He is also interested in the moral formation of surgical trainees. Kayte Spector-Bagdady, JD: @KayteSB Kayte Spector-Bagdady is the Wantz Professor of Bioethics and Director of Michigan Bioethics at the University of Michigan Medical School. Her research focuses on increasing accessibility of health data for research and generalizability for diverse patient populations. She is also the former Associate Director for President Obama’s bioethics commission. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

5d ago

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

6d ago

It’s 1:00 AM on a Saturday and a patient arrives with a gunshot wound and no distal pulses—who should hold the scalpel, Trauma or Vascular? In this episode of Big T Trauma, hosts Dr. Patrick Georgoff and Dr. Teddy Puzio are joined by vascular surgeon Dr. Brian Gilmore and dual-trained powerhouse Dr. Joe DuBose to debate this high-stakes turf war. We tackle the uncomfortable reality of declining vascular exposure in general surgery training and whether current "vascular expertise" standards are failing our patients. From the rise of endovascular technology to navigating institutional politics, our panel breaks down how to bridge the gap between specialties for better patient outcomes. This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dec 17

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

Dec 16

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

Dec 15

Welcome back to our BTK/ASGBI Series! During this series, BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam compare and contrast various aspects of surgery between the United States and the United Kingdom, debating who does what better. We are happy to be continuing our AI discussion further with another episode. While last episode lay a foundation on discussing the unique differences in the role and regulation of AI in both these countries, now we delve into some of the clinical challenges. What does AI and the future of surgery look like in underserved locations such as the battlefield or the rural communities. What does this mean for our future as surgeons…will we be replaced? And how should we address the integration of AI within our practices? We are thrilled to have our trio of experts discussing this further. Dr. Nelson is a surgical oncologist working at the Brook Army Medical Center in San Antonio, he's very interested in expanding the role of AI within surgical education and beyond. Dr. Larson is a general surgery resident at the Mayo Clinic. She's currently in her research time and finishing up her master's degree in AI and studying the role of machine learning within surgical practice. Dr. Mukherjee is a surgeon scientist alongside an Honorary Consultant General & Major Trauma Surgeon in Liverpool, England. His current research bridges academia with industry and is aimed at transforming the treatment of critical illness through the development of next-generation therapies for pancreatitis-induced acute lung injury through the utilisation of cutting-edge AI driven drug discovery approaches. Take a listen and let us know what you think! References: Johns’ Hopkins Ex-Vivo Cholecystectomy by a Robot https://hub.jhu.edu/2025/07/09/robot-performs-first-realistic-surgery-without-human-help/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dec 12

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

Dec 11

Welcome back to our BTK/ASGBI Series! During this series, BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam compare and contrast various aspects of surgery between the United States and the United Kingdom, debating who does what better. In this episode, we delve into all things artificial intelligence (AI) within surgery. Both the US and the UK have unique approaches to managing AI within healthcare and our experts help break down these key similarities and differences. We will discuss what AI and machine learning means, what does regulation look like in both these regions, and how is AI being used in both these countries. We are fortunate to have two representatives, Dr. Nelson and Dr. Larson, representing the US side. Dr. Nelson is a surgical oncologist working at the Brook Army Medical Center in San Antonio, he's very interested in expanding the role of AI within surgical education and beyond. Dr. Larson is a general surgery resident at the Mayo Clinic. She's currently in her research time and finishing up her master's degree in AI and studying the role of machine learning within surgical practice. We are fortunate to have Dr. Mukherjee representing the UK side. Dr. Mukherjee is a surgeon scientist alongside an Honorary Consultant General & Major Trauma Surgeon in Liverpool, England. He has a strong track record in research that spans the translational spectrum, with strengths in discovery science related to acute pancreatitis pathophysiology and mitochondrial injury, novel in vitro and in vivo experimental assay development and clinical translational research, including novel biomarker studies and clinical trials. He has won multiple awards, most recently the Hunterian Professorship 2024 from the Royal College of Surgeons of England. Take a listen and let us know what you think- what do you think is the best way to promote and regulate AI within healthcare? Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dec 10

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Behind the Knife in Español - repaso para el examen de certificación en cirugía general: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general

Dec 9

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review

Dec 8

In this episode of Behind the Knife, the minimally invasive surgery (MIS) team dives deep into the evolving field of common bile duct exploration (CBDE). From the historical context of laparoscopic approaches to the latest advances including robotic-assisted techniques, Drs. Shaina Eckhouse, James Jung, Zachary Weitzner, and Joey Lew discuss key evidence shaping modern practice. Listeners will learn about indications and anatomy guiding trans-cystic versus trans-choledochal approaches, practical tips for safe stone clearance, and critical considerations around learning curves and team coordination for robotic procedures. The episode also highlights important studies comparing single-stage laparoscopic CBDE with staged ERCP and cholecystectomy, emphasizing outcomes such as stone clearance, pancreatitis rates, and hospital length of stay. This comprehensive overview is a must-listen for MIS and acute care surgeons interested in optimizing the management of choledocholithiasis and streamlining patient care with minimally invasive techniques. Hosts: - Shaina Eckhouse, MD, Bariatric Surgery Medical Director and Vice Chair of Clinical Operations, Department of Surgery, Duke University - James Jung, MD, PhD, Assistant Professor of Surgery, Duke University - Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD - Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually Learning Goals: By the end of this episode, listeners will be able to: - Describe the historical approaches to managing choledocholithiasis, including staged interventions and the evolution toward single-stage laparoscopic common bile duct exploration (CBDE). - Summarize key clinical evidence comparing CBDE and ERCP, including landmark studies and meta-analyses evaluating outcomes, complications, and trends over time.​ - Distinguish between transcystic and transcholedochal approaches to CBDE, explaining indications, contraindications, and technical nuances for each technique.​ - Identify appropriate candidates for transcystic exploration based on cystic duct anatomy and stone characteristics.​ - Recognize the impact of newer surgical technologies—such as digital choledochoscopy, Spyglass, and robotic platforms—on CBDE practice, efficiency, and safety.​ - Discuss the importance of multidisciplinary teamwork, preparation, and perioperative planning for successful CBDE, particularly in complex or altered anatomy cases.​​ - Appraise the learning curve and quality of evidence for new CBDE procedures, outlining the need for mentorship, ongoing training, and knowing when to collaborate with GI or hepatopancreaticobiliary (HPB) surgery.​ - Outline approaches and bailout strategies for challenging cases, including patients with surgically altered anatomy and use of adjuncts such as intraoperative cholangiography (IOC), feeding tube placement, and Fanelli stents.​​ - Evaluate safety outcomes and limitations associated with robotic-assisted CBDE and single-stage management, incorporating recent data from population-based studies.​ - Reflect on strategies for tailoring CBDE techniques to individual patient anatomy, surgeon experience, and available resources, advocating for evidence-based practice and continuous learning. References: - Giurgiu DI, Margulies DR, Carroll BJ, et al. Laparoscopic Common Bile Duct Exploration: Long-term Outcome. Arch Surg . 1999;134(8):839-844. doi:10.1001/archsurg.134.8.839 https://pubmed.ncbi.nlm.nih.gov/10443806/ - Lyu Y, Cheng Y, Li T, Cheng B, Jin X. Laparoscopic common bile duct exploration plus cholecystectomy versus endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy for cholecystocholedocholithiasis: a meta-analysis. Surg Endosc . 2019;33(10):3275-3286. doi:10.1007/s00464-018-06613-w https://pubmed.ncbi.nlm.nih.gov/30511313/ - Bekheit M, Smith R, Ramsay G, Soggiu F, Ghazanfar M, Ahmed I. Meta‐analysis of laparoscopic transcystic versus transcholedochal common bile duct exploration for choledocholithiasis. BJS Open . 2019;3(3):242-251. doi:10.1002/bjs5.50132 https://pubmed.ncbi.nlm.nih.gov/31183439/ - Cironi K, Martin MJ. Reclaim the duct! Laparoscopic common bile duct exploration for the acute care surgeon. Trauma Surg Acute Care Open . 2025;10(Suppl 1). doi:10.1136/tsaco-2025-001821 https://pubmed.ncbi.nlm.nih.gov/40255986/ - Zhang C, Cheung DC, Johnson E, et al. Robotic Common Bile Duct Exploration for Choledocholithiasis. JSLS J Soc Laparosc Robot Surg . 2025;29(1):e2024.00075. doi:10.4293/JSLS.2024.00075 https://pubmed.ncbi.nlm.nih.gov/40144383/ - Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Surg . 2023;158(12):1303-1310. doi:10.1001/jamasurg.2023.4389 https://pubmed.ncbi.nlm.nih.gov/37728932/ Ad Disclosure: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dec 5

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review

Dec 4

In this Thoracic Surgery episode of Behind the Knife we enjoy a conversation with world-renowned thoracic surgeon and educator, Dr. Stephen Yang, as he takes us through 30 years of experience divulging his personal tips, tricks, and pitfalls to avoid when tackling the technical nuances of mastering robotic segmentectomies. Hosts: Dr. Stephen C. Yang, MD - professor of surgery and medical oncology The Johns Hopkins Hospital Dr. Kyla D. Rakoczy, MD - PGY3 General Surgery Resident at The Johns Hopkins Hospital Learning Objectives: Understand the utility of segmentectomies for peripheral T1N0 non-small-cell-lung cancer How to prepare for robotic segmentectomy using CT scans and 3D reconstructions Learn where to place your ports and how to optimize intra-operative techniques to minimize complications after robotic segmentectomy References: Kang MW. Evolution of Lung Cancer Surgery: Historical Milestones, Current Strategy, and Future Innovations. J Chest Surg. 2025 May 5;58(3):79-84. doi: 10.5090/jcs.25.025. Epub 2025 Apr 15. PMID: 40230346; PMCID: PMC12066400. https://pubmed.ncbi.nlm.nih.gov/40230346/ Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3. doi: 10.1016/0003-4975(95)00537-u. PMID: 7677489. https://pubmed.ncbi.nlm.nih.gov/7677489/ Pastorino U, Valente M, Bedini V, Infante M, Tavecchio L, Ravasi G. Limited resection for Stage I lung cancer. Eur J Surg Oncol. 1991 Feb;17(1):42-6. PMID: 1995356. https://pubmed.ncbi.nlm.nih.gov/1995356/ Liu L, Aokage K, Chen C, Chen C, Chen L, Kim YH, Lee CY, Liu C, Liu CC, Nishio W, Suzuki K, Tan L, Tseng YL, Yotsukura M, Watanabe SI. Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. JTCVS Open. 2023 Apr 7;14:483-501. doi: 10.1016/j.xjon.2023.03.013. PMID: 37425437; PMCID: PMC10328970. https://pubmed.ncbi.nlm.nih.gov/37425437/ Galvez C, Bolufer S, Lirio F, Recuero JL, Córcoles JM, Socci L, Cabañero A, López I, Sánchez D, Figueroa S, Salcedo JG, Campo-Cañaveral JL, Genovés M, Hernando F, Moldes M, Blanco A, Azcarate L, Rivo E, Viti A, Mongil R. "Complex segmentectomies: Comparison with simple and effect of experience on postoperative outcomes". Eur J Surg Oncol. 2025 Jul;51(7):109748. doi: 10.1016/j.ejso.2025.109748. Epub 2025 Mar 5. PMID: 40064065. https://pubmed.ncbi.nlm.nih.gov/40064065/ Perroni G, Veronesi G. Robotic segmentectomy: indication and technique. J Thorac Dis. 2020 Jun;12(6):3404-3410. doi: 10.21037/jtd.2020.02.53. PMID: 32642266; PMCID: PMC7330783. https://pubmed.ncbi.nlm.nih.gov/32642266/ Montagne, F., Dhainaut, C., & Benhamed, L. M. (n.d.). Pre-operative 3D reconstruction—let’s first anticipate the surgical procedure. Video-Assisted Thoracic Surgery. Retrieved November 13, 2025, from https://vats.amegroups.org/article/view/7889/html Shimizu K, Nakazawa S, Nagashima T, Kuwano H, Mogi A. 3D-CT anatomy for VATS segmentectomy. J Vis Surg. 2017 Jul 1;3:88. doi: 10.21037/jovs.2017.05.10. PMID: 29078650; PMCID: PMC5637987. https://pubmed.ncbi.nlm.nih.gov/29078650/ Zhang O, Alzul R, Carelli M, Melfi F, Tian D, Cao C. Complications of Robotic Video-Assisted Thoracoscopic Surgery Compared to Open Thoracotomy for Resectable Non-Small Cell Lung Cancer. J Pers Med. 2022 Aug 12;12(8):1311. doi: 10.3390/jpm12081311. PMID: 36013260; PMCID: PMC9410342. https://pubmed.ncbi.nlm.nih.gov/36013260/ Lee BE, Altorki N. Sub-Lobar Resection: The New Standard of Care for Early-Stage Lung Cancer. Cancers (Basel). 2023 May 25;15(11):2914. doi: 10.3390/cancers15112914. PMID: 37296877; PMCID: PMC10251869. https://pubmed.ncbi.nlm.nih.gov/37296877/ Zhang Y, Liu S, Han Y, Xiang J, Cerfolio RJ, Li H. Robotic Anatomical Segmentectomy: An Analysis of the Learning Curve. Ann Thorac Surg. 2019 May;107(5):1515-1522. doi: 10.1016/j.athoracsur.2018.11.041. Epub 2018 Dec 19. PMID: 30578780. https://pubmed.ncbi.nlm.nih.gov/30578780/ Peeters M, Jansen Y, Daemen JHT, van Roozendaal LM, De Leyn P, Hulsewé KWE, Vissers YLJ, de Loos ER. The use of intravenous indocyanine green in minimally invasive segmental lung resections: a systematic review. Transl Lung Cancer Res. 2024 Mar 29;13(3):612-622. doi: 10.21037/tlcr-23-807. Epub 2024 Mar 27. PMID: 38601441; PMCID: PMC11002498. https://pubmed.ncbi.nlm.nih.gov/38601441/ Altorki N, Wang X, Damman B, Mentlick J, Landreneau R, Wigle D, Jones DR, Conti M, Ashrafi AS, Liberman M, de Perrot M, Mitchell JD, Keenan R, Bauer T, Miller D, Stinchcombe TE. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2024 Jan;167(1):338-347.e1. doi: 10.1016/j.jtcvs.2023.07.008. Epub 2023 Jul 18. Erratum in: J Thorac Cardiovasc Surg. 2025 Apr;169(4):1181. doi: 10.1016/j.jtcvs.2024.12.011. PMID: 37473998; PMCID: PMC10794519. https://pubmed.ncbi.nlm.nih.gov/37473998/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dec 3

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review

Dec 2

Behind the Knife ABSITE 2026 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2026 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review

Dec 1

Does soot in the airway always mean an immediate intubation? Join our Burn Team as they debunk common myths surrounding inhalation injury and distinguish true airway threats from superficial flash burns. We break down critical management strategies, from the 'HAM' protocol to ventilator management, and explain why these patients require massive fluid resuscitation. Tune in to master these high-stakes clinical decisions and ensure you are ready for your next burn patient. Hosts: - Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento - Laura Johnson – Grady Memorial Hospital - Lauren Nosanov – Grady Memorial Hospital - Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans Learning Objectives: - Recognize the clinical features and diagnostic challenges of inhalation injury in burn patients, including differentiation from thermal airway injury and flash burns. - Apply evidence-based criteria to guide intubation and ventilatory management , including the avoidance of unnecessary intubation. - Implement key principles of supportive care and complication prevention , including fluid resuscitation, pharmacologic therapies, and long-term airway considerations. References: - Hope E Werenski, Anju Saraswat, James H Holmes, John K Bailey, Is Burn Center Admission Necessary After Home Oxygen Ignition Injury?, Journal of Burn Care & Research , 2025;, iraf189, https://doi.org/10.1093/jbcr/iraf189 - Kathleen S. Romanowski, Tina L. Palmieri, Soman Sen, David G. Greenhalgh, More Than One Third of Intubations in Patients Transferred to Burn Centers are Unnecessary: Proposed Guidelines for Appropriate Intubation of the Burn Patient, Journal of Burn Care & Research , Volume 37, Issue 5, September-October 2016, Pages e409–e414, https://doi.org/10.1097/BCR.0000000000000288 https://pubmed.ncbi.nlm.nih.gov/26284640/ - Walker PF, Buehner MF, Wood LA, Boyer NL, Driscoll IR, Lundy JB, Cancio LC, Chung KK. Diagnosis and management of inhalation injury: an updated review. Crit Care. 2015 Oct 28;19:351. doi: 10.1186/s13054-015-1077-4. PMID: 26507130; PMCID: PMC4624587. https://pubmed.ncbi.nlm.nih.gov/26507130/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 30

Enlace del curso: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo de Cirugía General SCORE. Cada descripción está diseñada para ayudar a los candidatos a prepararse de manera eficaz para el Examen de Certificación en Cirugía General. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. The course contains crisp, concise operative descriptions that cover all SCORE common topics and and most SCORE uncommon topics. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 29

Enlace del curso: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo de Cirugía General SCORE. Cada descripción está diseñada para ayudar a los candidatos a prepararse de manera eficaz para el Examen de Certificación en Cirugía General. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. The course contains crisp, concise operative descriptions that cover all SCORE common topics and and most SCORE uncommon topics. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 28

Enlace del curso: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo de Cirugía General SCORE. Cada descripción está diseñada para ayudar a los candidatos a prepararse de manera eficaz para el Examen de Certificación en Cirugía General. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. The course contains crisp, concise operative descriptions that cover all SCORE common topics and and most SCORE uncommon topics. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 28

Enlace del curso: https://app.behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo de Cirugía General SCORE. Cada descripción está diseñada para ayudar a los candidatos a prepararse de manera eficaz para el Examen de Certificación en Cirugía General. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. The course contains crisp, concise operative descriptions that cover all SCORE common topics and and most SCORE uncommon topics. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 27

In this episode, we break down the upcoming CMS policy that will reduce work RVUs for nearly all non–time-based surgical CPT codes beginning January 1st. Dr. Chris Childers, surgical oncologist and health-policy expert, and Christian Shaughnessy, ACS Senior VP for Advocacy, join us to explain what these cuts mean for surgeons in both private practice and employed models. We explore why CMS believes surgeons are becoming “more efficient,” and why newly published data suggest the opposite may be true. Our guests outline the downstream financial, workforce, and patient-access implications of this unprecedented policy shift. Finally, we discuss how every surgeon can—and should—take action now to help prevent these cuts from taking effect. Hosts: Patrick Georgoff, MD, @georgoff Christopher Childers, MD, PhD, @cchildersmd Christian Shalgian, ACS Division of Advocacy and Health Policy Senior Vice President Take action: https://www.facs.org/advocacy/regulatory-issues/fight-back-against-cuts-to-work-relative-value-units/ Longitudinal Trends in Efficiency and Complexity of Surgical Procedures: Analysis of 1.7 Million Operations Between 2019 and 2023: https://pubmed.ncbi.nlm.nih.gov/40801398/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 24

The treatment for locally advanced rectal cancer has undergone numerous changes and is now used routinely in clinical practice. Please join us in a thorough discussion of current evidence and ongoing research of total neoadjuvant therapy in locally advanced rectal cancer with leaders in the field including Drs J. Joshua Smith, Julio Garcia-Aguilar, Emmanouil Fokas, and Benjamin Schlechter Hosts: · Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center · Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian · Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center · Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Guests: 1. Julio Garcia-Aguilar, MD, PhD Benno C. Schmidt Chair in Surgical Oncology Chief, Colorectal Service, Department of Surgery Director, Colorectal Cancer Research Center, Memorial Sloan Kettering Cancer Center Professor of Surgery, Weill Cornell Medical College 2. Benjamin Schlechter, MD Senior Physician in the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute Assistant Professor of Medicine, Medicine, Harvard Medical School 3. Emmanouil Fokas, MD, DPhil Professor and Chairman | Department of Radiation Oncology, Cyberknife and Radiotherapy | Faculty of Medicine, University Hospital Cologne Learning objectives: · Define locally advanced rectal cancer (LARC) and describe the clinical staging that qualifies patients for total neoadjuvant therapy (TNT). · Explain the rationale for transitioning from traditional chemoradiotherapy (CRT) plus surgery to total neoadjuvant therapy in rectal cancer management. · Compare the designs, treatment regimens, and long-term outcomes of major TNT trials including RAPIDO, PRODIGE-23, OPRA, and CAO/ARO/AIO-12/16. · Evaluate organ preservation strategies—such as the watch-and-wait approach—after TNT and identify which patients are appropriate candidates based on clinical or near-complete response. · Summarize emerging research directions including: · Integration of circulating tumor DNA (ctDNA) in surveillance and response prediction. · The role of immunotherapy in mismatch repair proficient (MSS) and deficient (dMMR) tumors. References: 1. Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. JCO 40 , 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 2. Verheij, F. S. et al. Long-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA Trial. JCO 42 , 500–506 (2024). https://pubmed.ncbi.nlm.nih.gov/37883738/ 3. Fokas, E. et al. Randomized Phase II Trial of Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: CAO/ARO/AIO-12. JCO 37 , 3212–3222 (2019). https://pubmed.ncbi.nlm.nih.gov/31150315/ 4. Fokas, E. et al. Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Patients With Locally Advanced Rectal Cancer: Long-term Results of the CAO/ARO/AIO-12 Randomized Clinical Trial. JAMA Oncol 8 , e215445–e215445 (2022). https://pubmed.ncbi.nlm.nih.gov/34792531/ 5. Williams H*, Fokas E*, et al. Survival among patients treated with total mesorectal excision or selective watch-and-wait after total neoadjuvant therapy: a pooled analysis of the CAO/ARO/AIO-12 and OPRA randomized phase II trials. Ann Oncol 2025 May;36(5):543-547. https://pubmed.ncbi.nlm.nih.gov/39848335/ 6. Gani, C. et al. Organ preservation after total neoadjuvant therapy for locally advanced rectal cancer (CAO/ARO/AIO-16): an open-label, multicentre, single-arm, phase 2 trial. The Lancet Gastroenterology & Hepatology 10 , 562–572 (2025). https://pubmed.ncbi.nlm.nih.gov/40347958/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 20

Step outside the operating room with us to explore the art, creativity, and humanism that shape a surgeon’s life beyond medicine. Our guest Dr. Adnan Alseidi is not only a renowned hepatobiliary surgeon and surgical educator, but also an avid diver, photographer, and chef. Dr. Alseidi takes us from World War 2 shipwrecks to his restaurants around the world, reflecting on the fragility of humanity revealed in the oceans and moments of connection simmering in the kitchen. Along the way, he shares how creativity, service, and humility fuel his passions and his practice. Join hosts Pooja Varman, MD, Judith French, PhD, and Jeremy Lipman, MD, MHPE, for this inspiring conversation about finding joy and connection in and beyond surgical practice. Learning Objectives By the end of this episode, listeners will be able to 1. Describe the ways in which creative pursuits can deepen a surgeon’s perspective on medicine and life. 2. Identify parallels between artistry and surgery, including precision, patience, and respect for human fragility. 3. Discuss strategies for maintaining balance and encouraging trainees to integrate creativity into their professional identities. References 1. Executive Leadership Program in Health Policy and Management at Brandeis University , sponsored by the American College of Surgeons and several co-sponsoring organizations. 2. The Book of Joy , by Dalai Lama, Desmond Tutu, and Douglas Carlton Abrams 3. Dr. Alseidi’s Wildlife Photography Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 17

Stop powering through the pain! Surgery is a high-performance sport, yet surgeons often operate with minimal support, leading to chronic pain and potential career-ending injuries. This episode dives into the crucial topic of surgical ergonomics , explaining why your posture, instrument size, and even hydration impact your performance and longevity. Learn essential OR hacks—from adjusting monitor height and using micro-break stretches to strategic pre-case fueling—to mitigate the physical toll. We also share candid stories from surgeons who faced debilitating injuries, providing critical advice on acknowledging pain, seeking help, and treating recovery like a full-time job. It’s time to invest in your physical health, because your hands and posture are your most vital instruments. Hosts: Agnes Premkumar, MD (General Surgery Resident at Creighton University) @agnespremkumar Steven Thornton, MD (General Surgery Resident at Duke University) @swthorntonjr Guests: Kathryn Coan, MD (Dignity Health, Phoenix) Anathea Powell, MD (Renown Health, Reno) Danielle Tanner, MD (Creighton University, Phoenix) Dr. Kathryn Coan is an endocrine surgeon, and associate professor at the Creighton University School of Medicine in Phoenix. Outside of the OR, she enjoys being active such as playing golf, hockey, and hiking. Dr. Anathea Powell is a colorectal surgeon working at Renown Health in Reno, Nevada and the University of Nevada, Reno. Outside of the OR, she has certifications in personal training as well as coaching for nutrition, sleep and recovery, mobility, and menopause. She is also a former All American in triathlon and aquabike (swim-bike). Dr. Danielle Tanner is a PGY-5 at Creighton University School of Medicine in Phoenix and aspires to be a rural general surgeon. Publications and Applications Discussed: Black Belt Academic Surgical Skills: https://bbass.org/ Epstein S, Sparer EH, Tran BN, Ruan QZ, Dennerlein JT, Singhal D, Lee BT. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis. JAMA Surg. 2018 Feb 21;153(2):e174947. doi: 10.1001/jamasurg.2017.4947. Epub 2018 Feb 21. PMID: 29282463; PMCID: PMC5838584. https://pubmed.ncbi.nlm.nih.gov/29282463/ Sutton E, Irvin M, Zeigler C, Lee G, Park A. The ergonomics of women in surgery. Surg Endosc. 2014 Apr;28(4):1051-5. doi: 10.1007/s00464-013-3281-0. PMID: 24232047. https://pubmed.ncbi.nlm.nih.gov/24232047/ Patel VR, Stearns SA, Liu M, Tsai TC, Jena AB. Mortality Among Surgeons in the United States. JAMA Surg. 2025 Sep 1;160(9):1032-1034. doi: 10.1001/jamasurg.2025.2482. PMID: 40737024; PMCID: PMC12311820. https://pubmed.ncbi.nlm.nih.gov/40737024/ Lee MR, Lee GI. Does a robotic surgery approach offer optimal ergonomics to gynecologic surgeons?: a comprehensive ergonomics survey study in gynecologic robotic surgery. J Gynecol Oncol. 2017 Sep;28(5):e70. doi: 10.3802/jgo.2017.28.e70. Epub 2017 Jun 23. PMID: 28657231; PMCID: PMC5540729. https://pubmed.ncbi.nlm.nih.gov/28657231/ Berguer R. The application of ergonomics in the work environment of general surgeons. Rev Environ Health. 1997 Apr-Jun;12(2):99-106. doi: 10.1515/reveh.1997.12.2.99. PMID: 9273926. https://pubmed.ncbi.nlm.nih.gov/9273926/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 13

Carotid artery disease management has come a long way. From the days when every stroke meant an endarterectomy to a modern era defined by precision, evidence, and evolving technology. With advances in medical therapy and newer techniques like TCAR, the vascular surgeon has even more to consider when choosing the best treatment for carotid disease. Join us as we break down the major landmark trials NASCET, CREST and the Asymptomatic Carotid trials, and discuss how their findings shape our clinical decisions in practice today. Hosts: · Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center · Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center · Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center · Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning Objectives: · Review the key findings and clinical implications of the NASCET , ACST , and CREST trials. · Discuss patient selection for carotid endarterectomy (CEA) vs carotid artery stenting (CAS) . · Understand how age, calcification, and aortic arch anatomy affect stenting outcomes or choice between stent and CEA. · Identify how advances in medical therapy have influenced management of asymptomatic disease. · Discuss appropriate screening/ follow up plans for patients who do not meet criteria for intervention References: - North American Symptomatic Carotid Endarterectomy Trial Collaborators. (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. The New England Journal of Medicine, 325 (7), 445–453. https://pubmed.ncbi.nlm.nih.gov/1852179/ - Brott, T. G., Hobson, R. W. II, Howard, G., Roubin, G. S., Clark, W. M., Brooks, W., ... & Howard, V. J. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. The New England Journal of Medicine, 363 (1), 11–23. https://pubmed.ncbi.nlm.nih.gov/20505173/ - Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D.; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: Randomized controlled trial. The Lancet, 363 (9420), 1491–1502. https://pubmed.ncbi.nlm.nih.gov/15135594/ - Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., & Pan, H., & the ACST-2 Collaborative Group. (2021). Second asymptomatic carotid surgery trial (ACST-2): A randomised comparison of carotid artery stenting versus carotid endarterectomy. The Lancet, 398(10305), 1065-1073. https://doi.org/10.1016/S0140-6736(21)01910-3 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 10

Pediatric trauma hits differently—both emotionally and clinically. In this Big T Trauma episode (2 of 2), Drs. Teddy Puzio, Charles Cox, and Tyler Simpson join Dr. Patrick Georgoff to break down real-world pediatric trauma cases. They explore how mechanism predicts injury, when imaging helps (and when it harms), and the nuances of recognizing non-accidental trauma. Packed with practical takeaways and memorable teaching points, this episode will sharpen your instincts for the next injured child you treat. PECARN Pediatric Imaging Guidelines: https://emscimprovement.center/education-and-resources/peak/multisystem-trauma/imaging/ This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 6

Pediatric trauma hits differently—both emotionally and clinically. In this Big T Trauma episode (1 of 2), Drs. Teddy Puzio, Charles Cox, and Bhupaul Ramsuchit join Dr. Patrick Georgoff to break down real-world pediatric trauma cases that highlight the ABCs, airway pitfalls, and the art of staying one step ahead when things go sideways. From weight-based dosing and needle cricothyrotomy, to recognizing subtle signs of shock, this one’s packed with practical pearls you can use on your next pediatric activation. UT Houston Pediatric MTP: https://med.uth.edu/surgery/pedimtp/ This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Nov 3

Mesh infections are dreaded complications in hernia repair. This episode highlights relevant mesh properties, pathogens, and management strategies so you can tackle the next mesh infection with confidence! Hosts: Dr. Maggie Bosley - @MBosleyMD Dr. Sean Orenstein - @OrensteinSean Dr. Amber Sandoval Dr. Peter Ferrin Institution: Oregon Health & Science University Learning Objectives - Compare the long-term weight loss and diabetes remission rates of Gastric Bypass vs. Sleeve Gastrectomy. - Identify the appropriate revision options (Bypass vs. Sadie) for a patient with a failed sleeve based on the reason for failure (reflux vs. weight regain). - Recognize that all bariatric operations are superior to untreated obesity, making patient selection paramount. Episode Sponsor Disclosures: Visit goremedical.com/btk to learn more about GORE® ENFORM Biomaterial. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 30

In this episode, Drs. Ali, Georgoff, and Swenson share some big-time updates to our oral board simulator. We've also included a full example test for you to listen to. Whether you are studying for the exam, or for your next rotation, try the Behind the Knife Oral Board Simulator for free: https://behindtheknifeoralboardsimulator.org What's new: Massive Usage & Feedback: The Beta launch of the AI-powered oral board simulator has been a huge success, thanks to the incredible support and actionable feedback from the surgical community. Your feedback has allowed for advanced fine tuning and a better user experience. Next-Level Feedback: Your readiness score just got a whole lot more honest! The score is now a more accurate reflection of your performance and the number of the 362 testable conditions and procedures you've actually covered. The Examiner Makeover: Experience a real-world test day with 20 different examiner voices (fast, slow, accented) to prepare you for any personality you might face. Introducing your new study partners: Get ready for three game-changing features designed to elevate your training: Coach: The ultimate study buddy! Ask it questions, and it will provide the right answers, identify your weaknesses, and walk you through scenarios (the opposite of the unhelpful examiner!). OpGuide: Perfect for procedural review. Ask it how to perform a procedure (like a Whipple), and it will provide concise, board-appropriate surgical steps. Wingman: Practice unfamiliar topics without the stress! It presents a patient stem, and if you're stuck, Wingman will answer for you in the first person, teaching you the topic as it goes. The future is now! Specialty Expansion: The simulator is coming soon to Vascular, Colorectal, Surgical Oncology, CT Surgery, Pediatric Surgery, and even OBGYN ! Platform Integration: Look out for a big makeover as the simulator is fully integrated into the Behind the Knife app platform for a seamless and beautiful user experience. Listen to the end for a full scenario run-through and a detailed breakdown of the scoring to see the improvements for yourself! Your feedback is CRUCIAL to making this the best simulator it can be. Please use the in-app feedback button or the link below to share your thoughts! https://forms.gle/wAJxTtkEYowNeqNa9 Hosts: - Ayman Ali, MD (PGY-4, Duke Hospital) - Patrick Georgoff, MD (Trauma/Critical Care Surgeon, Duke Hospital): @georgoff - Matthew Swenson, MD (General Surgeon, Valley Health System) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 27

In this episode, we explore practical tips for caring for older adults in the clinical setting through a case-based discussion highlighting common perioperative challenges and strategies for success. We also take a deeper dive into the American College of Surgeons Geriatric Surgery Verification Program, including its goals, impact, and how clinicians can get involved in advancing surgical care for the aging patient population. Take Home Points: The older adult population is the fastest growing patient population and it is important we focus on patient-centered care for this population, as this is a population that almost all of us will engage with. If you or your hospital isn’t prepared to get verified yet, there are still small processes that can be implemented that can make an impactful difference on your patients. Geriatric Surgery Verification is at the cutting edge of quality improvement. Like other verification programs (trauma, bariatric) patients will soon seek out these centers that can best address their personal needs. Hosts: Agnes Premkumar, MD - General Surgery Resident at Creighton University, @agnespremkumar Nicole L. Petcka, MD – General Surgery Resident at Emory University, @npetcka2022 Guests: Marcia M. Russell, MD - Professor of Surgery and Vice Chair for Quality and Safety at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System Caroline Smolkin, MD - General Surgery Resident at Northwell and American College of Surgeons Clinical Scholar Resources: American College of Surgeons Geriatric Surgery Verification Program: https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/ Katlic MR, Wolf J, Demos SJ, Rosenthal RA. Making a Financial Case for the Geriatric Surgery Verification Program. Ann Surg Open. 2024 May 13;5(2):e439. doi: 10.1097/AS9.0000000000000439. PMID: 38911623; PMCID: PMC11191881. https://pubmed.ncbi.nlm.nih.gov/38911623/ Remer SL, Zhou L, Cohen ME, Russell MM, Rosenthal R, Ko CY. Discharge to Post-Acute Care as a Benchmarking Metric for Elderly Surgical Patients. J Am Coll Surg. 2025 Aug 14. doi: 10.1097/XCS.0000000000001495. Epub ahead of print. PMID: 40810404. https://pubmed.ncbi.nlm.nih.gov/40810404/ Jones TS, Jones EL, Richardson V, Finley JB, Franklin JL, Gore DL, Horney CP, Kovar A, Morin TL, Robinson TN. Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay. J Am Geriatr Soc. 2021 Jul;69(7):1993-1999. doi: 10.1111/jgs.17154. Epub 2021 Apr 7. PMID: 33826150. https://pubmed.ncbi.nlm.nih.gov/33826150/ *** UNC Surgery is inviting you to participate in a national survey designed to understand general surgery residents’ perspectives on core curriculum content, structure, & delivery. The results of this survey will inform the development of a standardized general surgery education curriculum. SURVEY LINK: https://docs.google.com/forms/d/e/1FAIpQLSeJztQwgB1rJXpCtvboHprGB_gmHGG4UzY1HITAHRmMx9FcRQ/viewform Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 23

In this episode, the Surgical Endoscopy team reviews applications of per oral endoscopic myotomy (POEM) at different locations in the gastrointestinal tract. Specifically, they discuss esophageal POEM for achalasia, G-POEM for gastroparesis, and Z-POEM for management of a Zenker’s diverticulum. The team describes outcomes for these procedures as well as an overview of the procedural steps and postoperative management. Common pitfalls to POEM are deliberated along with advice on how to mitigate challenging situations when they arise. VIDEO LINK: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-3-per-oral-endoscopic-myotomy Hosts: • Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery Fellow, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) • Dr. H. Mason Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL) • Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) • Dr. Michael McCormack, Minimally Invasive Surgeon, Swedish Hospital (Chicago, IL) Learning Objectives: • Describe the basic steps of the Peroral Endoscopic Myotomy (POEM) technique. • Identify the different applications for POEM in the esophagus, stomach, and pharynx. • Recognize the primary indications and success rates for esophageal, gastric, and Zenker's diverticulum POEM procedures. Surgical Endocsopy Series: - Surgical Endoscopy Series Ep. 1: An Introduction to Surgical Endoscopy: https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-1-an-introduction-to-surgical-endoscopy - Surgical Endoscopy Series Ep. 2: Endobariatrics - https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-2-endobariatrics Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 20

This new mini-series on Behind the Knife will delve into the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program. This first episode highlights the colon cancer operative standard. Hosts : Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology fellow at MD Anderson Cancer Center. Guest: George Chang, MD, MS, MHCM, FACS, FASCRS, FSSO is a Professor and the interim Department Chair in the Department of Colon and Rectal Surgery at MD Anderson Cancer Center. Learning Objectives: The extent of colon mobilization and resection depends on tumor location, with high vascular ligation of the tumor-bearing segment to complete adequate regional lymphadenectomy. The technical steps of right colectomy are reviewed, including high ligation of the ileocolic pedicle at the level of the superior mesenteric vein, and the right branch of the middle colic artery if present. Tips and tricks are discussed to identify vascular structures and avoid central vascular injury. Links to Papers Referenced in this Episode Operative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colon https://www.facs.org/quality-programs/cancer-programs/cancer-surgery-standards-program/operative-standards-for-cancer-surgery/purchase/ Kindle edition: https://www.amazon.com/Operative-Standards-Cancer-Surgery-Section-ebook/dp/B07MWSNFSB Short-term outcomes of complete mesocolic excision versus D2 dissection in patients undergoing laparoscopic colectomy for right colon cancer (RELARC): a randomized, controlled, phase 3, superiority trial Lancet Oncol. 2021 Mar; 22(3):391-401. https://pubmed.ncbi.nlm.nih.gov/33587893/ Impact of Proximal Vascular Ligation on Survival of Patients with Colon Cancer. Ann Surg Oncol. 2018 Jan;25(1):38-45. https://pubmed.ncbi.nlm.nih.gov/27942902/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 16

Sleeve, bypass, or something new – which surgery really dominates the day? This Bariatric Surgery Journal Club dives into the debate over which bariatric operation is best. We compare the outcomes of the gastric bypass, sleeve gastrectomy, and the newer Sadie procedure, exploring how bypass may have an edge in long-term diabetes remission and weight loss. We also discuss revisional options for failed sleeves and the importance of matching the patient to the right operation for their specific needs. Hosts: - Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) - Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio) - Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) - Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) Learning objectives: - Contrast the outcomes of Roux-en-Y gastric bypass, sleeve gastrectomy, and revisional options such as the single-anastomosis duodeno-ileal bypass (SADI) - Article #1: Hauge 2025, Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple blind, randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/40185112/ - Describe the design and unique triple-blind methodology of a single-center randomized trial comparing bypass and sleeve in patients with obesity and type 2 diabetes. - Interpret the clinical relevance of the 5-year outcomes, including 63% diabetes remission with bypass vs 30% with sleeve. - Examine secondary outcomes such as weight loss and cholesterol reduction, which favored bypass over the sleeve - Formulate patient-centered strategies for selecting bypass versus sleeve in populations with advanced metabolic disease, balancing efficacy with patient preference - Article #2: The By-Band-Sleeve Collaborative Group 2025, Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicenter, open-label, three-group, randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/40179925/ - Summarize the findings of this multi-center, open-label randomized controlled trial of over 1,300 patients comparing bypass, sleeve, and gastric banding at 5 years - Discuss the relative weight loss outcomes: 67% excess weight loss for bypass, 63% for sleeve, and 28% for adjustable gastric band - Evaluate the improvements in diabetes remission, hypertension control, and lipid management with bypass and sleeve compared to banding. - Analyze the declining role of gastric banding in modern bariatric surgery, while acknowledging its benefits compared to no weight loss treatment - Article #3: Thomopoulos 2024, Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis https://pubmed.ncbi.nlm.nih.gov/39579238/ - Compare long-term outcomes of bypass versus SADI after failed sleeve gastrectomy, based on pooled analysis of over 1,000 patients - Interpret the trade-offs: SADI provides greater weight loss and metabolic improvements, but carries a higher risk for malnutrition and fat-soluble vitamin deficiencies - Develop strategies for preoperative counseling, nutritional supplementation, and close long-term monitoring, particularly for patients undergoing SADI - Individualize decision-making for revisional surgery, considering factors such as patient goals, comorbidity burden, prior anatomy, BMI, and reliability with follow-up - Evolving revisional strategies will influence the next decade of bariatric surgical innovation - Overall, bariatric surgery consistently improves weight, diabetes control, and cardiovascular risk. - The procedure of choice should be tailored to the patient through detailed discussion between surgeon and patient, aligning clinical evidence with patient goals and risks. References 1. Wågen Hauge J, Borgeraas H, Birkeland KI, Johnson LK, Hertel JK, Hagen M, Gulseth HL, Lindberg M, Lorentzen J, Seip B, Kolotkin RL, Svanevik M, Valderhaug TG, Sandbu R, Hjelmesæth J, Hofsø D. Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple-blind, randomised controlled trial. Lancet Diabetes Endocrinol. 2025 May;13(5):397-409. doi: 10.1016/S2213-8587(24)00396-6. Epub 2025 Apr 1. PMID: 40185112. https://pubmed.ncbi.nlm.nih.gov/40185112/ 2. By-Band-Sleeve Collaborative Group. Roux-en-Y gastric bypass, adjustable gastric banding, or sleeve gastrectomy for severe obesity (By-Band-Sleeve): a multicentre, open label, three-group, randomised controlled trial. Lancet Diabetes Endocrinol. 2025 May;13(5):410-426. doi: 10.1016/S2213-8587(25)00025-7. Epub 2025 Mar 31. PMID: 40179925. https://pubmed.ncbi.nlm.nih.gov/40179925/ 3. Thomopoulos T, Mantziari S, Joliat GR. Long-term results of Roux-en-Y gastric bypass (RYGB) versus single anastomosis duodeno-ileal bypass (SADI) as revisional procedures after failed sleeve gastrectomy: a systematic literature review and pooled analysis. Langenbecks Arch Surg. 2024 Nov 23;409(1):354. doi: 10.1007/s00423-024-03557-9. PMID: 39579238; PMCID: PMC11585492. https://pubmed.ncbi.nlm.nih.gov/39579238/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 13

Liver transplantation continues to evolve as strategies expand to address organ shortage and optimize outcomes. Normothermic machine perfusion (NMP) offers a novel way to preserve and assess donor livers prior to implantation. In this episode of Behind the Knife, our transplant team at University of Nebraska Medical Center discusses the latest evidence from randomized trials, practical applications in donation after circulatory death (DCD) grafts, and how NMP is shaping clinical decision-making in high-risk transplants. Hosts - Madeline Cloonan, MD PhD, General Surgery Resident, University of Nebraska Medical Center, @maddie_cloonan - Jacqueline Dauch, MD, Assistant Professor, University of Nebraska Medical Center - Shaheed Merani, MD PhD, Associate Professor, University of Nebraska Medical Center - Alan Langnas, DO, Professor, University of Nebraska Medical Center Learning Objectives - Describe the principles of normothermic machine perfusion (NMP) and how it differs from static cold storage. - Summarize the design and key outcomes of the PROTECT trial and the Chapman et al. trial on NMP in liver transplantation. - Recognize the clinical scenarios where NMP provides the greatest benefit, particularly in high-risk grafts (e.g., DCD donors, high donor risk index). - Apply a practical viability assessment framework for livers on NMP, including hemodynamics, bile production, lactate trajectory, and histology when indicated. - Discuss the implications of NMP for allocation, system logistics, and future adoption trends in transplantation. References 1. Markmann JF, Abouljoud MS, Ghobrial RM, et al. Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant: the OCS Liver PROTECT randomized clinical trial. JAMA Surg. 2022;157(3):189-198. doi:10.1001/jamasurg.2021.6781. https://pubmed.ncbi.nlm.nih.gov/34985503/ 2. Chapman WC, Barbas AS, D’Alessandro AM, et al. Normothermic machine perfusion of donor livers for transplantation in the United States: a randomized controlled trial. Ann Surg. 2023;278(5):e912-e921. doi:10.1097/SLA.0000000000005934. https://pubmed.ncbi.nlm.nih.gov/37389552/ 3. Nasralla D, Coussios CC, Mergental H, et al; Consortium for Organ Preservation in Europe. A randomized trial of normothermic preservation in liver transplantation. Nature. 2018;557(7703):50-56. doi:10.1038/s41586-018-0047-9. https://pubmed.ncbi.nlm.nih.gov/29670285/ 4. Brubaker AL, Sellers MT, Abt PL, et al. US liver transplant outcomes after normothermic regional perfusion vs standard super rapid recovery. JAMA Surg. 2024;159(6):677-685. doi:10.1001/jamasurg.2024.0520. https://pubmed.ncbi.nlm.nih.gov/38568597/ 5. Wall A, Snoddy M, Du J, et al. The current landscape of in situ and ex situ machine perfusion utilization for liver grafts from cardiac donation after circulatory death donors in the US. Am J Transplant. 2025;25(3):574-582. doi:10.1016/j.ajt.2024.09.012. https://pubmed.ncbi.nlm.nih.gov/39293517/ 6. Watson CJE, Gaurav R, Fear C, Swift L, Selves L, Ceresa CDL, Upponi SS, Brais R, Allison M, Macdonald-Wallis C, Taylor R, Butler AJ. Predicting Early Allograft Function After Normothermic Machine Perfusion. Transplantation. 2022 Dec 1;106(12):2391-2398. doi: 10.1097/TP.0000000000004263. https://pubmed.ncbi.nlm.nih.gov/36044364/ 7. Watson CJE, Hunt F, Messer S, Currie I, Large S, Sutherland A, Crick K, Wigmore SJ, Fear C, Cornateanu S, Randle LV, Terrace JD, Upponi S, Taylor R, Allen E, Butler AJ, Oniscu GC. In situ normothermic perfusion of livers in controlled circulatory death donation may prevent ischemic cholangiopathy and improve graft survival. Am J Transplant. 2019 Jun;19(6):1745-1758. doi: 10.1111/ajt.15241. https://pubmed.ncbi.nlm.nih.gov/30589499/ 8. Olthoff KM, Kulik L, Samstein B, et al. Validation of a current definition of early allograft dysfunction in liver transplant recipients and analysis of risk factors. Liver Transpl. 2010;16(8):943-949. doi:10.1002/lt.22091. https://pubmed.ncbi.nlm.nih.gov/20677285/ 9. Kwong AJ, Kim WR, Lake JR, Schladt DP, Handarova D, Howell J, Schumacher B, Weiss S, Snyder JJ, Israni AK. OPTN/SRTR 2023 Annual Data Report: Liver. Am J Transplant. 2025 Feb;25(2S1):S193-S287. doi: 10.1016/j.ajt.2025.01.022. https://pubmed.ncbi.nlm.nih.gov/39947804/ Ad Disclosures: Visit goremedical.com/btk to learn more about GORE® ENFORM Biomaterial. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 9

In this kickoff episode of the Behind the Knife Global Surgery Series , we dive into what global surgery really means—and why it matters to all of us. Five billion people lack access to safe, timely, and affordable surgical care. Our guest, Dr. Juan Carlos Puyana, shares powerful insights on redefining global surgery, building meaningful collaborations, and why surgeons in high-resource countries should care deeply about this work. If you want to broaden your vision of surgery, challenge assumptions, and hear stories that connect operating rooms from South Carolina to South Africa, this is an episode you won’t want to miss. Hosts/Guest: Mike M. Mallah, MD, FACS, FICS Director of Global Surgery at Medical University of South Carolina @MikeMMallahMD @MUSCGlobalSurg mallahm@musc.edu Juan Carlos Puyana, MD, FACS O’Brian Chair of Global Surgery at the Royal College of Surgeons Ireland @jcpuyanamd @RCSI_GlobalSurg Learning objectives: Define global surgery and explain how its meaning has evolved to highlight disparities in access to safe, timely, and affordable surgical care worldwide. Recognize the value of global surgery engagement for trainees and surgeons in high-resource settings, including broadening perspectives and fostering humility. Identify principles of ethical collaboration in global surgery, using real-world examples of partnerships built on trust, mutual respect, and shared goals. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 6

Surgical resection of perihilar cholangiocarcinoma (pCCA) is one of the highest-risk elective operations performed. The obstructive jaundice suffered by patients preoperatively, central location of the tumors, and extensive nature of the resection make pCCA one of the most challenging HPB disease processes. In this episode from the HPB team at Behind the Knife, listen in on the discussion about perioperative strategies to improve outcomes for surgical resection of perihilar cholangiocarcinoma. Hosts Anish J. Jain MD (@anishjayjain) is a current PGY4 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology at the University of Texas MD Anderson Cancer Center. He is also the associate program director of the HPB fellowship. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center. Learning Objectives · Develop an understanding of the three treatment sequences for resection of disease in patients with synchronous liver metastasis from a primary rectal cancer (reverse, combined, and classic approach) · Develop an understanding of the benefits, risks, and nuances of each of the three treatment sequences · Develop an understanding of which patient cases each treatment sequence is ideal for as well as which cases they are not suitable for. Papers Referenced: 1) Ribero D, Zimmitti G, Aloia TA, Shindoh J, Fabio F, Amisano M, Passot G, Ferrero A, Vauthey JN. Preoperative Cholangitis and Future Liver Remnant Volume Determine the Risk of Liver Failure in Patients Undergoing Resection for Hilar Cholangiocarcinoma. J Am Coll Surg . 2016 Jul;223(1):87-97. https://pubmed.ncbi.nlm.nih.gov/27049784/ 2) Jain AJ, Lendoire M, Haddad A, Tzeng CD, Boyev A, Maki H, Chun YS, Arvide EM, Lee S, Hu I, Pant S, Javle M, Tran Cao HS, Vauthey JN, Newhook TE. Improved Outcomes Following Resection of Perihilar Cholangiocarcinoma: A 27-Year Experience . Ann Surg Oncol . 2025 Jun;32(6):4352-4362. https://pubmed.ncbi.nlm.nih.gov/40000564/ Additional Suggested Reading Olthof PB, Erdmann JI, Alikhanov R, Charco R, Guglielmi A, Hagendoorn J, Hakeem A, Hoogwater FJH, Jarnagin WR, Kazemier G, Lang H, Maithel SK, Malago M, Malik HZ, Nadalin S, Neumann U, Olde Damink SWM, Pratschke J, Ratti F, Ravaioli M, Roberts KJ, Schadde E, Schnitzbauer AA, Sparrelid E, Topal B, Troisi RI, Groot Koerkamp B; Perihilar Cholangiocarcinoma Collaboration Group. Higher Postoperative Mortality and Inferior Survival After Right-Sided Liver Resection for Perihilar Cholangiocarcinoma: Left-Sided Resection is Preferred When Possible . Ann Surg Oncol . 2024 Jul;31(7):4405-4412. https://pubmed.ncbi.nlm.nih.gov/38472674/ Mueller M, Breuer E, Mizuno T, Bartsch F, et al. Perihilar Cholangiocarcinoma - Novel Benchmark Values for Surgical and Oncological Outcomes From 24 Expert Centers . Ann Surg. 2021 Nov 1;274(5):780-788. https://pubmed.ncbi.nlm.nih.gov/34334638/ Ad Disclosures: Visit goremedical.com/btk to learn more about GORE® ENFORM Biomaterial. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Oct 2

Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center. Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson. Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath. Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center. Galen Gist, MD (@gistgalen) is a General Surgery research resident between his second and third year at Brooke Army Medical Center. Learning Objectives: 1) Review the presentation of patients with pheochromocytomas. 2) Review the work up of patients with pheochromocytomas. 3) Review the treatment of patients with pheochromocytomas. 4) Review the surveillance of patients with pheochromocytomas. References used in the making of this episode: Patel D. Surgical approach to patients with pheochromocytoma. Gland Surg . 2020;9(1):32-42. doi:10.21037/gs.2019.10.20. PMID: 32206597; PMCID: PMC7082266 . Eisenhofer G, Lenders JW, Siegert G, et al. Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer . 2012;48(11):1739-1749. doi:10.1016/j.ejca.2011.07.016. PMID: 22036874 ; PMCID: PMC3372624. Lenders JWM, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet . 2005;366(9486):665-675. doi: 10.1016/S0140-6736(05)67139-5 . Vicha A, Musil Z, Pacak K. Genetics of pheochromocytoma and paraganglioma syndromes: new advances and future treatment options. Curr Opin Endocrinol Diabetes Obes . 2013;20(3):186-191. doi:10.1097/MED.0b013e32835fcc45. PMID: 23481210; PMCID: PMC4711348. https://pubmed.ncbi.nlm.nih.gov/23481210/ Dickson PV, Alex GC, Grubbs EG, et al. Posterior retroperitoneoscopic adrenalectomy is a safe and effective alternative to transabdominal laparoscopic adrenalectomy for pheochromocytoma. Surgery . 2011;150(3):452-458. doi:10.1016/j.surg.2011.07.004. https://pubmed.ncbi.nlm.nih.gov/21878230/ Lei K, Wang X, Yang Z, et al. Comparison of the retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for large (≥6 cm) pheochromocytomas: a single-centre retrospective study. Front Oncol . 2023;13:1043753. doi:10.3389/fonc.2023.1043753. PMID: 36910608; PMCID: PMC9992891. https://pubmed.ncbi.nlm.nih.gov/36910608/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 29

“It’s 5pm and your Consultant (attending) has headed off home. A patient arrives in the resuscitation room blood spurting from a stab wound in the armpit. Join Roisin – a junior Major Trauma fellow, Prash – a surgical trainee, Max – a senior trauma surgery fellow, and Chris – a Consultant trauma surgeon, as we talk through decision making from point of injury to aftercare in this challenging trauma surgical case”. • Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated 1. Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool 2. Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital. 3. Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83 4. Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin • Learning objectives: Bulleted list of learning objectives. A) To become familiar with prehospital methods of haemorrhage control in penetrating junctional injuries. B) To recognise the benefits of prehospital blood product resuscitation in some trauma patients. C) To follow the nuanced decision making in decision for CT scan in a patient with a penetrating junctional injury. D) To describe the possible approaches to the axillary artery in the context of resuscitative trauma surgery. E) To become familiar with decision making around intraoperative systemic anticoagulation in the trauma patient. F) To become familiar with decision making on type of repair and graft material in vascular trauma. G) To recognise the team approach in holistic trauma care through the continuum of trauma care. • References: Bulleted list of references with PubMed links. 1. Perkins Z. et al., 2012. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. EJVES. https://www.ejves.com/article/S1078-5884(12)00337-1/fulltext 2. Ramaraj P., et al. 2025. The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study. Injury. https://www.injuryjournal.com/article/S0020-1383(24)00771-X/ 3. Smith, S., et al. 2019. The effectiveness of junctional tourniquets: A systematic review and meta-analysis. J Trauma Acute Care Surg . https://journals.lww.com/jtrauma/abstract/2019/03000/the_effectiveness_of_junctional_tourniquets__a.20.aspx 4. Rijnhout TWH, et al. 2019. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury . https://www.injuryjournal.com/article/S0020-1383(19)30133-0/ 5. Davenport R, et al. 2023. Prehospital blood transfusion: Can we agree on a standardised approach? Injury . https://www.injuryjournal.com/article/S0020-1383(22)00915-9 . 6. Borgman MA., et al. 2007. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital. J Trauma Acute Care Surg . https://journals.lww.com/jtrauma/fulltext/2007/10000/the_ratio_of_blood_products_transfused_affects.13.aspx 7. Holcomb JB., et al. 2013. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. Comparative Effectiveness of a Time-Varying Treatment With Competing Risks. JAMA Surgery . https://jamanetwork.com/journals/jamasurgery/fullarticle/1379768 8. Holcomb JB, et al. 2015. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma. The PROPPR Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2107789 9. Davenport R., et al. 2023. Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury. The CRYOSTAT-2 Randomized Clinical Trial. JAMA . https://jamanetwork.com/journals/jama/fullarticle/2810756 10. Baksaas-Aasen K., et al. 2020. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. ICM. https://link.springer.com/article/10.1007/s00134-020-06266-1 11. Wahlgren CM., et al. 2025. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. EJVES. https://esvs.org/wp-content/uploads/2025/01/2025-Vascular-Trauma-Guidelines.pdf 12. Khan S., et al. 2020. A meta-analysis on anticoagulation after vascular trauma. Eur J Traum Emerg Surg . https://link.springer.com/article/10.1007/s00068-020-01321-4 13. Stonko DP., et al. 2022. Postoperative antiplatelet and/or anticoagulation use does not impact complication or reintervention rates after vein repair of arterial injury: A PROOVIT study. Vascular . https://journals.sagepub.com/doi/10.1177/17085381221082371?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 25

Learn more: https://behindtheknifeoralboardsimulator.org/ It has arrived! Introducing Behind the Knife's Oral Board Simulator (beta version): Unlimited unique oral board scenarios Available 24/7 Diverse examiners Natural conversation Detailed, actionable feedback based on SCORE curriculum and American Board of Surgery grading scheme Try it for free for a limited time! Note, this is our FIRST version of the Oral Board Simulator. To make it better, we need your feedback. After using the simulator, please take <1 minute to complete the feedback form. This will help us refine the simulator and improve the user experience. On this pod, we are thrilled to introduce the newest member of the Behind the Knife team, Dr. Matthew Swenson. Dr. Swenson is a general surgeon and U.S. Air Force veteran. He earned his medical degree from the Uniformed Services University and completed his general surgery residency at the University of Nevada in Las Vegas. After training he was stationed in Anchorage, Alaska for 7 years, where he took part in multiple domestic and overseas military exercises. His practice in Alaska also involved partnerships with the local community, including working with residents and local surgeons at the Alaska Native Medical Center. At the completion of his military service, he was recruited to return to Las Vegas as the Associate Program Direct for the Valley Health System General Surgery residency program. Dr. Swenson's primary passion is ensuring surgical residents are fully prepared for independent practice upon graduation, which has led him to create innovative, AI-powered study tools for oral board exam preparation. Whenever time allows, he enjoys family time and all things outdoors. Hosts: Ayman Ali, MD (PGY-4, Duke Hospital) Patrick Georgoff, MD (Trauma/Critical Care Surgeon, Duke Hospital): @georgoff Matthew Swenson, MD (General Surgeon, Valley Health System) Talha Rafeeqi, MD (Foregut Surgeon, The Oregon Clinic) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 18

Welcome to the 6th episode of our BTK/ASGBI series! During this series, BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam will compare and contrast various aspects of surgery between the United States and the United Kingdom, debating who does what better. In this episode, we delve into surgical training, current challenges, and hopes for the future of surgical training in the US and the UK. We will be discussing the advent of the EPA curriculum in the US, the current challenge of obtaining a speciality position in the UK, and tips for making the resident to attending/junior faculty transition smoothly. Dr. Jeremy Lipman represents the US while Dr. Phil Pearce represents the UK in this thought-provoking conversation. Dr. Lipman is a colorectal surgeon at the Cleveland Clinic and the director of graduate medical education for all training programs at the Cleveland Clinic. Additionally, he is an Associate Dean for Graduate Medical Education and Professor of Surgery at Case Western Reserve University. He is passionate about surgical training and holds the James E. Sampliner Endowed Chair in Surgical Education. Dr. Phil Pearce is a consultant in emergency general surgery in Oxford with interests in trauma, complex biliary disease, and most importantly a passion for training. Take a listen and let us know what you think- who does surgical education and training better? References: Speciality training position in the NHS https://www.ft.com/content/e4b364c3-6a20-42ee-a9a5-ab9eea441c87?utm_source=chatgpt.com https://www.theguardian.com/society/2025/jul/02/nhs-in-england-told-to-slash-recruitment-of-overseas-trained-medics?utm_source=chatgpt.com Surgery job market in the US https://surgpli.com/the-state-of-surgery-as-a-career-in-2025/ EPA curriculum https://www.aamc.org/about-us/mission-areas/medical-education/cbme/core-epas Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 15

Why are we still treating acute uncomplicated diverticulitis with antibiotics? There is plenty of evidence from several randomized controlled trials demonstrating that symptomatic management alone yields similar results. If we should continue prescribing antibiotics for acute uncomplicated diverticulitis, which patients should undergo treatment and when? Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss the management of uncomplicated diverticulitis while reviewing groundbreaking literature. Hosts: -Jared Hendren, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Elissa Dabaghi, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Joseph Trunzo, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter @joseph_trunzo - Ajaratu Keshinro, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @AJKesh - David Rosen, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @davidrrosenmd Learning Objectives: By the end of this episode, listeners will be able to: 1. Identify criteria for managing acute uncomplicated diverticulitis without antibiotics based on recent literature 2. Define uncomplicated and complicated diverticulitis 3. Discuss nuanced management decisions of patients with uncomplicated diverticulitis to determine when antibiotics may be appropriate for management References: 1. Azhar, N., Aref, H., Brorsson, A., Lydrup, M.‑L., Jörgren, F., Schultz, J. K., & Buchwald, P. (2022). Management of acute uncomplicated diverticulitis without antibiotics: Compliance and outcomes – a retrospective cohort study. BMC Emergency Medicine, 22 (1), Article 28. https://doi.org/10.1186/s12873‑022‑00584‑X 2. Mora‑López, L., Ruiz‑Edo, N., Estrada‑Ferrer, O., Piñana‑Campón, M. L., Labró‑Ciurans, M., Escuder‑Perez, J., Sales‑Mallafré, R., Rebasa‑Cladera, P., Navarro‑Soto, S., Serra‑Aracil, X., & DINAMO‑study Group. (2021). Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO‑study): A multicentre, randomised, open‑label, noninferiority trial. Annals of Surgery , 274 (5), e435–e442. https://doi.org/10.1097/SLA.0000000000005031 3. Daniels, L., Ünlü, Ç., de Korte, N., van Dieren, S., Stockmann, H. B., Vrouenraets, B. C., Consten, E. C., van der Hoeven, J. A., Eijsbouts, Q. A., Faneyte, I. F., Bemelman, W. A., Dijkgraaf, M. G., & Boermeester, M. A. (2017). Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT‑proven uncomplicated acute diverticulitis. British Journal of Surgery , 104 (1), 52‑61. https://doi.org/10.1002/bjs.10309 4. Chabok, A., Påhlman, L., Hjern, F., Haapaniemi, S., & Smedh, K.; AVOD Study Group. (2012). Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. British Journal of Surgery, 99 (4), 532–539. https://doi.org/10.1002/bjs.8688 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 11

Psst… wanna hear some tea? Join Drs. Maya Hunt, John Woodward, and Cait Silvestri as they discuss gossip - what it is, what it means, and how it can impact the surgical training environment. Joined by authors of a recent paper deconstructing gossip in surgical residency, Dr. Bobbi Ann Adair White and former CoSEF leader Dr. Joseph L’Huillier, the team examines the ways gossip can be positive and negative, how we can mitigate the harms that come with it, and reflect on some of our own experiences with gossip as trainees. Episode Hosts: - Dr. Maya Hunt, Indiana University, mayahunt@iu.edu - Dr. John Woodward, University at Buffalo, @JohnWoodward76, jmwoodwa@buffalo.edu - Dr. Cait Silvestri, Columbia University, @CaitSilvestri, cs4004@cumc.columbia.edu - CoSEF: @surgedfellows, cosef.org Guests: - Dr. Joseph L’Huillier, University of Buffalo, @JoeLHuillier101, josephlh@buffalo.edu - Dr. Bobbi Ann Adair White, MGH Institute of Health Professions, @_BAAW_, bwhite2@mghihp.edu Learning Objectives: - Define gossip in the context of surgical education, distinguishing between its academic definition and common perceptions - Identify how forms of gossip can be constructive, as well as destructive - Explore the process model of gossip in surgical residency programs, including what choices recipients have when receiving gossip - Recognize environmental factors that contribute to gossip in surgical settings - Apply practical strategies to mitigate harmful gossip in training environments References: - L'Huillier JC, Silvestri C, Brian R, et al. The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency. Surgery . 2025;180:109126. doi:10.1016/j.surg.2024.109126 https://pubmed.ncbi.nlm.nih.gov/39862712/ - L'Huillier JC, Woodward JM, Lund S, et al. Is it gossip or feedback? Surgical attendings' perceptions of gossip within residency. J Surg Educ . 2024;81(10):1362-1373. doi:10.1016/j.jsurg.2024.07.004 https://pubmed.ncbi.nlm.nih.gov/39173427/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 8

Ductal carcinoma in situ (DCIS) represents a clinical crossroads in breast surgery—balancing the risks of over-treatment with the need to prevent invasive cancer. With new data from active monitoring trials, the pressure is on for surgeons to personalize care. Tune in to this essential episode to stay ahead of the curve on DCIS management and to hear expert insights from two leading breast surgical oncologists. Hosts: - Rashmi Kumar, MD, PhD Resident, University of Michigan General Surgery Residency Program Twitter/X: @ RashmiJKumar - Melissa Pilewskie, MD Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine Twitter/X: @ MPilewskie - Stephanie Downs-Canner, MD Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program Twitter/X: @ SDownsCanner Learning Objectives: - Define DCIS and explain its significance as a precursor to invasive breast cancer. - Discuss challenges in diagnosing and risk-stratifying DCIS. - Review current standards for surgical and adjuvant management of DCIS. - Understand the implications of new research, including the COMET trial, for low-risk DCIS. - Evaluate patient-centered strategies for managing DCIS and preventing over-treatment. References: - Worni M, Akushevich I, Greenup R, et al. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ. J Natl Cancer Inst . 2015;107(12):djv263. PubMed - Francis A, Thomas J, Fallowfield L, et al. Addressing overtreatment of screen detected DCIS; the LORIS trial. Eur J Cancer . 2015 Jan;51(16):2296-303. PubMed - Elshof LE, Tryfonidis K, Slaets L, et al. Feasibility of a non-surgical management strategy for low-grade DCIS: The LORD study. Eur J Cancer . 2015;51(12):1497–1510. PubMed - Toss MS, et al. Ductal carcinoma in situ (DCIS): current management and future directions. Cancer Treat Rev . 2020;90:102091. PubMed - Comparative Effectiveness of Surgery versus Active Monitoring for Low-Risk DCIS (COMET) Trial Results. Early COMET Results: King TA, et al. Surgical excision versus active monitoring for low-risk ductal carcinoma in situ (DCIS): 2-year results of the COMET randomized trial. J Clin Oncol. 2024; e2400110. PubMed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 4

Welcome back our series on AI for the clinician! In this episode, we go over some basics of machine learning statistics with the goal to help you read and analyze contemporary studies. Some of this will be a review, and parts will be technical, but by the end we hope reading these studies is less daunting. Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. Julie Doberne, MD, PhD: @juliedoberne Julie Doberne is an Assistant Professor of Surgery, Assistant Professor of Medical Informatics and Clinical Epidemiology, cardiothoracic surgeon, and faculty member of the Surgical Data and Decision Sciences Lab at Oregon Health and Science University. Phillip Jenkins, MD: @PhilJenkinsMD Phil Jenkins is a general surgery PGY-4 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics. Steven Bedrick, PhD: @stevenbedrick Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Department of Medical Informatics and Clinical Epidemiology. Shelby Willis, MD Shelby Willis is a general surgery PGY-4 at Oregon Health and Science University. She is currently in her research time in the Surgical Data and Decision Sciences lab at OHSU pursuing advanced training in informatics. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen BTK Fan Favorites: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Sep 1

In the second episode of this new collaboration between BTK and Annals of surgery, we discuss another hot topic: academic surgery. Specifically, we discuss dedicated research time for residents and how surgical leaders think about building the academic surgery enterprise. This discussion was inspired by a couple of recent papers in Annals of Surgery that stirred up a lot of conversation on social media which can be found below. Host: Cody Mullens, MD MPH — general surgery resident at University of Michigan current BTK Surgery Education Fellow (@Cody_Mullens) Guest: Justin Dimick, MD MPH — Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of you Michigan and Editor in Chief at Annals of Surgery (@jdimick1) Papers: Career Trajectory After General Surgery Residency Do Academic Program Graduates Pursue Academic Surgery? https://journals.lww.com/annalsofsurgery/abstract/2025/05000/career_trajectory_after_general_surgery_residency_.10.aspx Training the Surgeon-scientist: Time (and Money) Well Spent? https://journals.lww.com/annalsofsurgery/citation/9900/training_the_surgeon_scientist__time__and_money_.1318.aspx Introducing a New Annals of Surgery Section Professional Development for the Contemporary Surgeon https://journals.lww.com/annalsofsurgery/fulltext/2025/08000/introducing_a_new_annals_of_surgery_section_.8.aspx Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen BTK Fan Favorites: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Aug 28

In this episode of Behind the Knife, Dr. Patrick Georgoff sits down with Dr. Keri Seymour and Dr. Joey Lew to tackle the complex world of gastrostomy tubes. What may seem like a routine and straightforward procedure is anything but—full of nuanced patient considerations, timing dilemmas, technical challenges, and potential complications that can turn a “simple” consult into a 2 a.m. call you won’t forget. From who truly needs a G tube and when to managing difficult post-op issues like dislodgement and buried bumper syndrome, this episode breaks down the practical, evidence-based approach every surgeon should know. Whether you’re managing stroke patients, trauma cases, or navigating the tricky administrative obstacles around enteral access, this episode will equip you with the insights and strategies to confidently dominate your G tube consults. Hosts: · Dr. Patrick Georgoff (Acute Care Surgeon, Duke University) · Dr. Keri Seymour (Minimally Invasive & Acute Care Surgeon, Duke Regional) · Dr. Joey Lew (Surgical Resident, BTK MIS Team) Learning Goals: By the end of this episode, listeners will be able to: · Understand the nuanced indications for gastrostomy tube (G tube) placement. · Learn which patients truly benefit from G tubes, and when enteral access is not appropriate or indicated. · Appreciate the importance of goals of care discussions, assessment of comorbidities, and decision-makers—especially in neurocritical and elderly populations. · Know evidence-based timing for gastrostomy tube placement in stroke, TBI, and other complex scenarios. · Understand guideline recommendations and the clinical reasoning behind trial periods of nasogastric feeding versus early G tube placement. · Describe technical approaches to G tube placement and how to tailor the method to patient anatomy and clinical context. · Solidify knowledge of when to choose endoscopic, laparoscopic, open, or interventional radiology-guided placement. · Recognize, manage, and strive to prevent common and serious complications of G tubes, including early and late dislodgement, buried bumper syndrome, infection, bleeding, and gastrocutaneous fistula. · Discuss perioperative considerations, including anticoagulation, patient stability, and post-procedural care. · Understand why routine suturing of the G tube or bumper is not recommended, and how administrative and facility factors can drive clinical decisions. · Gain practical pearls and quick decision trees to dominate G tube consults and troubleshooting, day or night. References: · Braun R, Han K, Arata J, Gourab K, Hearn J, Gonzalez-Fernandez M. Establishing a clinical care pathway to expedite rehabilitation transitions for stroke patients with dysphagia and enteral feeding needs. Am J Phys Med Rehabil. 2024;103(5):390-394. doi:10.1097/PHM.0000000000002387 https://pubmed.ncbi.nlm.nih.gov/36867953/ · Burgermaster M, Slattery E, Islam N, Ippolito PR, Seres DS. Regional comparison of enteral nutrition-related admission policies in skilled nursing facilities. Nutr Clin Pract. 2016;31(3):342-348. doi:10.1177/0884533616629636 https://pubmed.ncbi.nlm.nih.gov/26993318/ · Chaudhry R, Kukreja N, Tse A, Pednekar G, Mouchli A, Young L, Didyuk O, Wegner RC, Grewal N, Williams GW. Trends and outcomes of early versus late percutaneous endoscopic gastrostomy placement in patients with traumatic brain injury: Nationwide population-based study. J Neurosurg Anesthesiol. 2018;30(3):251-257. doi:10.1097/ANA.0000000000000434 https://pubmed.ncbi.nlm.nih.gov/28459729/ · Cleverdon SA, Costantini TW, McGrew TM, Santorelli JE, Berndtson AE, Haines LN. Dysphagia in patients with traumatic brain injury, how often do they really need feeding access? Presented at: Academic Surgical Congress; February 2025; Washington, DC. Abstract 92.33. · Cmorej P, Mayuiers M, Sugawa C. Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement. BMJ Case Rep. 2019;12(9):e230728. doi:10.1136/bcr-2019-230728 https://pubmed.ncbi.nlm.nih.gov/31488448/ · Galovic M, Stauber AJ, Leisi N, et al. Development and validation of a prognostic model of swallowing recovery and enteral tube feeding after ischemic stroke. JAMA Neurol. 2019;76(5):561-570. doi:10.1001/jamaneurol.2018.4858 https://pubmed.ncbi.nlm.nih.gov/30742198/ · Gallo RJ, Wang JE, Madill ES. Things we do for no reason™. J Hosp Med. 2024;19(8):728-730. doi:10.1002/jhm.13263 https://pubmed.ncbi.nlm.nih.gov/38180160/ · George BP, Hwang DY, Albert GP, Kelly AG, Holloway RG. Timing of percutaneous endoscopic gastrostomy for acute ischemic stroke. Stroke. 2017;48(2):420-427. doi:10.1161/STROKEAHA.116.015119 https://pubmed.ncbi.nlm.nih.gov/27965430/ · Goldberg LS, Altman KW. The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review. Clin Interv Aging. 2014;9:1733-1739. doi:10.2147/CIA.S53153 https://pubmed.ncbi.nlm.nih.gov/25342891/ · Hartford A, Li W, Qureshi D, et al. Use of feeding tubes among hospitalized older adults with dementia. JAMA Netw Open. 2025;8(2):e2460780. doi:10.1001/jamanetworkopen.2024.60780 https://pubmed.ncbi.nlm.nih.gov/39976967/ · Hochu G, Soule S, Lenart E, Howley IW, Filiberto D, Byerly S. Synchronous tracheostomy and gastrostomy placement results in shorter length of stay in traumatic brain injury patients. Am J Surg. 2024;227:153-156. doi:10.1016/j.amjsurg.2023.10.012 https://pubmed.ncbi.nlm.nih.gov/37852846/ · Kobzeva-Herzog AJ, Nofal MR, Bodde J, et al. Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements. Am J Surg. 2025;(article 116522). doi:10.1016/j.amjsurg.2025.116522 https://pubmed.ncbi.nlm.nih.gov/40782502/ · Kurt Boeykens, Ivo Duysburgh. Prevention and management of major complications in percutaneous endoscopic gastrostomy. BMJ Open Gastroenterol. 2021;8:e000628. https://pubmed.ncbi.nlm.nih.gov/33947711/ · Murphy LM, Lipman TO. Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Arch Intern Med. 2003;163(11):1351-1353. doi:10.1001/archinte.163.11.1351 https://pubmed.ncbi.nlm.nih.gov/12796072/ · Papavramidis TS, Mantzoukis K, Michalopoulos N. Confronting gastrocutaneous fistulas. Ann Gastroenterol. 2011;24(1):16-19. https://pubmed.ncbi.nlm.nih.gov/24714282/ · Rajan A, Wangrattanapranee P, Kessler J, Kidambi TD, Tabibian JH. Gastrostomy tubes: fundamentals, periprocedural considerations, and best practices. World J Gastrointest Surg. 2022;14(4):286-303. doi:10.4240/wjgs.v14.i4.286 https://pubmed.ncbi.nlm.nih.gov/35664365/ · Reddy KM, Lee P, Gor PJ, Cheesman A, Al-Hammadi N, Westrich DJ, Taylor J. Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes. World J Gastrointest Pharmacol Ther. 2022;13(5):77-87. doi:10.4292/wjgpt.v13.i5.77 https://pubmed.ncbi.nlm.nih.gov/36157266/ · Singh D, Laya AS, Vaidya OU, Ahmed SA, Bonham AJ, Clarkston WK. Risk of bleeding after percutaneous endoscopic gastrostomy (PEG). Dig Dis Sci. 2012;57(4):973-980. doi:10.1007/s10620-011-1965-7 https://pubmed.ncbi.nlm.nih.gov/22138961/ · Thosani N, Rashtak S, Kannadath BS, et al. Bleeding risk and mortality associated with uninterrupted antithrombotic therapy during percutaneous endoscopic gastrostomy tube placement. Am J Gastroenterol. 2021;116(9):1868-1875. doi:10.14309/ajg.0000000000001348 https://pubmed.ncbi.nlm.nih.gov/34158462/ · Ward EC, Green K, Morton AL. Patterns and predictors of swallowing resolution following adult traumatic brain injury. J Head Trauma Rehabil. 2007;22(3):184-191. doi:10.1097/01.HTR.0000271119.96780.f5 https://pubmed.ncbi.nlm.nih.gov/17510594/ · Wick B. Timing of PEG tube placement in stroke patients with dysphagia: a multi-center retrospective cohort analysis using the TriNetX database. Am J Gastroenterol. 2024;119(10 Suppl):S1146-S1147. doi:10.14309/01.ajg.0001035684.98119.d5 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen BTK Fan Favorites: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Aug 25

A silent danger lurks within the descending thoracic aorta. While most Type B aortic dissections are managed medically, up to half of these patients will either require life-saving surgery or die within just five years. So how do we separate those who will quietly recover from those on the edge of catastrophe? How do we protect the spinal cord, bowel, and limbs from the devastating consequences of malperfusion? Join the University of Michigan Department of Vascular Surgery as they tackle the high-stakes decisions behind managing this unpredictable disease—where timing is critical, interventions are evolving, and lives hang in the balance. Hosted by the University of Michigan Department of Vascular Surgery: · Robert Beaulieu, Program Director · Frank Davis, Assistant Professor of Surgery · Luciano Delbono, PGY-5 House Officer · Andrew Huang, PGY-4 House Officer · Carolyn Judge, PGY-2 House Officer Learning Objectives: 1. Discuss general approach to diagnosis and management of TBAD. 2. Identifying high-risk features in uncomplicated TBAD and understanding their role in determining the need for surgical management. 3. Review endovascular techniques for managing malperfusion of the limbs, viscera, and spinal cord and discuss associated decision making. References: Authors/Task Force Members, Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., Kim, K. M., Kreibich, M., Lescan, M., Di Marco, L., Martens, A., Mestres, C. A., Milojevic, M., Nienaber, C. A., … Hughes, G. C. (2024). EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. The Annals of Thoracic Surgery, 118(1), 5–115. https://doi.org/10.1016/j.athoracsur.2024.01.021 de Kort, J. F., Hasami, N. A., Been, M., Grassi, V., Lomazzi, C., Heijmen, R. H., Hazenberg, C. E. V. B., van Herwaarden, J. A., & Trimarchi, S. (2025). Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection. Annals of Vascular Surgery, S0890-5096(25)00004-4. https://doi.org/10.1016/j.avsg.2024.12.060 Eidt, J. F., & Vasquez, J. (2023). Changing Management of Type B Aortic Dissections. Methodist DeBakey Cardiovascular Journal, 19(2), 59–69. https://doi.org/10.14797/mdcvj.1171 Lombardi, J. V., Hughes, G. C., Appoo, J. J., Bavaria, J. E., Beck, A. W., Cambria, R. P., Charlton-Ouw, K., Eslami, M. H., Kim, K. M., Leshnower, B. G., Maldonado, T., Reece, T. B., & Wang, G. J. (2020). Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections. Journal of Vascular Surgery, 71(3), 723–747. https://doi.org/10.1016/j.jvs.2019.11.013 MacGillivray, T. E., Gleason, T. G., Patel, H. J., Aldea, G. S., Bavaria, J. E., Beaver, T. M., Chen, E. P., Czerny, M., Estrera, A. L., Firestone, S., Fischbein, M. P., Hughes, G. C., Hui, D. S., Kissoon, K., Lawton, J. S., Pacini, D., Reece, T. B., Roselli, E. E., & Stulak, J. (2022). The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection. The Annals of Thoracic Surgery, 113(4), 1073–1092. https://doi.org/10.1016/j.athoracsur.2021.11.002 Papatheodorou, N., Tsilimparis, N., Peterss, S., Khangholi, D., Konstantinou, N., Pichlmaier, M., & Stana, J. (2025). Pre-Emptive Endovascular Repair for Uncomplicated Type B Dissection—Is This an Option? Annals of Vascular Surgery, S0890-5096(25)00007-X. https://doi.org/10.1016/j.avsg.2025.01.003 Trimarchi, S., Gleason, T. G., Brinster, D. R., Bismuth, J., Bossone, E., Sundt, T. M., Montgomery, D. G., Pai, C.-W., Bissacco, D., de Beaufort, H. W. L., Bavaria, J. E., Mussa, F., Bekeredjian, R., Schermerhorn, M., Pacini, D., Myrmel, T., Ouzounian, M., Korach, A., Chen, E. P., … Patel, H. J. (2023). Editor’s Choice - Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 66(6), 775–782. https://doi.org/10.1016/j.ejvs.2023.05.015 Writing Committee Members, Isselbacher, E. M., Preventza, O., Hamilton Black Iii, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Jones, W. S., Kalahasti, V., … Woo, Y. J. (2022). 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 80(24), e223–e393. https://doi.org/10.1016/j.jacc.2022.08.004 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 21

What if we could train patients for surgery the way elite athletes train for game day? In this episode, we review the science, shed light on the disparities, explore real-world challenges, and honor the behind-the-scenes workers that facilitate prehabilitation in thoracic cancer care. Join attending surgeon Doctor Jinny Ha, 3rd year general surgery resident Doctor Kyla Rakoczy, and Community Outreach Patient Navigator, Leslie Ricks Chandler, in discussing prehabilitation in thoracic surgery. Hosts: Dr. Jinny Ha, MD, MHS, assistant professor of surgery and thoracic surgeon at Johns Hopkins Leslie Ricks Chandler, Community Outreach Program Advisor Johns Hopkins Thoracic Surgery Dr. Kyla Rakoczy, MD, 3rd year general surgery resident at Johns Hopkins LinkedIn: Kyla Rakoczy Learning objectives : After listening to this episode, participants will be able to: Define the role and components of prehabilitation in the context of thoracic oncology and ERAS/ESTS guidelines. Interpret key findings from recent clinical trials on prehabilitation, including outcomes related to functional capacity and readmission rates. Identify socioeconomic and structural barriers to prehabilitation participation and discuss strategies to improve equitable access to these interventions. Apply evidence-based criteria to assess which patients may benefit most from preoperative nutrition and exercise interventions. Recognize the importance of interdisciplinary collaboration—including social work and patient navigation—in optimizing surgical readiness and long-term outcomes. References : Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial - PubMed https://pmc.ncbi.nlm.nih.gov/articles/PMC12070588/ https://pubmed.ncbi.nlm.nih.gov/39775660/ https://ccts.amegroups.org/article/view/68030/html https://pubmed.ncbi.nlm.nih.gov/36435646/ https://www.sciencedirect.com/science/article/abs/pii/S1043067918301643?via%3Dihub https://pubmed.ncbi.nlm.nih.gov/30304509/ https://pubmed.ncbi.nlm.nih.gov/28385477/ https://pubmed.ncbi.nlm.nih.gov/27226400/ https://pubmed.ncbi.nlm.nih.gov/38546649/ https://pubmed.ncbi.nlm.nih.gov/38614212/ https://www.hopkinsmedicine.org/surgery/specialty-areas/thoracic-surgery/patient-education Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 18

Primary hyperparathyroidism is an underdiagnosed condition which leads to decreased bone mineral density, fracture, renal disease, among other symptoms that can decrease the quality of a patient’s life. Moreover, once diagnosed, only a small fraction of patients with the diease end up being offered surgery. Whether it is because of misunderstood indications and benefits of surgery, non-localization of disease, or various other reasons, we thought it was worthwhile to review relevant literature. Hosts: Dr. Becky Sippel is an endowed professor of surgery at Division Chief of endocrine surgery at University of Wisconsin Madison and she is the most recent past president of the AAES. She is an internationally recognized leader in the field of endocrine surgery. She has over 250 publications. She was the PI for a RCT which studies prophylactic central neck dissections which is a widely read and quoted study in endocrine surgery. Dr. Amanda Doubleday is a fellowship trained endocrine surgeon in private practice with an affiliation to UW Health. Her primary practice is with Waukesha Surgical Specialists in Waukesha WI. Dr. Simon Holoubek is a fellowship trained endocrine surgeons affiliated with UW Health. He works for UW Health with privileges at UW Madison and UW Northern Illinois. His clinical interests are aggressive variants of thyroid cancer, parathyroid autofluorescence, and nerve monitoring. Learning Objectives: 1 Understand the natural history of primary hyperparathyroidism and how the disease process can affect bone mineral density. 2 Learn about fracture risk associated with primary hyperparathyroidism. 3 Learn about decreased fracture risk in patients with primary hyperparathyroidism who have parathyroidectomy compared to those who are observed. References: 1 Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab. 2008 Sep;93(9):3462-70. doi: 10.1210/jc.2007-1215. Epub 2008 Jun 10. PMID: 18544625; PMCID: PMC2567863. https://pubmed.ncbi.nlm.nih.gov/18544625/ 2 Frey S, Gérard M, Guillot P, Wargny M, Bach-Ngohou K, Bigot-Corbel E, Renaud Moreau N, Caillard C, Mirallié E, Cariou B, Blanchard C. Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia. J Clin Endocrinol Metab. 2024 May 17;109(6):1494-1504. doi: 10.1210/clinem/dgad718. PMID: 38152848. https://pubmed.ncbi.nlm.nih.gov/38152848/ 3 VanderWalde LH, Liu IL, Haigh PI. Effect of bone mineral density and parathyroidectomy on fracture risk in primary hyperparathyroidism. World J Surg. 2009 Mar;33(3):406-11. doi: 10.1007/s00268-008-9720-8. PMID: 18763015. https://pubmed.ncbi.nlm.nih.gov/18763015/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 14

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 13

In this episode, the Behind the Knife team shares exciting updates, including updates to the General Surgery Oral Board Review with 123 expert-commentary scenarios, 10 interactive videos, and 97 operative descriptions. They announce upcoming projects such as an AI-powered oral board simulator, Spanish-language review, a free pediatric surgery resource, and detailed surgical instrument flashcards. The team also introduces Dominate Surgery courses for medical students and advanced practice providers, designed to modernize and elevate surgical education. ***Choledocholithiasis wtih Gastric Bypass Video Scenario Link: https://app.behindtheknife.org/video/behindtheknife-general-surgery-oral-board-review-video-sample-choledocholithiasis-w-gastric-bypass --- Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 12

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 11

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 7

When the gallbladder turns hostile, sometimes you must do more than just pause—you have to call in a senior partner for help. Join the Behind the Knife EGS team at Mizzou as we dive into the art and grit of open cholecystectomy. From fundus-first dissection to navigating the “barrier to happiness,” this episode is packed with surgical pearls, tough love, and the kind of wisdom only scars can teach. Participants: Dr. Rushabh Dev FACS (Moderator, Surgical Attending) – Assistant Professor of Surgery, Associate PD ACS & SCCM Fellowship, SICU Medical Director, Lieutenant Commander United States Navy Reserve Dr. Jeffery Coughenour FACS (Surgical Attending) – Professor of Surgery and Emergency Medicine, Trauma Medical Director at the University of Missouri SOM Dr. Christopher Nelson FACS (Surgical Attending) – Associate Professor of Surgery, Medical Director of Emergency General Surgery at the University of Missouri SOM Dr. Micah Ancheta (ACS Fellow) – Major, United States Airforce Dr. Desra Fletcher (3rd year general surgery resident) Learning Objectives: · Recognize Indications for Conversion Identify clinical and intraoperative factors that necessitate conversion from laparoscopic to open cholecystectomy. · Apply Risk Stratification Tools Utilize grading systems (e.g., Parkland, Tokyo, AAST) to assess cholecystitis severity and predict surgical difficulty. · Implement Safe Cholecystectomy Techniques Describe the six steps of the SAGES Safe Cholecystectomy Program to minimize bile duct injury. · Understand Bailout Strategies Differentiate between fenestrating and reconstituting subtotal cholecystectomy techniques and their respective risks. · Master Key Operative Steps Outline the essential components of open cholecystectomy: positioning, incision, exposure, and dissection. · Navigate High-Risk Anatomy Recognize “zones of danger” and use the B-SAFE mnemonic to reorient and ensure safe progression. · Develop Intraoperative Judgment Demonstrate when to proceed with subtotal techniques, convert to open, or call for assistance. · Perform Technical Nuances Safely Identify proper dissection planes, manage gallbladder bed inflammation, and secure cystic structures with confidence. · Prevent and Manage Complications Understand the risks of bile leaks, bilomas, and subcostal hernias—and how to mitigate them through technique and closure. · Foster Surgical Maturity Emphasize humility, collaboration, and mentorship in difficult operations—knowing when to ask for help is a skill. References: 1. Dhanasekara, C. S., Shrestha, K., Grossman, H., Garcia, L. M., Maqbool, B., Luppens, C., ... & Dissanaike, S. (2024). A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study. Surgery, 176 (5), 605–613. https://doi.org/10.1016/j.surg.2024.03.057 2. Motter, S. B., de Figueiredo, S. M. P., Marcolin, P., Trindade, B. O., Brandao, G. R., & Moffett, J. M. (2024). Fenestrating vs reconstituting laparoscopic subtotal cholecystectomy: A systematic review and meta-analysis. Surgical Endoscopy, 38 , 7475–7485. https://doi.org/10.1007/s00464-024-11225-8 3. Brunt, L. M., Deziel, D. J., Telem, D. A., Strasberg, S. M., Aggarwal, R., Asbun, H., ... & Stefanidis, D. (2020). Safe cholecystectomy multi-society practice guideline and state of the art consensus conference on prevention of bile duct injury during cholecystectomy. Surgical Endoscopy. https://www.sages.org/publications/guidelines/safe-cholecystectomy-multi-society-practice-guideline/ 4. Elshaer, M., Gravante, G., Thomas, K., Sorge, R., Al-Hamali, S., & Ebdewi, H. (2015). Subtotal cholecystectomy for “difficult gallbladders”: Systematic review and meta-analysis. JAMA Surgery, 150 (2), 159–168. https://doi.org/10.1001/jamasurg.2014.1219 5. Koo, S. S. J., Krishnan, R. J., Ishikawa, K., Matsunaga, M., Ahn, H. J., Murayama, K. M., & Kitamura, R. K. (2024). Subtotal vs total cholecystectomy for difficult gallbladders: A systematic review and meta-analysis. The American Journal of Surgery, 229 (1), 145–150. https://doi.org/10.1016/j.amjsurg.2023.12.022 6. Strasberg, S. M., Pucci, M. J., Brunt, L. M., & Deziel, D. J. (2016). Subtotal cholecystectomy—“Fenestrating” vs “reconstituting” subtypes and the prevention of bile duct injury: Definition of the optimal procedure in difficult operative conditions. Journal of the American College of Surgeons, 222 (1), 89–96. https://doi.org/10.1016/j.jamcollsurg.2015.09.019 7. Ahmed, O., & Walsh, T. N. (2020). Surgical trainee experience with open cholecystectomy and the Dunning-Kruger effect. Journal of Surgical Education. https://doi.org/10.1016/j.jsurg.2020.03.025 8. Seshadri, A., & Peitzman, A. B. (2024). The difficult cholecystectomy: What you need to know. The Journal of Trauma and Acute Care Surgery, 97 (3), 325–336. https://doi.org/10.1097/TA.0000000000004156 9. Invited commentary on “A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study”. (2024). Surgery, 176 (5), 614–615. https://doi.org/10.1016/j.surg.2024.05.003 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 4

You’re on call at a level I trauma center and you get called that you’re receiving a large TBSA burn patient – you’re not working at a burn center! You remember hearing about some controversy surrounding burn resuscitation – was it the parkland formula? Consensus formula? ABSITE asked about the Modified Brooke Formula?!? Join Dr. Kathleen Romanowski, Dr. Laura Johnson, Dr. Victoria Miles, and Dr. Lauren Nosanov to discuss modern burn fluid resuscitation! Hosts: · Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento · Laura Johnson – Grady Memorial Hospital · Lauren Nosanov – Grady Memorial Hospital · Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans Learning Objectives: · Review the basics of initial burn fluid resuscitation · Evaluate the literature informing national burn fluid resuscitation guidelines · Consider the causes of failed burn resuscitation and strategies for identifying these complications References: · Pham TN, Cancio LC, Gibran NS. American Burn Association Practice Guidelines Burn Shock Resuscitation. J Burn Care Res. 2008: 257-266. doi:10.1097/jbcr.0b013e31815f3876. https://pubmed.ncbi.nlm.nih.gov/18182930/ · Rizzo JA, Coates EC, Serio-Melvin ML, et al. Higher Initial Formula for Resuscitation After Severe Burn Injury Means Higher 24-Hour Volumes. J Burn Care Res . 2023:1017-1022. doi:10.1093/jbcr/irad065. https://pubmed.ncbi.nlm.nih.gov/37339255/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 31

Today, we’re diving into a condition that’s as fascinating as it is complex: Achalasia —where the esophagus stops playing nice, and swallowing becomes a daily challenge. We’re breaking down the latest evidence , comparing POEM, pneumatic dilation, and Heller myotomy , and digging into what actually matters when deciding how to treat each achalasia subtype. Join show hosts Drs. Jake Greenberg, Dana Portenier, Zach Weitzner, and Joey Lew as they discuss the past, present, and future of Achalasia management. Whether you're a medical student or a seasoned attending, this episode will arm you with the tools to think critically about diagnosis, tailor your treatment strategy, and stay ahead of the curve on the future of achalasia care. Hosts: · Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University · Dana Portenier, MD, MIS Fellowship Director, Duke University · Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD · Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually Learning Goals: By the end of this episode, listeners will be able to: · Describe the pathophysiology and key diagnostic criteria for achalasia , including the role of manometry, EGD, and esophagram. · Differentiate between the three subtypes of achalasia based on the Chicago Classification and understand the clinical significance of each. · Compare treatment options for achalasia—pneumatic dilation, Lap Heller myotomy, and POEM—including indications, efficacy, and long-term outcomes. · Interpret landmark studies (e.g., European Achalasia Trial, JAMA POEM trial) and their impact on treatment decision-making. · Recognize patient-specific factors (age, comorbidities, achalasia subtype) that influence the choice of therapy. · Discuss evolving technologies and future directions in achalasia management, including endoluminal robotics, ARMS, and combined anti-reflux strategies. · Outline a basic treatment algorithm for newly diagnosed achalasia, incorporating diagnostic steps and tailored interventions. · Appreciate the multidisciplinary approach to achalasia care, including the roles of MIS surgeons, gastroenterologists, and emerging procedural skillsets. References: · Boeckxstaens G, Elsen S, Belmans A, Annese V, Bredenoord AJ, Busch OR, Costantini M, Fumagalli U, Smout AJPM, Tack J, Vanuytsel T, Zaninotto G, Salvador R; European Achalasia Trial Investigators. 10‑year follow-up results of the European Achalasia Trial: a multicentre randomised controlled trial comparing pneumatic dilation with laparoscopic Heller myotomy. Gut. 2024 Mar;73(4):582‑589. doi: 10.1136/gutjnl‑2023‑331374. PMID: 38050085 https://pubmed.ncbi.nlm.nih.gov/38050085/ · He J, Yin Y, Tang W, Jiang J, Gu L, Yi J, Yan L, Chen S, Wu Y, Liu X. Objective Outcomes of an Extended Anti‑reflux Mucosectomy in the Treatment of PPI‑Dependent Gastroesophageal Reflux Disease (with Video). J Gastrointest Surg. 2022 Aug;26(8):1566–1574. doi:10.1007/s11605‑022‑05396‑9. PMID: 35776296 https://pubmed.ncbi.nlm.nih.gov/35776296/ · Modayil RJ, Zhang X, Rothberg B, et al. Peroral endoscopic myotomy: 10-year outcomes from a large, single-center U.S. series with high follow-up completion and comprehensive analysis of long-term efficacy, safety, objective GERD, and endoscopic functional luminal assessment. Gastrointest Endosc . 2021;94(5):930-942. doi:10.1016/j.gie.2021.05.014. PMID: 33989646. https://pubmed.ncbi.nlm.nih.gov/33989646/ · Ponds FA, Fockens P, Lei A, Neuhaus H, Beyna T, Kandler J, Frieling T, Chiu PWY, Wu JCY, Wong VWY, Costamagna G, Familiari P, Kahrilas PJ, Pandolfino JE, Smout AJPM, Bredenoord AJ. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial. JAMA. 2019 Jul 9;322(2):134–144. doi:10.1001/jama.2019.8859. PMID: 31287522. https://pubmed.ncbi.nlm.nih.gov/31287522/ · Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT; ACG Clinical Guidelines Committee. ACG clinical guidelines: Diagnosis and management of achalasia. Am J Gastroenterol. 2020 Sep;115(9):1393–1411. doi:10.14309/ajg.0000000000000731. PMID: 32773454; PMCID: PMC9896940 https://pubmed.ncbi.nlm.nih.gov/32773454/ · West RL, Hirsch DP, Bartelsman JF, de Borst J, Ferwerda G, Tytgat GN, Boeckxstaens GE. Long term results of pneumatic dilation in achalasia followed for more than 5 years. Am J Gastroenterol . 2002;97(6):1346-1351. doi:10.1111/j.1572-0241.2002.05771.x. PMID:12094848. https://pubmed.ncbi.nlm.nih.gov/12094848/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 28

Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas ( https://www.trauma-criticalcare.com/ ). The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too! A favorite feature is the annual debates. Today, we are featuring a showdown between Drs. Teddy Puzo and Joseph Dubois as they battle it out over the use of a DIRECT TO OR TRAUMA RESUSCITATION STRATEGY . You can listen on the podcast or watch the debate with accompanying slides on our website or app. Let's get ready to RUMMMBLLLEEEE! Video Link: https://www.youtube.com/watch?v=-DTTGBaLcHo TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/trauma-surgery-video-atlas Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 25

Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas ( https://www.trauma-criticalcare.com/ ). The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too! A favorite feature is the annual debates. Today, we are featuring a showdown between Drs. Ryan Dumas and Bellal Joseph (@TopKniFe_B) as they battle it out over the use of TRAUMA VIDEO REVIEW . You can listen on the podcast or watch the debate with accompanying slides on our website or app. Let's get ready to RUMMMBLLLEEEE! Video Link: https://app.behindtheknife.org/video/mattox-conference-pro-con-debate-2025-trauma-video-review TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/trauma-surgery-video-atlas Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 24

In this episode of the Big T Trauma Series, Dr. Patrick Georgoff (@georgoff) and Dr. Jason Brill dive into the evolving world of Trauma Video Review (TVR) with special guests Dr. Michael Vella and Dr. Ryan Dumas. Together, they explore how TVR is transforming trauma care by offering unprecedented insight into both technical and non-technical performance in the trauma bay. The conversation covers everything from implementation logistics and HIPAA concerns to cultural shifts and emerging AI applications. Whether you're curious about getting started or wondering if TVR should be part of trauma verification, this episode delivers essential insights from two national leaders in the space. Don’t miss it! Dr. Ryan Dumas is an associate professor of surgery at Baylor College of Medicine in Houston Texas where he serves as the Section Chief of Acute Care Surgery. Dr. Dumas conducts and publishes research in trauma surgery and artificial intelligence, with a specific emphasis on video technology to capture and review trauma resuscitations. He has helped develop and run several Trauma Video Review programs across the country and utilizes video review as a tool for quality improvement, education, and research. Dr. Dumas is a consultant for Teleflex and Surgical Safety Technologies. Dr. Michael Vella is an associate professor of surgery, division of acute care surgery and trauma, at the university of Rochester medical center in Rochester, NY and the trauma medical director of the Kessler Level I trauma center. He currently serves as chair of the New York State Committee on Trauma. He has a clinical and research interest in trauma video review, particularly as it relates to trauma team dynamics and initial resuscitation. Dr. Dumas is a consultant for Teleflex. This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 21

The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center - Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian - Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center - Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center - Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center - Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Learning objectives: - Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC. - Identify age groups and demographics most affected by EOCRC. - Summarize USPSTF recommendations for colorectal cancer screening. - Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity. - Understand treatment approaches for colon and rectal cancer (CRC) - Understand the role of mismatch repair (MMR) status in guiding treatment. - Outline the importance of genetic counseling and testing in young patients. - Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes. - Describe the impact of cancer treatment on fertility and sexual health. - Review fertility preservation options. - Identify the value of integrated care teams for young CRC patients. References: 1. Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109 , djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/ 2. Abboud, Y. et al. Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis. Cancers 17 , 1500 (2025). https://pubmed.ncbi.nlm.nih.gov/40361427/ 3. Phang, R. et al. Is the Incidence of Early-Onset Adenocarcinomas in Aotearoa New Zealand Increasing? Asia Pac. J. Clin. Oncol. https://pubmed.ncbi.nlm.nih.gov/40384533/ 4. Vitaloni, M. et al. Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries. BMC Gastroenterol. 25 , 378 (2025). https://pubmed.ncbi.nlm.nih.gov/40375142/ 5. Siegel, R. L. et al. Global patterns and trends in colorectal cancer incidence in young adults. (2019) doi:10.1136/gutjnl-2019-319511. https://pubmed.ncbi.nlm.nih.gov/31488504/ 6. Cercek, A. et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. J. Natl. Cancer Inst. 113 , 1683–1692 (2021). https://pubmed.ncbi.nlm.nih.gov/34405229/ 7. Zheng, X. et al. Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer. JNCI J. Natl. Cancer Inst. 113 , 543–552 (2021). https://pubmed.ncbi.nlm.nih.gov/33136160/ 8. Standl, E. & Schnell, O. Increased Risk of Cancer—An Integral Component of the Cardio–Renal–Metabolic Disease Cluster and Its Management. Cells 14 , 564 (2025). https://pubmed.ncbi.nlm.nih.gov/40277890/ 9. Muller, C., Ihionkhan, E., Stoffel, E. M. & Kupfer, S. S. Disparities in Early-Onset Colorectal Cancer. Cells 10 , 1018 (2021). https://pubmed.ncbi.nlm.nih.gov/33925893/ 10. US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 325 , 1965–1977 (2021). https://pubmed.ncbi.nlm.nih.gov/34003218/ 11. Fwelo, P. et al. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med. 14 , e70612 (2025). https://pubmed.ncbi.nlm.nih.gov/40040375/ 12. Lansdorp-Vogelaar, I. et al. Contribution of Screening and Survival Differences to Racial Disparities in Colorectal Cancer Rates. Cancer Epidemiol. Biomarkers Prev. 21 , 728–736 (2012). https://pubmed.ncbi.nlm.nih.gov/22514249/ 13. Ko, T. M. et al. Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer. Surgery 176 , 626–632 (2024). https://pubmed.ncbi.nlm.nih.gov/38972769/ 14. Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A. & Jemal, A. Colorectal cancer statistics, 2023. CA. Cancer J. Clin. 73 , 233–254 (2023). https://pubmed.ncbi.nlm.nih.gov/36856579/ 15. Jain, S., Maque, J., Galoosian, A., Osuna-Garcia, A. & May, F. P. Optimal Strategies for Colorectal Cancer Screening. Curr. Treat. Options Oncol. 23 , 474–493 (2022). https://pubmed.ncbi.nlm.nih.gov/35316477/ 16. Zauber, A. G. The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference? Dig. Dis. Sci. 60 , 681–691 (2015). https://pubmed.ncbi.nlm.nih.gov/25740556/ 17. Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116 , 544–573 (2010). https://pubmed.ncbi.nlm.nih.gov/19998273/ 18. Cercek, A. et al. Nonoperative Management of Mismatch Repair–Deficient Tumors. New England Journal of Medicine 392, 2297–2308 (2025). https://pubmed.ncbi.nlm.nih.gov/40293177/ 19. Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Molecular Heterogeneity in Early-Onset Colorectal Cancer: Pathway-Specific Insights in High-Risk Populations. Cancers 17 , 1325 (2025). https://pubmed.ncbi.nlm.nih.gov/40282501/ 20. Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Ethnicity-Specific Molecular Alterations in MAPK and JAK/STAT Pathways in Early-Onset Colorectal Cancer. Cancers 17 , 1093 (2025). https://pubmed.ncbi.nlm.nih.gov/40227607/ 21. Benson, A. B. et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 19 , 329–359 (2021). https://pubmed.ncbi.nlm.nih.gov/33724754/ 22. Christenson, E. S. et al. Nivolumab and Relatlimab for the treatment of patients with unresectable or metastatic mismatch repair proficient colorectal cancer. https://pubmed.ncbi.nlm.nih.gov/40388545/ 23. Dasari, A. et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. The Lancet 402 , 41–53 (2023). https://pubmed.ncbi.nlm.nih.gov/37331369/ 24. Strickler, J. H. et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. 24 , 496–508 (2023). https://pubmed.ncbi.nlm.nih.gov/37142372/ 25. Sauer, R. et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N. Engl. J. Med. 351 , 1731–1740 (2004). https://pubmed.ncbi.nlm.nih.gov/15496622/ 26. Cercek, A. et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol. 4 , e180071 (2018). https://pubmed.ncbi.nlm.nih.gov/29566109/ 27. Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J. Clin. Oncol. 40 , 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 28. Schrag, D. et al. Preoperative Treatment of Locally Advanced Rectal Cancer. N. Engl. J. Med. 389 , 322–334 (2023). https://pubmed.ncbi.nlm.nih.gov/37272534/ 29. Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A. & Dixon, J. M. Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. N. Engl. J. Med. 388 , 585–594 (2023). https://pubmed.ncbi.nlm.nih.gov/36791159/ 30. Jacobsen, R. L., Macpherson, C. F., Pflugeisen, B. M. & Johnson, R. H. Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer. JCO Oncol. Pract. (2021) doi:10.1200/OP.20.00840. https://pubmed.ncbi.nlm.nih.gov/33566700/ 31. Ruddy, K. J. et al. Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer. J. Clin. Oncol. (2014) doi:10.1200/JCO.2013.52.8877. https://pubmed.ncbi.nlm.nih.gov/24567428/ 32. Su, H. I. et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J. Clin. Oncol. 43 , 1488–1515 (2025). https://pubmed.ncbi.nlm.nih.gov/40106739/ 33. Smith, K. L., Gracia, C., Sokalska, A. & Moore, H. Advances in Fertility Preservation for Young Women With Cancer. Am. Soc. Clin. Oncol. Educ. Book 27–37 (2018) doi:10.1200/EDBK_208301. https://pubmed.ncbi.nlm.nih.gov/30231357/ 34. Blumenfeld, Z. How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries. The Oncologist 12 , 1044–1054 (2007). 35. Bhagavath, B. The current and future state of surgery in reproductive endocrinology. Curr. Opin. Obstet. Gynecol. 34 , 164 (2022). 36. Ribeiro, R. et al. Uterine transposition: technique and a case report. Fertil. Steril. 108 , 320-324.e1 (2017). 37. Yazdani, A., Sweterlitsch, K. M., Kim, H., Flyckt, R. L. & Christianson, M. S. Surgical Innovations to Protect Fertility from Oncologic Pelvic Radiation Therapy: Ovarian Transposition and Uterine Fixation. J. Clin. Med. 13 , 5577 (2024). 38. Holowatyj, A. N., Eng, C. & Lewis, M. A. Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer. JCO Oncol. Pract. 18 , 169–172 (2022). ***Behind the Knife Colorectal Surgery Oral Board Audio Review: https://app.behindtheknife.org/course-details/colorectal-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 17

You have probably seen recent headlines that Microsoft has developed an AI model that is 4x more accurate than humans at difficult diagnoses. It’s been published everywhere, AI is 80% accurate compared to a measly 20% human rate, and AI was cheaper too! Does this signal the end of the human physician? Is the title nothing more than clickbait? Or is the truth somewhere in-between? Join Behind the Knife fellow Ayman Ali and Dr. Adam Rodman from Beth Israel Deaconess/Harvard Medical School to discuss what this study means for our future. Studies: Sequential Diagnosis with Large Language Models: https://arxiv.org/abs/2506.22405v1 METR study: https://metr.org/blog/2025-07-10-early-2025-ai-experienced-os-dev-study/ Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on applications of data science and artificial intelligence to surgery. Adam Rodman, MD, MPH, FACP, @AdamRodmanMD Dr. Rodman is an Assistant Professor and a practicing hospitalist at Beth Israel Deaconess Medical Center. He’s the Beth Israel Deaconess Medical Center Director of AI Programs. In addition, he’s the co-director of the Beth Israel Deaconess Medical Center iMED Initiative. Podcast Link: http://bedside-rounds.org/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 14

Join us as we dissect the use of robotics in bariatric surgery – where precision meets programming, and the scalpel gets a software upgrade. Video Clip Link: https://app.behindtheknife.org/video/clinical-challenges-in-robotic-bariatric-surgery-the-robot-is-here-to-stay This videos includes: - Robotic RYGB - Robotic Sleeve Gastrectomy - SADI: Single Anastomosis Duodenoileostomy Hosts: - Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) - Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio) - Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) - Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) Learning objectives: Strengths of the robot: Surgical robots are at the forefront of technology and continue to improve with detailed, precision cameras and the ability to remove baseline tremors Allows for smooth movements, fine dissection, and precise tissue handling Ergonomics are more advantageous to the surgeon when compared to laparoscopy Weaknesses of the robot: The loss of haptic feedback can be challenging for surgeons early in their learning curve Emphasis on surgical robots means some trainees may be losing exposure to laparoscopic techniques Longer operative time when working robotically, and more time under anesthesia for the patient Increased cost for robotic surgery Outcomes data: Mixed data from the MBSA QIP database (metabolic and bariatric surgery accreditation and quality improvement program) The most recent study looked at 824,000 patients from 2015-2022 who had a sleeve gastrectomy or RNY gastric bypass, either laparoscopically (lap sleeve 61%, lap RYGB 24%) or robotically (robo sleeve 11%, robo RYGB 4%). Robotic sleeves were reported to have higher complication rates compared to laparoscopy, seen as higher overall morbidity and an increased rate of leaks While the robotic RYGBs have lower overall complications, including decreased morbidity and bleeding. Robotic RYGB can be especially advantageous with revisional surgeries when compared to lap. Setting up for success Train your eyes to determine tension on tissue, since there is no haptic feedback Learn how to assist yourself (manipulating the camera and effectively utilizing the fourth arm) Understand how techniques of the surgery change when doing it robotically, as compared to laparoscopy Experienced operating room team When learning, recommend putting all cases feasible on the robot (including easier cases), to master the straightforward cases before moving to technically challenging revision cases. Don’t hesitate to add an additional trocar or assistant port when needed Education in Robotic learning Learning by observation/mirroring – ex: robotic bilateral inguinal hernia (mirroring the attending/instructor) Easy for the attending/instructor in the case to switch instruments seamlessly, then give them back intermittently at the appropriate time Helpful when the attending annotates the screen to depict where to go Data-driven teaching tools on the Davinci system Tips for robotic sleeve gastrectomy: Of the robotic bariatric surgeries, sleeve gastrectomy is most similar to its laparoscopic procedure 30-40 degrees of reverse Trendelenburg Liver hammock stitch instead of a liver retractor (one less trocar), which makes a total of 4 trocars needed for the case Green staple load for the first firing, then the rest are typically blue loads Mixed opinions on reinforced staple loads versus non-reinforced staple loads and oversewing the staple line (discussed cost-benefit) Tips for robotic gastric bypass: Watch videos from colleagues to learn what they do Gastric bypass is a multi-quadrant surgery; thus, you must set yourself up for success so that your arms are not fighting when moving through different quadrants A size 12 trocar on the left can make the formation of the gastric pouch easier GJ and JJ anastomosis formed with a linear fire, then a two-layer closure with absorbable barb suture Don’t forget to close the mesenteric defect (non-absorbable braided suture) Tips for robotic DS and SADI: If doing a duodenal anastomosis hand-sewn, then recommend planning the exact number of sutures and locations of each for ease Hand-sewn anastomosis can have less bleeding and fewer strictures for patients, and is completed in a much more seamless fashion with the robot Future of Robotics Haptic feedback Integrated visual overlays to identify anatomical structures/serve as an intraoperative map Artificial intelligence integration Telesurgery – ex, small surgical robot deployed to space Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 10

It’s 2 a.m. The on-call resident’s voice is shaky. The CT shows an 18cm abdominal aortic aneurysm with a Type 1B endoleak. There’s gas in the sac, fluid in the belly, and the patient has a defibrillator on both sides of his chest. Is it a rupture? A graft infection? An aortoenteric fistula? All of the above? You’re the vascular surgeon, what do you do? This episode dives deep into decision-making when EVAR fails, when infection strikes, and when the patient might not survive a definitive repair. Let’s talk about what happens when clinical textbooks meet real-world chaos. Hosts: · Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center · Paul Haser -Division chief, Vascular Surgery, Brookdale Hospital Medical Center · Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center · Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning objectives: · Understand the clinical implications and management of late EVAR complications, including Type 1B endoleak and aortoenteric fistula. · Explore the decision-making process in critically ill patients with multiple comorbidities and infected aortic grafts. · Compare endovascular vs open surgical approaches in the setting of infected AAA, and when each is appropriate. · Recognize the role of multidisciplinary collaboration in complex vascular cases. · Discuss the ethical considerations and goals-of-care planning in high-risk, potentially terminal vascular patients. · Highlight the importance of long-term surveillance after EVAR and the consequences of noncompliance. References · Karl Sörelius et al. Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair.Circulation. 2016;134(22):1822–1832. PubMed: https://pubmed.ncbi.nlm.nih.gov/27799273/ pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15researchgate.net+15 · PARTNERS Trial (OVER Trial). Outcomes Following Endovascular vs Open Repair of Abdominal Aortic Aneurysm: A Randomized Trial.JAMA. 2009;302(14):1535–1542. PubMed: https://pubmed.ncbi.nlm.nih.gov/19826022/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6jamanetwork.com+6 · B.T. Müller et al. Mycotic Aneurysms of the Thoracic and Abdominal Aorta and Iliac Arteries: Experience with Anatomic and Extra-anatomic Repair in 33 Cases.J Vasc Surg. 2001;33(1):106–113. PubMed: https://pubmed.ncbi.nlm.nih.gov/11137930/ sciencedirect.com+5pubmed.ncbi.nlm.nih.gov+5periodicos.capes.gov.br+5 · Chung‑Dann Kan et al. Outcome after Endovascular Stent Graft Treatment for Mycotic Aortic Aneurysm: A Systematic Review.J Vasc Surg. 2007 Nov;46(5):906–912. PubMed: https://pubmed.ncbi.nlm.nih.gov/17905558/ researchgate.net+15pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15 · Hamid Gavali et al. Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra‑anatomic Bypass with In Situ Reconstruction: A Nationwide Multicentre Study.Eur J Vasc Endovasc Surg. 2021;62(6):918–926. PubMed: https://pubmed.ncbi.nlm.nih.gov/34782231/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6diva-portal.org+6 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 7

In the corner of the ICU, on multiple pressors, distended, oliguric, and intubated you’ll find the necrotizing pancreatitis patient. Sounds intimidating, but with the persistence, patience, and the proper care these patients can make it! In this episode from the HPB team at Behind the Knife listen in as we discuss the Step-Up approach, when to surgically intervene, various approaches to pancreatic Necrosectomy, and additional aspects of the multidisciplinary care required for the successful treatment of necrotizing pancreatitis. Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He will be joining as faculty at the Massachusetts General Hospital in Boston, MA at the conclusion of his fellowship in July 2024. Learning Objectives · Develop an understanding of the severity of necrotizing pancreatitis and the proper indications to surgical intervene on this often-tenuous patients. · Develop an understanding of the Step-Up approach and key aspects (reimaging, clinical status, physiologic status, etc.) that determine when to “step-up” treatment for patients with necrotizing pancreatitis. · Develop an understanding of long term sequalae and complications associated with necrotizing pancreatitis and operative management · Develop an understanding of multidisciplinary care and long-term follow-up necessary for adequate treatment of patients suffering from necrotizing pancreatitis. Suggested Reading Maurer LR, Fagenholz PJ. Contemporary Surgical Management of Pancreatic Necrosis. JAMA Surg. 2023;158(1):81–88. doi:10.1001/jamasurg.2022.5695 https://pubmed.ncbi.nlm.nih.gov/36383374/ Harrison JM, Day H, Arnow K, Ngongoni RF, Joseph A, Aldridge T, Wheeler KJ, DeLong JC, Bergquist JR, Worth PJ, Dua MM, Friedland S, Park W, Eldika S, Hwang JH, Visser BC. What's Behind it all: A Retrospective Cohort Study of Retrogastric Pancreatic Necrosis Management. Ann Surg. 2024 Sep 3. doi: 10.1097/SLA.0000000000006521. https://pubmed.ncbi.nlm.nih.gov/39225420/ Harrison JM, Visser BC. Not Dead Yet: Managing the Abdominal Catastrophe in Necrotizing Pancreatitis. Pancreas. 2025 May 20. doi: 10.1097/MPA.0000000000002512. https://pubmed.ncbi.nlm.nih.gov/40388698/ Harrison JM, Li AY, Sceats LA, Bergquist JR, Dua MM, Visser BC. Two-Port Minimally Invasive Nephrolaparoscopic Retroperitoneal Debridement for Pancreatic Necrosis. J Am Coll Surg. 2024 Dec 1;239(6):e7-e12. doi: 10.1097/XCS.0000000000001152. https://pubmed.ncbi.nlm.nih.gov/39051721/ van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; Dutch Pancreatitis Study Group. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010 Apr 22;362(16):1491-502. doi: 10.1056/NEJMoa0908821. https://pubmed.ncbi.nlm.nih.gov/20410514/ Bang JY, Arnoletti JP, Holt BA, Sutton B, Hasan MK, Navaneethan U, Feranec N, Wilcox CM, Tharian B, Hawes RH, Varadarajulu S. An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis. Gastroenterology. 2019 Mar;156(4):1027-1040.e3. doi: 10.1053/j.gastro.2018.11.031. https://pubmed.ncbi.nlm.nih.gov/30452918/ Zyromski NJ, Nakeeb A, House MG, Jester AL. Transgastric Pancreatic Necrosectomy: How I Do It. J Gastrointest Surg. 2016 Feb;20(2):445-9. doi: 10.1007/s11605-015-3058-y. https://pubmed.ncbi.nlm.nih.gov/26691148/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 5

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GENERAL TIPS FOR SUCCESS ON THE WARDS Spend time with the patient! Trust, but verify. Be kind to everyone. Stay humble. Be flexible. Seek and apply feedback. HOW TO LEARN IN THE OR Double scrub as many cases as you can. Write down/record everything after a case. MAINTAIN YOUR PERSONAL SANITY Figure out your stress outlets and what brings you joy. Decompress after work. Maintain work/life boundaries. Keep in touch with loved ones. Vacations are meant for relaxation. Repeat after me: NO WORK ON VACATION! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 4

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. Today, we’re hitting the wards and tackling some of the scary clinical scenarios you will see as an intern. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: THINGS TO REMEMBER · BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn’t help anybody. · See the patient. Getting a bunch of pages? Worried about someone? Confused as to what’s going on? Go see the patient and chat with the bedside team. · Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients. · Load the boat. You’ve heard this one from us all week! Loop senior level residents in early. HYPOTENSION · Differential: measurement error, patient’s baseline, and don’t miss – SHOCK. - Etiologies of shock: hemorrhagic, hypovolemic, · On the phone: full set of vitals, accurate I/Os, · On the way: recent notes, PMH/PSH including from this hospital stay, and vitals/I&Os/studies from earlier in the day · In the room: ABCDs – rapidly gives you a sense of how high acuity the patient is · Get more info: labs, consider imaging, work up specific types of shock based on clinical concern. · Initial management: depends on etiology of hypotension; don’t forget to consider peripheral or central access, foley catheterization for close monitoring of urine output, and level of care HYPOXEMIA · Differential: atelectasis, baseline pulmonary disease, pneumonia, PE, hemo/pneumothorax, volume overload · On the phone: full set of vitals, amount of supplemental oxygen required and delivery device, rate of escalation in oxygen requirement · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, pulmonary and cardiac exam, volume status exam · Get more info: basic labs, ABG if worried about oxygenation, CXR, consider bedside US of the lungs/heart, if high suspicion for PE consider CTA chest · Initial Management: supplemental O2, higher level of care, consider intubation or other supplemental oxygenation adjuncts, additional management dependent on suspected etiology · ABG Vs VBG (IBCC): https://emcrit.org/ibcc/vbg/ ALTERED MENTAL STATUS · Differential: stroke, medication effect, hypoxemia or hypercarbia, toxic or medication effect, endocrine/metabolic, stroke or MI, psychiatric illness, or infections, delirium · On the way: review PMH/PSH, recent notes for evidence of altered mentation or agitation, or signs hinting at above etiologies · In the room: ABCDs, focal neuro deficits?, alert/oriented? Be sure the patient’s mental status is adequate for airway protection! · Get more info: basic labs, blood gas/lactate, CT head noncontrast if concerned for stroke. · Initial management: rule out above; if concerned about delirium, optimize sleep/wake cycles, pain control, and lines/drains/tubes. OLIGURIA · Differential: prerenal due to hypovolemia or low effective circulating volume, intrinsic renal disease, post-renal obstruction · On the phone: clarify functional foley or bladder scan results, full set of vitals · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, confirm functioning foley catheter · Get more info: basic labs, urine electrolytes, consider fluid challenge to evaluate responsiveness, consider adjuncts including renal US · Initial management: typically consider IVF bolus initially, but if patient not volume responsive, don't overload them -- look for other etiologies! TACHYCARDIA · Differential: sinus tachycardia (pain, hypovolemia, agitation, infection), cardiac arrhythmia, MI, PE · On the phone: full set of vitals, acuity of change in heart rate, updated I/Os · On the way: Review PMH/PSH, known cardiac history, cardiac and PE risk factors, volume resuscitation, signs concerning for infection, updated I/Os · In the room: ABCDs, cardiac/pulmonary exam, evaluate for any localizing signs for infection · Get more info: basic labs, EKG, consider CXR, troponins · Initial management: depends heavily on etiology Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 3

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll talk about how to give and receive consults in the hospital like a pro. We’ll also provide some tips on how to make those long call days a little more manageable. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GIVING CONSULTS Clear and Concise Question! Develop a script, such as: “Hi, this is XX with the general surgery team. We’re calling to request an evaluation for a patient presenting with XX. I can give you the MRN whenever you are ready…” Follow this with a brief H&P. If you are asking another team to perform a procedure on your patient, be prepared with the following information: NPO Status Ability to Consent or Proxy Contact Blood Thinners Urgency of Procedure RECEIVING CONSULTS Make sure you are clear on what the team is asking of you as a consultant. Clarify if the patient is expecting to receive a surgery before talking to them about an operation! Quickly gather information about the patient and their hospital course from the consultant, electronic medical record, and, most importantly, the patient! Note the callback number on the primary team and call them with the plan after you have staffed the patient with your attending. If you are asked to perform a procedure as a consultant, clarify the following information: NPO Status Ability to Consent or Proxy Contact Blood Thinners Urgency of Procedure Develop a system to stay organized and keep track of your to-do list with consults! CALL SHIFTS Bring a survival bag with toothbrush/toothpaste, face wash, deodorant, change of clothes, etc to reset. Try to nap when you can, but: PM round to address non-urgent pages ahead of time Set alarms! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 2

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. You’ve been a doctor for about 3.5 seconds, and suddenly that bright eyed, bushy-tailed medical student on service is looking to you for advice? Don’t fret, in this episode we’ll give you some tips for how to handle it. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: REMEMBER HOW INTERNS DO AND DO NOT TEACH - Nobody, not even the med students, expect you to be an expert in everything or give a fully-planned formal lecture - You WILL however spend a ton of time working with students on your team – and via modeling and teachable moments, you can help them learn how it’s done! MODELING - Remember how hard everything has been in the few days since you started residency? Think about all the information you’ve picked up, tips and tricks you’re developing for efficiency, and best practices you’re learning in the care of your patients. ALL of these are things you can pass on to students. - Presentations, case prep, answering questions from senior members of the team are ALL excellent opportunities to teach (and show students how you learn yourself, so they can do it independently). TEACHABLE MOMENTS - Find small topics that you know or are getting to know well – things like looking at a CXR, CT scan, etc. - Once you’re getting more comfortable caring for specific disease processes, think about high yield lessons for students: - Acute trauma evaluation and management (ABCDE’s), appendicitis, diverticulitis, benign biliary disease all make great 5 minute chalk talks that you can have in your back pocket IN THE OR - Watch students practice skills, and try to give some feedback and tips that you use (you learned knot tying and suturing more recently than ANYONE else in the OR and probably have some tips that you’re still using to improve) - If you’re not sure where or why the student is struggling with a particular skill (like tying a knot), model doing it yourself in slow motion while watching them do it – often the side by side comparison can help you identify where they’re going astray BE THE RESIDENT YOU WISH YOU HAD - Refer to EVERYONE with respect - Model being a kind, conscientious, and curious physician - Try to find universal lessons and crossover topics that non-surgeons need to know - A great student makes their interns look even better – be explicit about how they can be successful, then advocate for them to have opportunities to show everything they’re learning! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 1

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll tackle the resources that you should know about to support your own learning throughout residency. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: STRUCTURE YOUR STUDYING - 2 things you need to do: (1) develop a knowledge base and (2) answer questions - Knowledge base Pick a level-appropriate textbook, read it (ideally all of it) yearly. Ideally, lead a little bit every day - 10 pages/day is a good goal to start with and you may need to adjust. - Questions Do some questions every week – 50/week is a good goal to start Plan to do more questions closer to ABSITE! Consider storing everything you learn in one place – either a notebook you carry with you or a cloud-based note app Share this with others, use it to take notes while reading, doing cases, getting feedback, or gaining experience while taking care of patients every day. SPECIFIC RESOURCES - Textbooks Sabiston: big book, very dense, with a lot of great information. Schwartz: shorter chapters, clinically oriented, ideal for junior residents Cameron: shorter chapters, clinically oriented, ideal for senior residents - ABSITE review books Fiser: Classic, packed with facts but can be difficult to read, good for looking things up quickly BTK ABSITE Companion: https://www.amazon.com/Behind-Knife-ABSITE-Review-Companion-ebook/dp/B0CLBZ273F/ref=sr_1_2?crid=3382SFZ81ZHKA&keywords=absite+review+behind+the+knife&qid=1698106031&sprefix=absite+review+behind+the+knife%2Caps%2C64&sr=8-2 - Question banks TrueLearn: high quality, can be pricy depending on program SCORE: written/edited by ABS, free for subscribing programs LEARN HOW TO OPERATE?? - Carry suture and a needle driver with you and practice basic moves - Consider a home suture kit for practice when you don’t want to be in sim lab – BTK released one this year - Use VIDEOS to ensure learning things the correct way! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jun 30

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. First up, the first day of intern year. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: BRING WHAT YOU NEED Name badge Scrubs, white coat, and extra clinic clothes Comfortable shoes - even on clinic days Pager Phone Pen Bonus stuff that’s good to keep in your bag: Snacks, extras of everything, toothbrusth/toothpaste/deodorant, suture STAY ORGANIZED Preround purposefully and systematically Look at the same things in the same order every day on every patient Write data in the same physical location on your sheet so you can quickly find information on the fly Keep track of to-do’s from rounds Check box system: Nina’s system: empty = not done, half full = ordered/needs follow up, full = completely done and followed up on Don’t forget to look at the results of imaging studies, labs, or consults after they are entered! Prioritize urgent/emergent things first, then consults and discharges, then routine orders, then notes As you get more efficient, start drafting your notes as you pre-round – it will save you lots of time later in the afternoon! OWN THE FLOOR During the day, be ready to shift your priorities as urgent issues arise. Develop a system for remembering what happened after rounds so you can quickly update seniors Shanaz’s system: One color for AM rounds, a different color for afternoon events Load the boat! Your team is there to help you. If you are concerned about someone or have a question, ask. There is truly no better time than as an intern. Master the art of getting your seniors’ attention in the OR - be conscientious, be clear in what you’re asking, and be prepared to report back about urgent findings! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills - https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jun 26

In this surgical education episode, the Cleveland Clinic General Surgery Education Team explores the past, present, and future of resident autonomy in the operating room. With guest colorectal surgeons Dr. Tracy Hull (recently retired) and Dr. David Rosen (early career faculty), we discuss how autonomy was granted in “the good ole days,” how educational culture and institutional pressures shape current practice, and what thoughtful autonomy looks like moving forward. Through candid stories—from emergent cases and missed enterotomies to thumbtacks pulled off the wall to stop bleeding—we get a nuanced look at what surgical independence really means, and how to responsibly develop it. Join hosts Pooja Varman, MD, Judith French, PhD, and Jeremy Lipman, MD, MHPE, for this conversation about what it means to train competent, confident, and independent surgeons. Learning Objectives By the end of this episode, listeners will be able to 1. Define operative autonomy and its educational value in surgical training 2. Identify barriers to providing resident autonomy in modern surgical environments 3. Discuss strategies for tailoring autonomy to the skill level and readiness of the trainee 4. Describe approaches to communicating resident involvement to patients References 1. Sehat AJ, Oliver JB, Yu Y, Kunac A, Anjaria DJ. Declining Surgical Resident Operative Autonomy in Acute Care Surgical Cases. J Surg Res . 2023;281(k7b, 0376340):328-334. doi:10.1016/j.jss.2022.08.041 https://pubmed.ncbi.nlm.nih.gov/36240719/ 2. Teman NR, Gauger PG, Mullan PB, Tarpley JL, Minter RM. Entrustment of General Surgery Residents in the Operating Room: Factors Contributing to Provision of Resident Autonomy. J Am Coll Surg . 2014;219(4):778-787. doi:10.1016/j.jamcollsurg.2014.04.019 https://pubmed.ncbi.nlm.nih.gov/25158911/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 23

Join the Behind the Knife Surgical Oncology Team as we discuss the two key studies investigating optimal management strategies of neuroendocrine tumors of the small bowel. Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center - Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. - Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson. - Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode we review two important papers that discuss optimal management strategies of neuroendocrine tumors (NET) of the small bowel. The first paper by Singh and colleagues discusses the NETTER-2 trial investigating the role of radioligand therapy for NET as a first-line treatment. The second article by Maxwell et all challenges surgical dogma regarding optimal debulking cutoffs for debulking of NET. Links to Papers Referenced in this Episode: 1. Singh S, Halperin D, Myrehaug S, Herrmann K, Pavel M, Kunz PL, Chasen B, Tafuto S, Lastoria S, Capdevila J, García-Burillo A, Oh DY, Yoo C, Halfdanarson TR, Falk S, Folitar I, Zhang Y, Aimone P, de Herder WW, Ferone D; all the NETTER-2 Trial Investigators. [177Lu]Lu-DOTA-TATE plus long-acting octreotide versus high‑dose long-acting octreotide for the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, gastroenteropancreatic neuroendocrine tumours (NETTER-2): an open-label, randomised, phase 3 study. Lancet. 2024 Jun 29;403(10446):2807-2817. doi: 10.1016/S0140-6736(24)00701-3. Epub 2024 Jun 5. PMID: 38851203. https://pubmed.ncbi.nlm.nih.gov/38851203/ 2. Maxwell JE, Sherman SK, O'Dorisio TM, Bellizzi AM, Howe JR. Liver-directed surgery of neuroendocrine metastases: What is the optimal strategy? Surgery. 2016 Jan;159(1):320-33. doi: 10.1016/j.surg.2015.05.040. Epub 2015 Oct 9. PMID: 26454679; PMCID: PMC4688152. https://pubmed.ncbi.nlm.nih.gov/26454679/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 19

You have a patient with complicated diverticulitis s/p IR drain with colo-cutaneous fistula and colo-vaginal fistula. They are scheduled for surgery. How will you do it? What is the role for hand assist? How can hand assist help? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, and Tess Aulet as they discuss high yield papers discussing hand assist laparoscopy in Colon and Rectal surgery. Learning Objectives 1. Describe the technical considerations and how to do hand assist laparoscopic surgery (HALS) 2. Discuss the indications for use of HALS 3. Review literature supporting use of HALS Video Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-hand-assist-laparoscopy-in-colon-and-rectal-surgery References: Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, Feingold DL, Lee SW, Mutch MG, Sonoda T, Yan Y, Whelan RL. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum. 2008 Jun;51(6):818-26; discussion 826-8. doi: 10.1007/s10350-008-9269-5. Epub 2008 Apr 17. PMID: 18418653. https://pubmed.ncbi.nlm.nih.gov/18418653/ Jacobs C, Read TE. "Peek port": avoiding conversion during laparoscopic colectomy-an update. Surg Endosc. 2020 Sep;34(9):3944-3948. doi: 10.1007/s00464-019-07165-3. Epub 2019 Oct 4. PMID: 31586252. https://pubmed.ncbi.nlm.nih.gov/31586252/ Heneghan HM, Martin ST, Kiran RP, Khoury W, Stocchi L, Remzi FH, Vogel JD. Laparoscopic colorectal surgery for obese patients: decreased conversions with the hand-assisted technique. J Gastrointest Surg. 2013 Mar;17(3):548-54. doi: 10.1007/s11605-012-2089-x. Epub 2012 Nov 27. PMID: 23188222. https://pubmed.ncbi.nlm.nih.gov/23188222/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 16

Intern year: where the learning curve is steep and you’re not sure if the patient is crashing or you are. In this episode of Behind the Knife, our surgical education fellows reflect on what they wish they had known before Day 1—and all the humbling, hilarious, and genuinely formative moments along the way. From getting lost wheeling a critical patient through the hospital, to triple-scrubbing just to be acknowledged, to accidentally spraying TPA into your own eye (yes, really)—this episode is a candid conversation about the highs, lows, and everything in between. Whether you're gearing up to start your intern year or reflecting on how far you've come, this is the episode we all needed. Hosts: Elizabeth Maginot, MD – General Surgery Resident, University of Nebraska Medical Center @e_magination95 Nina Clark, MD – General Surgery Resident, University of Washington @clarkninam Ayman Ali, MD – General Surgery Resident, Duke University Michelle LaBella, MD – General Surgery Resident, University of North Carolina Emma Burke, MD – General Surgery Resident, Baylor College of Medicine @emmaburke017 Learning Objectives: Identify common misconceptions about intern year—and how to manage expectations Understand how to approach early mistakes with humility and resilience Recognize the importance of teamwork and asking for help Reflect on what makes a strong, dependable intern References BTK Intern Survival Guide: https://app.behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide Institutional pharmacists (seriously, call them—they’re the unsung heroes) Check out our Medical Student and Intern Survival Guide HERE : https://app.behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide

Jun 12

This new series will be a collaboration between BTK and Annals of Surgery, where we will be discussing hot topics in surgery research. No, we won’t be getting into the nitty gritty of methods of individual papers but rather will focus on high-level discussions of contemporary topics that are moving our field forward. Hosts: Cody Mullens, MD is a general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens) Justin B. Dimick, MD MPH is the Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of Michigan. He also serves as the Editor in Chief at Annals of Surgery. (@jdimick1) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 9

The evidence for climate change is irrefutable. But how does surgical care contribute to global emissions, and is there anything we can do to make surgery more sustainable? Join Jon Williams and our ASGBI partners for the next installment of our BTK/ASGBI collaborative series, where we discuss how to make surgical care greener. Mrs. Cleo Kennington from the UK and Dr. Benjamin Miller from the US are our guest experts, and provide valuable insights into local sustainability efforts you can take home to your hospital, broader concepts of how high-quality care is sustainable, innovations in sustainability, and what the future of sustainable surgery may look like. After listening, you get to decide–Who has more sustainable surgical practices? The UK or US? Mrs. Cleo Kenington is a Consultant Emergency General and Trauma Surgeon at St George’s Hospital, London and was the recent ASGBI Sustainability Lead. She is a big advocate for practicing what she preaches, focusing on how we can reduce the environmental impact at all stages, from cycling to work, preventing complications and unnecessary surgeries, to reducing the use of disposable surgical components. Dr. Benjamin Miller is a general and minimally invasive surgeon at the Cleveland Clinic, with a clinical focus on complex abdominal wall reconstruction. After earning his MD from University of Minnesota School of Medicine in 2011, Dr. Miller went to Nashville to complete his general surgery residency at Vanderbilt University Medical Center. Following this, he became a MIS/complex ab wall fellow at Cleveland Clinic, after which he joined as faculty in 2023. In addition to his clinical interests, Dr. Miller has a deep passion for sustainability efforts within surgical practice, carrying on the legacy of established sustainability efforts within surgical care at Cleveland Clinic and training the next generation of sustainable surgeons. If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative content. If you have any questions or comments, please feel free to reach out to us at hello@behindtheknife.org . Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 5

Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan Ellis as they review mesh materials used in hernia repair and the general properties surgeons who perform hernia repairs should know. Hosts: - Sara Maskal, MD, Cleveland Clinic - Ryan Ellis, MD, Cleveland Clinic - Benjamin T. Miller, MD, Cleveland Clinic - Michael Rosen, MD, Cleveland Clinic Learning Objectives: - Understand common mesh materials - Review properties of the different mesh materials - Understand how to apply knowledge of the different mesh properties to different patient scenarios References: - Ellis R, Miller BT. Mesh selection in abdominal wall reconstruction: an update on biomaterials. Surgical Clinics. 2023 Oct 1;103(5):1019-28. https://pubmed.ncbi.nlm.nih.gov/37709387/ - Krpata DM, Petro CC, Prabhu AS, Tastaldi L, Zolin S, Fafaj A, Rosenblatt S, Poulose BK, Pierce RA, Warren JA, Carbonell AM. Effect of hernia mesh weights on postoperative patient-related and clinical outcomes after open ventral hernia repair: a randomized clinical trial. JAMA surgery. 2021 Dec 1;156(12):1085-92. https://pubmed.ncbi.nlm.nih.gov/34524395/ - Rosen MJ, Krpata DM, Petro CC, Carbonell A, Warren J, Poulose BK, Costanzo A, Tu C, Blatnik J, Prabhu AS. Biologic vs synthetic mesh for single-stage repair of contaminated ventral hernias: a randomized clinical trial. JAMA surgery. 2022 Apr 1;157(4):293-301. https://pubmed.ncbi.nlm.nih.gov/35044431/ - Maskal S, Miller B, Ellis R, Phillips S, Prabhu A, Beffa L, Krpata D, Rosenblatt S, Rosen M, Petro C. Mediumweight polypropylene mesh fractures after open retromuscular ventral hernia repair: incidence and associated risk factors. Surgical Endoscopy. 2023 Jul;37(7):5438-43. https://pubmed.ncbi.nlm.nih.gov/37038022/ - Harris HW, Primus F, Young C, Carter JT, Lin M, Mukhtar RA, Yeh B, Allen IE, Freise C, Kim E, Sbitany H. Preventing recurrence in clean and contaminated hernias using biologic versus synthetic mesh in ventral hernia repair: the PRICE randomized clinical trial. https://pubmed.ncbi.nlm.nih.gov/33443907/ - Olavarria OA, Bernardi K, Dhanani NH, Lyons NB, Harvin JA, Millas SG, Ko TC, Kao LS, Liang MK. Synthetic versus biologic mesh for complex open ventral hernia repair: a pilot randomized controlled trial. Surgical Infections. 2021 Jun 1;22(5):496-503. https://pubmed.ncbi.nlm.nih.gov/33259771/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 2

Welcome back to our series on AI for the clinician! Large language models, like ChatGPT, have been taking the world by storm, and healthcare is no exception to that rule – your institution may already be using them! In this episode we’ll tackle the fundamentals of how they work and their applications and limitations to keep you up to date on this fast-moving, exciting technology. Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-3 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. Ruchi Thanawala, MD: @Ruchi_TJ Ruchi Thanawala is an Assistant Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU. Phillip Jenkins, MD: @PhilJenkinsMD Phil Jenkins is a general surgery PGY-3 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics. Steven Bedrick, PhD: @stevenbedrick Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Department of Medical Informatics and Clinical Epidemiology. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 29

Mastering the surgical consult is a true milestone in every young surgeon’s career. But it’s not easy! It is a difficult transition from lowly data gatherer to mighty data synthesizer. It is, in many ways, an art form. Is there anything more beautiful than breaking down a complex, convoluted patient presentation into an immaculate assessment and plan? Something so bullet proof that the attending surgeon has been left speechless. Perhaps not! Join Drs. Joey Lew and Patrick Georgoff as they review 10 CONSULT COMMANDMENTS TO DOMINATE THE DAY: Have a System Trust No One, Expect Sabotage Always Ask at Least One Why Always Look at the Imaging Yourself Don’t Worry Alone Don’t Bury the Lead Never Lie Include a Real Assessment and Plan in Your Note Goals of care are important and individual Over-communicate Hosts: Dr. Joey Lew, MD, MFA, PGY2, Duke University (@LewActually) Dr. Patrick Georgoff, MD, Duke University (@georgoff) Insensible Losses – Poems by Joey Lew: https://www.amazon.com/Insensible-Losses-Joey-Lew/dp/B0D773LSHL Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 26

In this episode, we dive into the rapidly evolving world of ambient listening AI in healthcare. From outpatient clinics to inpatient wards and operating rooms, this technology is reshaping how care is delivered, documented, and experienced. We explore how ambient listening AI is improving clinic flow by streamlining documentation and reducing interruptions, allowing clinicians to stay more present with their patients. The technology is increasingly adaptive to individual provider styles, learning preferences and workflows to deliver more personalized support. Plus, we share practical tips for new users to get the most out of their ambient listening AI systems from day one. Join us as we hear from experts on the front lines and debate the future of ambient listening AI in medicine—where the walls really do have ears, but for all the right reasons. Host: - Nicole Petcka, MD – General Surgery Resident, Emory University, @npetcka2022 Guests: - Samuel R. Torres Landa Fernández, MD – Minimally Invasive Surgery Fellow, Emory University - Anastasios Nikolaos (Nick​) Panagopoulos, MD – Internal Medicine Resident, Emory University - Joe Sharma, MD - McGarity Chair in Endocrine Surgery and Professor of Surgery, Vice-chair for Patient Safety, Quality and Innovation, Emory University Resources: Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video Khanna A, Wolf T, Frank I, Krueger A, Shah P, Sharma V, Gettman MT, Boorjian SA, Asselmann D, Tollefson MK. Enhancing Accuracy of Operative Reports with Automated Artificial Intelligence Analysis of Surgical Video. J Am Coll Surg. 2025 May 1;240(5):739-746. doi: 10.1097/XCS.0000000000001352. Epub 2025 Apr 16. PMID: 39918224. https://pubmed.ncbi.nlm.nih.gov/39918224/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 22

Join the University of Washington Surgical Palliative Care Team for their final episode of this series — a dual journal review and clinical challenges discussion on assessing medical decision-making capacity. Using Dr. Paul Applebaum’s foundational framework, the team outlines the four key criteria for evaluating capacity and brings the topic to life through two contrasting standardized patient scenarios. This episode highlights why capacity assessment is not only relevant but essential for surgeons navigating complex, high-stakes decisions. Hosts: Dr. Katie O’Connell (@katmo15) is an associate professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is an assistant professor of surgery at the University of Washington. She is a trauma and emergency general surgeon and palliative care physician. Ali recently completed fellowships in palliative care at the University of Washington and Trauma and Critical Care at Parkland. Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY6 general surgery resident at the University of Washington with an interest in surgical oncology. Dr. Virginia Wang is a PGY3 general surgery resident at the University of Washington. Learning Objectives: 1. Decipher the distinction between the terms “capacity” and “competence”. 2. Describe the four criteria for assessing medical decision-making capacity presented in Dr. Paul Applebaum’s article “Assessment of Patients’ Competence to Consent to Treatment.” 3. Apply the capacity assessment framework to real-world clinical scenarios in surgical practice. References: 1. Applebaum, PS. Assessment of Patients’ Competence to Consent to Treatment. New England Journal of Medicine 2007; 357(18):1834-1840. https://pubmed.ncbi.nlm.nih.gov/17978292/ 2. Special thank you to Mr. Mark Fox for his acting contribution to this episode. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 19

In their last Behind the Knife episode, the Hernia Content Team from Carolinas Medical Center discusses quality improvement in abdominal wall reconstruction (AWR). The complexity of AWR patients makes this discipline a perfect match for quality improvement efforts. The group review two papers published by their group: one that tracks patient outcomes over time and then another that reviews a specific quality improvement initiative (penicillin allergy protocol). Hosts: · Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) · Dr. Monica Polcz, Assistant Professor, University of South Florida (Tampa, FL) · Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center (Charlotte, NC), @VedraAugenstein (Twitter) · Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center (Charlotte, NC), @THeniford (Twitter) Learning Objectives: - Define Quality Improvement and its Importance in Surgical Practice - Identify Key Strategies and Examples of Quality Improvement Initiatives in Abdominal Wall Reconstruction - Explain the Process of Implementing and Evaluating a Quality Improvement Project - Recognize the Value of Multidisciplinary Collaboration in Quality Improvement Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 15

Welcome to our new series – the AI Journal Club! In this series, we’ll cover some interesting studies and evidence-based applications of artificial intelligence in surgery in a case-based format. Surely AI can find a DVT by now … or can it? Stay tuned and find out! Hosts: - Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-3 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. - Ruchi Thanawala, MD: @Ruchi_TJ Ruchi Thanawala is an Assistant Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU. - Marisa Sewell, MD: @MarisaSewell Marisa Sewell is a general surgery PGY-4 at Oregon Health and Science University. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 12

It is the final episode of our Challenging Cases in Emergency General Surgery series and we’re diving into another dreaded topic: the complex abdominal wall. This structure is a daily partner to the general surgeon—but when things go wrong, it can quickly become our biggest challenge. In this episode, we’ll walk through the emergency presentation of a patient with multiple prior hernia repairs and mesh placements, and how these complicate diagnosis and management. From imaging pearls to OR decision-making and post-op dilemmas, this episode covers it all. We round things off with a fun game (as always!) and some hot takes on abdominal wall strategies in emergency general surgery. Whether you’re an EGS surgeon, trainee, or surgical enthusiast, this episode is packed with practical insights, decision-making frameworks, and real-world nuance. Hosts: - Dr. Ashlie Nadler - Dr. Jordan Nantais - Dr. Graham Skelhorne-Gross Learning Objectives: - Identify key factors to assess in patients presenting with complex abdominal wall problems, including detailed surgical history, hernia characteristics, and signs of complications. - Discuss the role of imaging, particularly CT scans, in evaluating patients with ventral hernias and bowel obstruction, with a focus on identifying transition points and signs of strangulation. - Outline the surgical approach to incarcerated incisional ventral hernias, including pre-operative considerations, operative techniques, and management of threatened bowel. - Recognize the importance of patient-specific factors and interdisciplinary collaboration in the management of complex abdominal wall cases, including the role of pre-habilitation and hernia specialists. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 8

We got the gang together (minus John, who is on mission). Today, we are talking about diverticulitis with super expert Scott Steele. Scott walks Jason, Patrick, and Kevin through the nuances of modern-day management of diverticulitis. We cover laparoscopic lavage, review decision making for surgical resection after drainage, and discuss the evolving role of antibiotics in uncomplicated cases. Surgical techniques, including resection boundaries and the consideration of diverting ostomies in emergent situations, are also reviewed. DOMINATE THE COLON! Hosts Scott Steele, MD: @ScottRSteeleMD Scott is the Rupert B. Turnbull MD Endowed Chair in Colorectal Surgery and Chairman of Colorectal Surgery at Cleveland Clinic in Cleveland, OH. A graduate of the United States Military Academy at West Point, he was an active duty Army officer for over 20 years, serving as the Chief of Colorectal Surgery at Madigan Army Medical Center. He also received his MBA from Case Western University Weatherhead School of Business and Management. Patrick Georgoff, MD: @georgoff Patrick Georgoff is an Acute Care Surgeon at Duke University. He went to medical school at the University of Pennsylvania, completed General Surgery residency and Surgical Critical Care fellowship at the University of Michigan, and a Trauma Surgery fellowship at the University of Texas in Houston. His clinical practice includes the full spectrum of Acute Care Surgery in addition to elective hernia surgery. Patrick is the Associate Program of the General Surgery Residency and associate Trauma Medical Director at Duke. Kevin Kniery, MD: @Kniery_Bird Kevin is a vascular surgeon at Brooke Army Medical Center. He completed his undergraduate degree at the United States Military Academy in West Point, medical school at Tulane University, general surgery residency at Madigan Army Medical Center, and vascular fellowship at Cornell and Columbia. Jason Bingham, MD: @BinghamMd Jason is a general and bariatric surgeon at Madigan Army Medical Center. He also serves as the Director of Research and Associate Program Director for the general surgery residency program. He received his undergraduate degree from New York University and medical degree at the Uniformed Services University of Health Sciences. He is a medical officer in the US Army with several combat deployments under his belt. Jason’s research efforts focus on the management of hemorrhagic shock, trauma induced coagulopathy, and ischemia-reperfusion injury. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 5

In our recent episode on global burn surgery with Dr. Barclay Stewart and Dr. Manish Yadav, we discussed several cases at Kirtipur Hospital in Nepal to illustrate the global burden of burns and similarities and differences in treating burns at Harborview Medical Center, a level 1 trauma and ABA verified burn center in Seattle, WA and Kirtipur Hospital (Nepal Cleft and Burn Center) in Kathmandu, Nepal. In this episode Dr. Stewart and Dr. Yadav return for an interview by UW Surgery Resident, Paul Herman, sharing insights on how to get involved in global surgery with an emphasis on sustainable participation. Hosts: Manish Yadav, Kirtipur Hospital, Nepal Barclay Stewart, UW/Harborview Medical Center Paul Herman, UW/Harborview General Surgery Resident, @paul_herm Tam Pham, UW/Harborview Medical Center (Editor) Learning Objectives 1. Approaches to global surgery a. Describe historical perspectives on global health and global surgery reviewing biases global surgery inherits from global health due to the history of colonialism, neo-colonialism and systemic inequalities b. Review a recently published framework and evaluation metrics for sustainable global surgery partnerships (GSPs) as described by Binda et al., in Annals of Surgery in March 2024. c. Provide examples of this framework from a successful global surgery partnership d. Define vertical, horizontal and diagonal global surgery approaches e. Share tips for initial engagement for individuals interested in getting involved in global surgery References 1. Gosselin, R., Charles, A., Joshipura, M., Mkandawire, N., Mock, C. N. , et. al. 2015. “Surgery and Trauma Care”. In: Disease Control Priorities (third edition): Volume 1, Essential Surgery, edited by H. Debas, P. Donkor, A. Gawande, D. T. Jamison, M. Kruk, C. N. Mock. Washington, DC: World Bank. 2. Qin R, Alayande B, Okolo I, Khanyola J, Jumbam DT, Koea J, Boatin AA, Lugobe HM, Bump J. Colonisation and its aftermath: reimagining global surgery. BMJ Glob Health. 2024 Jan 4;9(1):e014173. doi: 10.1136/bmjgh-2023-014173. PMID: 38176746; PMCID: PMC10773343. https://pubmed.ncbi.nlm.nih.gov/38176746/ 3. Binda CJ, Adams J, Livergant R, Lam S, Panchendrabose K, Joharifard S, Haji F, Joos E. Defining a Framework and Evaluation Metrics for Sustainable Global Surgical Partnerships: A Modified Delphi Study. Ann Surg. 2024 Mar 1;279(3):549-553. doi: 10.1097/SLA.0000000000006058. Epub 2023 Aug 4. PMID: 37539584; PMCID: PMC10829902. https://pubmed.ncbi.nlm.nih.gov/37539584/ 4. Jedrzejko N, Margolick J, Nguyen JH, Ding M, Kisa P, Ball-Banting E, Hameed M, Joos E. A systematic review of global surgery partnerships and a proposed framework for sustainability. Can J Surg. 2021 Apr 28;64(3):E280-E288. doi: 10.1503/cjs.010719. PMID: 33908733; PMCID: PMC8327986. https://pubmed.ncbi.nlm.nih.gov/33908733/ 5. Frenk J, Gómez-Dantés O, Knaul FM: The health systems agenda: prospects for the diagonal approach. The handbook of global health policy. 2014 Apr 24; pp. 425–439 6. Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT; SOSAS4 Research Group. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns. 2018 Aug;44(5):1228-1234. doi: 10.1016/j.burns.2018.01.015. Epub 2018 Feb 21. PMID: 29475744. https://pubmed.ncbi.nlm.nih.gov/29475744/ 7. Strain, S., Adjei, E., Edelman, D. et al. The current landscape of global international surgical rotations for general surgery residents in the United States: a survey by the Association for Program Directors in Surgery’s (APDS) global surgery taskforce. Global Surg Educ 3 , 77 (2024). https://doi.org/10.1007/s44186-024-00273-2 8. Francalancia S, Mehta K, Shrestha R, Phuyal D, Bikash D, Yadav M, Nakarmi K, Rai S, Sharar S, Stewart BT, Fudem G. Consumer focus group testing with stakeholders to generate an enteral resuscitation training flipbook for primary health center and first-level hospital providers in Nepal. Burns. 2024 Jun;50(5):1160-1173. doi: 10.1016/j.burns.2024.02.008. Epub 2024 Feb 15. PMID: 38472005; PMCID: PMC11116054. https://pubmed.ncbi.nlm.nih.gov/38472005/ 9. Shrestha R, Mehta K, Mesic A, Dahanayake D, Yadav M, Rai S, Nakarmi K, Bista P, Pham T, Stewart BT. Barriers and facilitators to implementing enteral resuscitation for major burn injuries: Reflections from Nepalese care providers. Burns. 2024 Oct 28;51(1):107302. doi: 10.1016/j.burns.2024.107302. Epub ahead of print. PMID: 39577105. https://pubmed.ncbi.nlm.nih.gov/39577105/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 1

Surgical conferences are a forum of the profession–where we all gather to socialize, share clinical experiences, promote academic work, and learn from each other. But what goes into putting these conferences together? In this next installment of the BTK/ASGBI collaborative series, Jon Williams and ASGBI co-hosts Kellie Bateman and Jared Wohlgemut welcome Mr. Dimitrios Damaskos from Edinburgh and Dr. Anne Lidor from the University of Wisconsin to take a look behind the scenes of conference planning. We’ll cover logistics, program selection, how surgical societies strive to support their members and trainees, and much more! Mr Dimitrios Damaskos, initially from Greece, he came to the UK for his fellowship and is a UGI and Emergency General Surgical Consultant with an interest in abdominal wall surgery based in The Royal Infirmary Edinburgh. He is the current Director of Scientific Programme for ASGBI and responsible for organising our main International Congress which this year happens to be in Edinburgh. He has also held numerous other events for surgical societies including the British Hernia Society. Dr. Lidor serves as the program chair for the Society for American Gastrointestinal and Endoscopic Surgeons (i.e. SAGES), which is a wide-reaching US-based international surgical society that encompasses many facets of general surgery. The SAGES Annual Meeting was just last month, and is a great opportunity for surgeons to convene and share clinical experiences, academic work, and professionally connect. Dr. Lidor completed medical school at the New York Medical College, and then moved on to George Washington University for general surgery residency training. Following residency, she moved to Baltimore to Johns Hopkins where she completed her MIS/Bariatric Surgery fellowship and subsequently stayed on as a faculty surgeon. After years at Hopkins during which she held many education leadership roles both at the medical school and as fellowship director, she moved to the University of Wisconsin to become Chief of Minimally Invasive and Bariatric Surgery, a role she continues to hold today. If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative content. If you have any questions or comments, please feel free to reach out to us at hello@behindtheknife.org . Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 30

Hey APPs - Are you ready to DOMINATE surgery? Well let's go! Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos. Go beyond rote memorization and learn what really matters. We are talking practical, high-yield, and engaging content all available at your fingertips. Get the information you need to know FAST. Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered. Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation Course Link: https://app.behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation

Apr 29

Hey APPs - Are you ready to DOMINATE surgery? Well let's go! Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos. Go beyond rote memorization and learn what really matters. We are talking practical, high-yield, and engaging content all available at your fingertips. Get the information you need to know FAST. Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered. Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation Course Link: https://app.behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation

Apr 28

Hey APPs - Are you ready to DOMINATE surgery? Well let's go! Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos. Go beyond rote memorization and learn what really matters. We are talking practical, high-yield, and engaging content all available at your fingertips. Get the information you need to know FAST. Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered. Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation Course Link: https://app.behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation

Apr 24

In this episode, the Surgical Endoscopy team, accompanied by Chief Medical Officer Dr. Brian Dunkin of Boston Scientific, review primary and revisional endoscopic treatment options for bariatric patients. They focus on the emerging data available for procedures such as endoscopic sleeve gastroplasty (ESG) and endoscopic gastrojejunal revision (EGJR) and offer technical tips on how to perform the procedures. In addition, they discuss accessibility challenges for patients and provide insight into the future direction of bariatric endoscopy as a field. Hosts: · Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) · Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) · Dr. H. Masson Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL) · Dr. Michael Ujiki, Professor and Louis Biegler Chair of Surgery, Endeavor Health (Evanston, IL), @UjikiMike · Dr. Brian Dunkin, Chief Medical Officer at Boston Scientific, @briandunkinmd Learning Objectives: - Identify and Describe Common Endobariatric Procedures: Learners will be able to name and briefly describe at least three common endobariatric procedures discussed in the episode, including Endoscopic Sleeve Gastroplasty (ESG), Endoscopic GJ Revisions (Transoral Outlet Reduction - TORR/EGJR), and Intragastric Balloons, along with their historical context and evolution. - Explain the Mechanism and Benefits of Endoscopic Sleeve Gastroplasty (ESG): Learners will be able to articulate the procedural technique of ESG, including the U-shaped suture pattern, its impact on gastric volume reduction, and the proposed mechanisms of weight loss, such as slowed gastric emptying and hormonal changes, as compared to laparoscopic sleeve gastrectomy. - Discuss the Role of Technology and Training in Endobariatrics: Learners will be able to explain the significance of endoscopic suturing devices like the Overstitch in the advancement of endobariatric procedures and recognize the importance of specialized training, including the recommendations against fundal suturing for safety during the initial learning curve. - Compare and Contrast Endobariatric Procedures with Surgical and Pharmacological Obesity Treatments: Learners will be able to discuss the position of endobariatric procedures as a "gap therapy" in the spectrum of obesity treatments, highlighting their benefits such as reduced invasiveness, lower complication rates, faster recovery, and increased patient access compared to surgery, as well as their potential role in conjunction with pharmacologic therapies like GLP-1 agonists. - Recognize Key Considerations and Potential Complications of Endobariatric Procedures: Learners will be able to identify important technical considerations during ESG, such as achieving full-thickness bites while avoiding injury to adjacent organs, and describe common post-procedure issues associated with intragastric balloons, including nausea, vomiting, and the need for general anesthesia during removal. Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity: https://pubmed.ncbi.nlm.nih.gov/39888616/ ** VIDEO LINK: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-2-endobariatrics Surgical Endoscopy Series Ep. 1: An Introduction to Surgical Endoscopy: https://app.behindtheknife.org/podcast/surgical-endoscopy-series-ep-1-an-introduction-to-surgical-endoscopy Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 21

Thinking about doing an away rotation? In this episode of Behind the Knife, we break down everything you need to know about away rotations and sub-internships. From how to apply and what to expect to making a great impression and building connections, we’ve got you covered. Plus, we discuss whether you should even do an away rotation at all and how to decide if it's the right move for your application. We’re joined by a fantastic and diverse group of general surgery residents who share their insights, tips, and experiences. Episode Hosts: –Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, jaroshal@utmb.edu –Dr. Colleen McDermott, University of Utah, @ColleenMcDMD, Colleen.McDermott@hsc.utah.edu –Dr. Sophia Williams-Perez, Baylor College of Medicine, @SophWPerez, Sophia.Williams-Perez@bcm.edu –CoSEF: @surgedfellows, cosef.org Guests: Dr. Steven Thornton, Duke University Medical Center, @swthorntonjr swt12@duke.edu Dr. Nicole Santucci, Washing University in St. Louis, @nicolemsantucci snicole@wustl.edu Abbas Karim, MS3, University of Texas Medical Branch, @_AbbasKarim aakarim@utmb.edu Reagan Collins, MS4, Texas Tech University Health Sciences Center, @ReaganACollins, reagan.collins@ttuhsc.edu Dr. Annie Hierl, Indiana University, @annie_hierl ahierl@iu.edu Dr. Jorge Zarate Rodriguez, Washington University in St Louis, @jzaraterod, j.zarate@wustl.edu References: McDermott CE, Anand A, Brian R, Gan C, L'Huillier JC, Lund S, Sathe T, Silvestri C, Woodward JM. Should I Do a General Surgery Away Rotation?: Perspectives From the Collaboration of Surgical Education Research Fellows (CoSEF). Ann Surg Open. 2024 Dec 3;5(4):e509. doi: 10.1097/AS9.0000000000000509. PMID: 39711667; PMCID: PMC11661735. https://pubmed.ncbi.nlm.nih.gov/39711667/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 17

Listen as we discuss the highly-awaited ESOPEC trial, which examines treatment regimens for esophageal and EGJ adenocarcinoma. Wildly impress your thoracic attendings or peers with your nuanced knowledge! FLOT who? You’ll know. Pull out the paper and listen along! Learning Objectives: -Discuss the patient population in the ESOPEC trial -Discuss the main differences between the ESOPEC trial and the CROSS trial -Describe the main drawbacks between FLOT and the CROSS regimen. Hosts: Chloe Hanson MD, Brian Louie MD, and Peter White MD Referenced Material https://www.nejm.org/doi/full/10.1056/NEJMoa2409408 Hoeppner J, Brunner T, Schmoor C, Bronsert P, Kulemann B, Claus R, Utzolino S, Izbicki JR, Gockel I, Gerdes B, Ghadimi M, Reichert B, Lock JF, Bruns C, Reitsamer E, Schmeding M, Benedix F, Keck T, Folprecht G, Thuss-Patience P, Neumann UP, Pascher A, Imhof D, Daum S, Strieder T, Krautz C, Zimmermann S, Werner J, Mahlberg R, Illerhaus G, Grimminger P, Lordick F. Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer. N Engl J Med. 2025 Jan 23;392(4):323-335. doi: 10.1056/NEJMoa2409408. PMID: 39842010. https://www.nejm.org/doi/full/10.1056/NEJMoa1112088 van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Cuesta MA, Blaisse RJ, Busch OR, ten Kate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van der Sangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van der Gaast A; CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012 May 31;366(22):2074-84. doi: 10.1056/NEJMoa1112088. PMID: 22646630. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/abstract Al-Batran SE, Homann N, Pauligk C, Goetze TO, Meiler J, Kasper S, Kopp HG, Mayer F, Haag GM, Luley K, Lindig U, Schmiegel W, Pohl M, Stoehlmacher J, Folprecht G, Probst S, Prasnikar N, Fischbach W, Mahlberg R, Trojan J, Koenigsmann M, Martens UM, Thuss-Patience P, Egger M, Block A, Heinemann V, Illerhaus G, Moehler M, Schenk M, Kullmann F, Behringer DM, Heike M, Pink D, Teschendorf C, Löhr C, Bernhard H, Schuch G, Rethwisch V, von Weikersthal LF, Hartmann JT, Kneba M, Daum S, Schulmann K, Weniger J, Belle S, Gaiser T, Oduncu FS, Güntner M, Hozaeel W, Reichart A, Jäger E, Kraus T, Mönig S, Bechstein WO, Schuler M, Schmalenberg H, Hofheinz RD; FLOT4-AIO Investigators. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019 May 11;393(10184):1948-1957. doi: 10.1016/S0140-6736(18)32557-1. Epub 2019 Apr 11. PMID: 30982686. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 14

In 2002 a group of surgeons got together and radically changed surgical training forever. They just got together again... They call themselves the Blue Ribbon Committee. When they met in 2002 they addressed critical issues such as residency structure, specialization, work-life balance, and simulation-based training. Now, with rapid advancements in medicine and education, BRC II has revisited these topics and introduced new priorities to ensure that surgical education meets the demands of the modern era. In this episode, we are joined by Dr. Steven Stain, co-chair of BRC II and a leader in surgical education. Dr. Stain shares insights into the motivations behind the second committee, its key findings, and how competency-based education, entrustable professional activities (EPAs), and other innovations are shaping the future of surgical training. Join hosts Pooja Varman MD, Judith French PhD, and Jeremy Lipman MD, MHPE for an engaging discussion on what surgical educators, trainees, and institutions need to know about the new recommendations from BRC II and the future of surgical education. Learning Objectives By the end of this episode, listeners will be able to 1. Under the origins and impact of the first Blue Ribbon Committee (BRC I) 2. Explain the factors that led to the formation of the BRC II and its major recommendations 3. Identify challenges and opportunities in modern surgical education 4. Discuss the role of competency-based education and EPAs in training future surgeons 5. Recognize how institutions and educators can adapt to BRC II recommendations References 1. Recommendations on Surgical Education and Training in the United States: 2024. Ann Surg . 2024;280(4):535. doi:10.1097/SLA.0000000000006360 https://pubmed.ncbi.nlm.nih.gov/38814074/ 2. Blue Ribbon Committee II Advises Sweeping Changes in Surgical Education. ACS. Accessed January 12, 2025. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/may-2024-volume-109-issue-5/blue-ribbon-committee-ii-advises-sweeping-changes-in-surgical-education/ ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 10

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon, with guest Dr. Farr Nezhat, as they discuss management, surgical treatment, and outcomes of bowel endometriosis. Come with us as we learn from expert Dr. Nezhat’s experience and discuss the importance of interdisciplinary approach to bowel endometriosis. Hosts: - Susan Galandiuk, University of Louisville, Louisville, KY, @DCREdInChief - Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas, University of Louisville, Louisville, KY, @sandykava - Hillary Simon, University of Louisville, Louisville, KY, @HillaryLSimon Guest Host: - Farr Nezhat, Nezhat Surgery for Gynecology/Oncology (Cornell/NYU), New York, NY Producer: - Manasa Sunkara MS4, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review pathophysiology of endometriosis. - Understand key goals of bowel endometriosis treatment. - Discuss interdisciplinary surgical care and outcomes of bowel endometriosis. References: 1. Tsuei A, Nezhat F, Amirlatifi N, Najmi Z, Nezhat A, Nezhat C. Comprehensive Management of Bowel Endometriosis: Surgical Techniques, Outcomes, and Best Practices. J Clin Med. 2025 Feb 3;14(3):977. doi: 10.3390/jcm14030977 https://pubmed.ncbi.nlm.nih.gov/39941647/ 2. Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H. Surgical Outcomes after Colorectal Surgery for Endometriosis: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2021 Mar;28(3):453-466. doi: 10.1016/j.jmig.2020.08.015. https://pubmed.ncbi.nlm.nih.gov/32841755/ 3. Erdem S, Imboden S, Papadia A, Lanz S, Mueller MD, Gloor B, Worni M. Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results. Dis Colon Rectum. 2018 Jun;61(6):733-742. doi: 10.1097/DCR.0000000000001047. https://pubmed.ncbi.nlm.nih.gov/29664797/ 4. Nasseri Y, Ma R, Fani N, La K, Solis-Pazmino P, Xu V, Siedhoff MT, Wright KN, Schneyer R, Hamilton KM, Barnajian M, Meyer R. The impact of surgeon specialty on surgical outcomes following colorectal resection for endometriosis. Colorectal Dis. 2025 Feb;27(2):e70028. doi: 10.1111/codi.70028. https://pubmed.ncbi.nlm.nih.gov/39949080/ 5. Chua, Heidi, and Michael J Snyder. "Endometriosis.” ASCRS Textbook of Colon and Rectal Surgery , 4th ed., Springer Nature Switzerland AG, 2022. ASCRS U , www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285036/all/Endometriosis . ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 7

BIG T TRAUMA is back with more TRAUMA PITFALLS ! Join Drs. Teddy Puzio (University of Texas in Houston), Jason Brill (Tripler Army Medical Center), Patrick Georgoff (Duke University, @georgoff) and special guest Dr. Tyler Simpson (Trauma Fellow at Duke University) for a fast-moving, no-nonsense discussion on the many pitfalls you are bound to encounter in the high-stakes world of trauma surgery. Remember, the eyes do not see what the mind does not know ... More from the BIG T series: https://app.behindtheknife.org/podcast-series/big-t-trauma This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 3

BIG T TRAUMA is back with more TRAUMA PITFALLS ! Join Drs. Teddy Puzio (University of Texas in Houston), Jason Brill (Tripler Army Medical Center), Patrick Georgoff (Duke University, @georgoff) and special guest Dr. Jared Ourieff (Trauma Fellow at University of Texas in Houston) for a fast-moving, no-nonsense discussion on the many pitfalls you are bound to encounter in the high-stakes world of trauma surgery. Remember, the eyes do not see what the mind does not know ... More from the BIG T series: https://app.behindtheknife.org/podcast-series/big-t-trauma This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 31

In the third episode of our rural surgery series, Dr. Cody Mullens meets with Dr. Randy Lehman, a rural general surgeon from Rensselaer, Indiana to discuss rural practice, lifestyle, resources, and tips & tricks for general surgery residents interested in pursuing rural practice. The Rural American Surgeon Podcast and Contact: https://www.theruralamericansurgeon.com/ The North American Rural Surgery Society: https://www.northamericanrss.org/ ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 27

In the second episode of our rural surgery series, Dr. Cody Mullens sits down with Dr. Brad Muncy, a 2nd year general surgery resident at Marshall University Rural General Surgery Residency Program and Dr. Jodi Cisco-Goff, an Associate Program Director at Marshall University Rural General Surgery Residency Program to discuss educating and training rural surgeons at Marshall University, the first of its kind training program. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 24

Introducing a new series on rural surgery - In this episode, BTK fellow Dr. Cody Mullens sits down with Dr. Bret Autrey, a general surgery attending at Ludington Hospital in Ludington, MI. Dr. Autrey is a career rural surgeon who discusses, in detail, rural surgery practice, how it's evolved, and both the upside and challenges of practicing rural general surgery. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 20

Join BTK hosts Dr. Scott Steele and Dr. John McClellan and our guest Julia Zumpano, RD. She is a registered dietitian at the Cleveland Clinic’s Center for Human Nutrition, and her expert insight helped inform the guidelines for two programs featured in the hospital’s new wellness and diet coaching app, the Cleveland Clinic Diet app. Both programs aim to educate and empower users in making healthier diet and lifestyle choices. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 17

Dr. Christian Jones was a trauma and acute care surgeon, and an early innovator in surgical education. Dr. Jones generously participated and promoted Behind The Knife in its early years. He passed away in late 2024, and we spend the first 15 minutes of this episode reflecting on the person he was and the impact he made in surgery. Here is a link to his obituary https://www.peacefulalternatives.com/obituary/christian-jones Dr. Lisa Kodadek is a trauma and acute care surgeon at Yale. She was a resident under Dr. Jones at Johns Hopkins. She shares her insights and gratitude for being able to train under Dr. Jones. Following the memorial portion of this interview we listen to mock oral cases that Dr. Jones took Kevin Kniery and Woo Do through when they were general surgery residents in 2017. If you would like to hear more episodes from Dr. Jones, please search his name in our app as there are multiple others to enjoy. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 13

Join Patrick Georgoff as he welcomes Dr. Gene Moore and Dr. Ian Roberts , two giants in trauma surgery and epidemiology, to discuss tranexamic acid (TXA) in trauma care . Dr. Moore, a legendary trauma surgeon and researcher, and Dr. Roberts, the architect of the CRASH trials , break down the science, controversies, and practical applications of TXA. They explore who should get TXA, when it should be given, optimal dosing, and its potential risks . With insights from landmark trials like CRASH-2, STAMP, PATCH, and ROC TXA , this episode cuts through the confusion surrounding TXA in trauma and traumatic brain injury. Is early administration the key to saving lives? Should TXA be given intramuscularly prehospital? Tune in as we tackle these critical questions and define the future of TXA in trauma care ! This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. ***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma

Mar 11

In this second part of a two-part series on disability insurance, Kevin and Larry delve into the specifics of Guaranteed Standard Issue (GSI) disability insurance. They discuss what GSI is, why it's crucial for residents and fellows, and how to avoid common pitfalls that could jeopardize eligibility.

Mar 10

In this first part of a two-part series, Dr. Kevin Kniery interviews Insurance Agent and Certified Financial Planner professional Larry Keller about the fundamentals of disability insurance for physicians, particularly surgeons. They discuss the importance of individual disability policies, key differences between policies, and how to choose the right agent. ***Fellowship Application Form: https://forms.gle/PQgAvGjHrYUqAqTJ9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 6

The Vascular Surgery Subspecialty Team dives into the pressing issue of burnout among vascular surgery trainees. Unveiling surprising statistics and expert insights, they explore the alarming prevalence of burnout, its causes like work-home conflict and physical discomfort, and the protective role of mentorship and a supportive learning environment. With research-backed discussions, they navigate strategies to combat burnout and enhance the well-being of medical professionals. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the definition and prevalence of burnout - Understand the risk factors, including both modifiable and non-modifiable risk factors, for burnout - Review the effects of burnout on trainees and attending surgeons References 1. Hekman KE, Sullivan BP, Bronsert M, Chang KZ, Reed A, Velazquez-Ramirez G, Wohlauer MV; Association of Program Directors in Vascular Surgery Issues Committee. Modifiable risk factors for burnout in vascular surgery trainees. J Vasc Surg. 2021 Jun;73(6):2155-2163.e3. doi: 10.1016/j.jvs.2020.12.064. https://pubmed.ncbi.nlm.nih.gov/33675887/ 2. Cui CL, Reilly MA, Pillado EB, Li RD, Eng JS, Grafmuller LE, DiLosa KL, Conway AM, Escobar GA, Shaw PM, Hu YY, Bilimoria KY, Sheahan MG 3rd, Coleman DM. Burnout is not associated with trainee performance on the Vascular Surgery In-Training Exam. J Vasc Surg. 2025 Jan;81(1):243-249.e4. doi: 10.1016/j.jvs.2024.08.057. https://pubmed.ncbi.nlm.nih.gov/39233022/ 3. Chia MC, Hu YY, Li RD, Cheung EO, Eng JS, Zhan T, Sheahan MG 3rd, Bilimoria KY, Coleman DM. Prevalence and risk factors for burnout in U.S. vascular surgery trainees. J Vasc Surg. 2022 Jan;75(1):308-315.e4. doi: 10.1016/j.jvs.2021.06.476. https://pubmed.ncbi.nlm.nih.gov/34298120/ 4. Davila VJ, Meltzer AJ, Hallbeck MS, Stone WM, Money SR. Physical discomfort, professional satisfaction, and burnout in vascular surgeons. J Vasc Surg. 2019 Sep;70(3):913-920.e2. doi: 10.1016/j.jvs.2018.11.026. https://pubmed.ncbi.nlm.nih.gov/31279532/ 5. Pillado E, Li RD, Chia MC, Eng JS, DiLosa K, Grafmuller L, Conway A, Escobar GA, Shaw P, Sheahan MG 3rd, Bilimoria KY, Hu YY, Coleman DM. Reported pain at work is a risk factor for vascular surgery trainee burnout. J Vasc Surg. 2024 May;79(5):1217-1223. doi: 10.1016/j.jvs.2024.01.003. https://pubmed.ncbi.nlm.nih.gov/38215953/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 3

Do you find yourself saying: “Hey, what’s the big idea with that newfangled whole blood in the refrigerator next to the trauma bay?” Like using whole blood but not sure why? Don’t like using whole blood but not sure why? Join us for a 30 minute power session in whole blood where we try to get you the information you need to know! Hosts: - Michael Cobler-Lichter, MD, PGY4/R2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (X/twitter) - Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow University of Pennsylvania Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency @urrechisme (X/twitter) - Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending: Loma Linda University Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 6 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Learning Objectives: - Describe the proposed benefits of whole blood resuscitation in trauma - Identify current problems with synthesizing the existing literature on whole blood resuscitation in trauma - Propose needed areas for future research regarding whole blood resuscitation in trauma Quick Hits: 1. There is significant heterogeneity in study design across whole blood resuscitation studies, complicating comparison 2. There is likely a mortality benefit to whole blood resuscitation in trauma, however this is likely dependent on the specific population 3. Future research directions should focus on prospective randomized work to try and better quantify the exact benefit of whole blood, and determine in which populations this benefit is actually realized References 1. Hazelton JP, Ssentongo AE, Oh JS, Ssentongo P, Seamon MJ, Byrne JP, Armento IG, Jenkins DH, Braverman MA, Mentzer C, Leonard GC, Perea LL, Docherty CK, Dunn JA, Smoot B, Martin MJ, Badiee J, Luis AJ, Murray JL, Noorbakhsh MR, Babowice JE, Mains C, Madayag RM, Kaafarani HMA, Mokhtari AK, Moore SA, Madden K, Tanner A 2nd, Redmond D, Millia DJ, Brandolino A, Nguyen U, Chinchilli V, Armen SB, Porter JM. Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding: A Multicenter Study. Ann Surg. 2022 Oct 1;276(4):579-588. doi: 10.1097/SLA.0000000000005603. Epub 2022 Jul 18. PMID: 35848743. https://pubmed.ncbi.nlm.nih.gov/35848743/ 2. Sperry JL, Cotton BA, Luther JF, Cannon JW, Schreiber MA, Moore EE, Namias N, Minei JP, Wisniewski SR, Guyette FX; Shock, Whole Blood, and Assessment of Traumatic Brain Injury (SWAT) Study Group. Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality. J Am Coll Surg. 2023 Aug 1;237(2):206-219. doi: 10.1097/XCS.0000000000000708. Epub 2023 Apr 11. PMID: 37039365; PMCID: PMC10344433. https://pubmed.ncbi.nlm.nih.gov/37039365/ 3. Meizoso JP, Cotton BA, Lawless RA, et al. Whole blood resuscitation for injured patients requiring transfusion: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg . 2024;97(3):460-470. doi:10.1097/TA.0000000000004327 https://pubmed.ncbi.nlm.nih.gov/38531812/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Feb 27

Join the BTK crew as they discuss how surgeons maintain relationships despite the demanding nature of their profession. The speakers are surgeons at different career stages (residents, fellows, attendings) and they share tips and tricks for maintaining relationships with significant others, children, parents, and friends. ***Scroll to the bottom and download our Coloring and Activity book for Kids here: https://app.behindtheknife.org/home ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 24

Join the Behind the Knife Bariatric Surgery Team as they kick off 2025 with a crucial discussion on pediatric and adolescent bariatric surgery. Drs. Matt Martin, Adrian Dan and Katherine Cironi delve into the latest ASMBS guidelines, comparing long-term outcomes of gastric bypass and sleeve gastrectomy in adolescents versus adults. They explore key comorbidities, including type 2 diabetes, hypertension, and orthopedic issues, and emphasize the importance of early intervention. This episode also tackles the complex ethical considerations surrounding surgery in this vulnerable population, including consent, multidisciplinary care, and the evolving role of medical therapies like GLP-1 agonists. Show Hosts: - Matthew Martin - Adrian Dan - Katherine Cironi Learning Objectives: · Identify the current ASMBS guidelines for pediatric and adolescent bariatric surgery, including BMI thresholds and associated comorbidities. · Describe common comorbidities seen in the pediatric population eligible for bariatric surgery, such as type 2 diabetes, hypertension, and orthopedic issues. · Compare and contrast long-term outcomes of bariatric surgery (gastric bypass and sleeve gastrectomy) in adolescents and adults, including remission rates of comorbidities and reoperation rates. · Discuss the importance of a multidisciplinary approach, including psychological and ethical considerations, when evaluating adolescent patients for bariatric surgery. · Explain the ethical framework used in evaluating adolescents for bariatric surgery, including consent/assent, parental involvement, and addressing potential coercion. · Recognize the evolving role of medical management (e.g., GLP-1 agonists) in conjunction with or as an alternative to bariatric surgery in adolescents. Article #1: Inge 2019 – Five-year outcomes of gastric bypass in adolescents as compared with adults https://pubmed.ncbi.nlm.nih.gov/31461610/ - The cumulative effect of sustained severe obesity (BMI >35) from adolescence into adulthood increases the likelihood of diabetes, hypertension, respiratory conditions, kidney dysfunction, walking limitations, and venous edema in legs/feet (when compared to adults that did not report severe obesity in adolescence) - American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines for adolescents who should be considered for bariatric surgery: BMI is ≥35 with a co-morbidity or if they have a BMI ≥40 (class 3 obesity, 140% of the 95th percentile) - This article utilizes the Teen-Longitudinal Assessment of Bariatric Surgery (TEENS LAB) and LABS (adults) databases to evaluate the outcomes of adolescents vs. adults who underwent bariatric surgery Roux-en-Y gastric bypass (2006-2009) - 161 adolescents (13-19 at the time of surgery) with severe obesity (BMI>35) vs 396 adults (25-50 years old at the time of surgery) who have remained obese (BMI>30) since adolescence - Both groups had the gastric bypass procedure as their primary bariatric operation - Both groups had unadjusted similar demographics, however, BMI was higher in adolescence (54) when compared to adults (51) - Results were analyzed using linear mixed and Poisson mixed models to analyze weight and coexisting conditions - After surgery, adolescents were significantly more likely than adults to have remission of type 2 diabetes and hypertension - Increased likelihood of remission of diabetes due to the shorter duration of diabetes, lower baseline glycated Hgb, less use of medications, and increased baseline C-peptide levels - Increased vascular stiffness in adults along with a longer duration of hypertension make the cessation of hypertension less responsive with surgery in adults - No significant difference in percent weight changes between adolescents and adults 5 years after surgery - Both adults and adolescent groups had decreased rates of hypertriglyceridemia and low HDL levels, albeit not significantly different when comparing the two groups - Of note, the rate of abdominal reoperations was significantly higher among adolescents (20%) than among adults (16%) with cholecystectomy representing nearly half the procedures in both groups - Limitations - At baseline, adults had a high prevalence of both diabetes and hypertension - only 14% of adolescents had diabetes vs 31% of adults - Only 30% of adolescents had hypertension vs 61% of adults Article #2: Ryder 2024 – Ten-year outcomes after bariatric surgery in adolescents https://pubmed.ncbi.nlm.nih.gov/39476348/ - The goal is to discuss the long-term durability of weight loss and remission of coexisting conditions in adolescents after bariatric surgery - This article utilizes the Teen-Longitudinal Assessment of Bariatric Surgery (TEENS LABS) database to evaluate the 10-year outcomes in adolescents who underwent gastric bypass or sleeve gastrectomy - 260 adolescents with an average age of 17 years old at the time of surgery (ages ranged from 13-19 years old) - 161 adolescents underwent gastric bypass, 99 adolescents underwent sleeve gastrectomy - Results were analyzed using propensity score-adjusted linear and generalized mixed models - At 10 years, the average BMI had decreased significantly with both groups experiencing about a 20% change in BMI on average - To assess comorbidities, both groups were analyzed together - 55% of patients who had DM2 at baseline, were in remission at 10 years - 57% of patients who had HTN at baseline, were in remission at 10 years - 54% of patients who had dyslipidemia at baseline, were in remission at 10 years - Limitations - Neither of these studies compare surgery to medical management. GLP-1s have shown promise for weight loss management but we need more data in terms of long-term outcomes in co-morbidities like diabetes, hypertension, dyslipidemia - Highlighted Outcomes - Metabolic bariatric surgery is quite effective in the adolescent population - Adolescents tend to have weight loss that is similar to that of adults and improved resolution of comorbid conditions (DM2, HTN, dyslipidemia) Article #3: Moore 2020 – Development and application of an ethical framework for pediatric metabolic and bariatric surgery evaluation https://pubmed.ncbi.nlm.nih.gov/33191162/ - The purpose of this paper is to describe the ethical framework that supports the use of metabolic & bariatric surgery (MBS) on the principle of justice, and how providers can conduct a thorough evaluation of patients presenting for these surgeries - Highlights adolescents with intellectual and developmental disabilities (IDD) and preadolescent children who pose more ethical questions before considering surgery - This article utilizes the bariatric surgery center at one children’s hospital and the institution’s ethics consult service to develop an ethical framework to evaluate pediatric patients seeking bariatric surgery – using the national ASMBS guidelines - This ethical framework utilized 4 central ethical questions 1. Should any patients be automatically excluded from evaluation for MBS? 2. How should it be determined that the benefits of MBS outweigh the risks? 3. How do we ensure the patient fully understands and is capable of cooperating with the surgery and follow-up care? 4. How do we make sure the decision to have surgery is truly voluntary, and not coerced by family or others? - Results: this ethical framework was discussed in depth in two case studies - Overview of framework: an ethical question would arise from the bariatric team they would review & apply the ethical framework. The question is either resolved by the bariatric team OR ethics consult, continue pre-operative workup vs no surgery - Case 1: 17M (BMI 42) with a history of autism spectrum disorder, pre-DM, depression with behavior challenges, HTN, dyslipidemia. Testing at school demonstrates intellectual functioning at a fourth-grade level. Pt lives with mom and 11-year-old sister. Mom endorses food insecurity (on supplemental nutrition assistance benefits) and struggles with her son’s large intake of food. 1. Co-morbidities should not be exclusionary, but pt should undergo a comprehensive psychosocial evaluation with attention to family dynamics and support and the patient’s decision-making capacity 2. Discuss benefits vs risks. Benefits – decreased progression of DM2, HTN, hyperlipidemia, cardiometabolic dx. Risks – gastric leak, infection, bleeding, dumping syndrome, etc. 3. Can assess decision-making capacity with the surgical team or if need be other teams. In this case, the pt had limited decision-making capacity - His level of understanding remained stable during the pre-op visits, and he gave assent to surgery - The mom identified a second source of support (extended family) - The team talked to both the patient and mother alone and then, together, found that the patient developed an independent desire for surgery, and thus moved forward. - Case 2: 8F (BMI 50) with a history of mod OSA, L slipped capital femoral epiphysis s/p surgical stabilization (6 mos prior). The patient is neurotypical & excels in school, and lives with mom & dad. Referred by mom & dad (mom with a recent history of sleeve gastrectomy). 1. An 8-year-old should not be discriminated against based solely on age, but the patient should be offered more conservative/less invasive options before OR. a. In this case, the family had not yet been offered these nonsurgical approaches (structured weight management program, physical support, dietician) 2. Discuss benefits vs risks. Benefits – preventing progression of hip disease, improvement of OSA, decreased risk of cardiometabolic dx. Risks – anatomic/infectious/nutrition risks 3. Decision-making capacity was assessed. Found that the parents were more advocating for the surgery saying she has a poor quality of life physically and socially. When the patient was separated from her parents, she said she could lose weight if she had healthier foods at home and someone to exercise with. The patient had decision-making capacity & did not assent to surgery. 4. When the ethics team interviewed the patient and parents, the parents had a strong preference toward surgery vs patient was scared of surgery and wanted to try other approaches first a. Decided that the child’s dissent outweighed the medical necessity for surgery and that there were conservative treatment options still available to try - Highlighted Outcomes - ASMBS guidelines give us good direction on who qualifies for surgery and emphasize an interdisciplinary approach to decision-making. The decision to pursue surgery should always weigh the benefits and risks and should be made collaboratively with the patient, family, and care team ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 20

You're a new attending leading a busy surgical service. You’re tasked with teaching a team that includes every learner from medical students to junior and senior residents—all from different generations. How do you adapt your teaching style to effectively reach everyone? Dr. Abbey Fingeret, Endocrine Surgeon at University of Nebraska and passionate Surgical Educator, joins our host, Dr. Elizabeth Maginot, to explore strategies for engaging learners across generations and creating inclusive, dynamic teaching environments. Hosts: Dr. Abbey Fingeret, MD, MHPTT, FACS: Associate Professor, University of Nebraska Medical Center Department of Surgery, Division of Surgical Oncology, Twitter: @DrFingeret Dr. Elizabeth Maginot, MD: General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95 Learning Objectives: - Understand the defining characteristics of Baby Boomers, Gen X, Millennials, and Gen Z, and how these traits influence their learning and teaching styles in medical education. - Explore how to adapt teaching strategies for multigenerational learners by understanding and addressing their unique perceptions of education, feedback, and expectations in the clinical setting. - Discuss methods to build a positive learning environment that fosters collaboration and inclusivity across all levels of trainees. - Recognize the strengths and challenges different generations bring to medical education and how to leverage these to enhance team learning and patient care." References Stillman, D., & Stillman, J. (2017). Gen Z@ work: How the next generation is transforming the workplace . HarperCollins. https://pubmed.ncbi.nlm.nih.gov/?term=Stillman%2C+D.%2C+%26+Stillman%2C+J.+%282017%29.+Gen+Z%40+work%3A+How+the+next+generation+is+transforming+the+workplace.+HarperCollins. Elmore, T., & McPeak, A. (2019). Generation Z unfiltered: Facing nine hidden challenges of the most anxious population . Poet Gardener Publishing. Twenge, J. M. (2023). Generations: The Real Differences Between Gen Z, Millennials, Gen X, Boomers, and Silents—and What They Mean for America's Future . Simon and Schuster. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 17

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of neuroendocrine tumors of the small bowel. Learning Objectives: In this episode, we review the basics of neuroendocrine (NE) tumors of the small bowel, including how to evaluate patients with presenting symptoms consistent with NE tumors, initial work-up, staging, and management. We discuss key concepts including DOTATATE scans and medical therapies high yield for direct patient care and board exams. Hosts : Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson. Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Links to Paper Referenced in this Episode: Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O'Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E; NETTER-1 Trial Investigators. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med. 2017 Jan 12;376(2):125-135. doi: 10.1056/NEJMoa1607427. PMID: 28076709; PMCID: PMC5895095. https://pubmed.ncbi.nlm.nih.gov/28076709/ ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 13

Join Patrick Georgoff to learn more about how YOU can make amazing digital education content. At Behind the Knife we are often asked how to create digital education content. Thanks to the democratization of technology and rise of the creator economy, all of the tools are at your fingertips. Would you like to enhance your next lecture, grant application, manuscript submission, or patient educational material? You can, even if you are part luddite! You don't need a publisher, advanced computer skills, or tons of money. Don't believe us? Listen to this short podcast for tipsand tricks on how you can make great content. Patrick Georgoff (@georgoff) is an Acute Care Surgeon at Duke University. He went to medical school at the University of Pennsylvania, completed General Surgery residency and Surgical Critical Care fellowship at the University of Michigan, and a Trauma Surgery fellowship at the University of Texas in Houston. His clinical practice includes the full spectrum of Acute Care Surgery in addition to elective hernia surgery. Patrick is deeply involved in surgical education and the is the Associate Program of the General Surgery Residency at Duke and Co-Director of Behind the Knife. He is passionate about trauma system performance and holds the position of associate Trauma Medical Director at Duke. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 10

Join Drs. Michael Rosen, Clayton Petro, and Sara Maskal as they review their recently published randomized controlled trial comparing open retromuscular Sugarbaker and Keyhole approaches to parastomal hernia repair Hosts: - Sara Maskal, MD, Cleveland Clinic - Clayton Petro, MD, Cleveland Clinic - Michael Rosen, MD, Cleveland Clinic Learning Objectives: - Understand the trial design - Review trial outcomes - Understand how to apply the outcomes to patients with parastomal hernias References: - Maskal SM, Ellis RC, Fafaj A, et al. Open Retromuscular Sugarbaker vs Keyhole Mesh Placement for Parastomal Hernia Repair: A Randomized Clinical Trial. JAMA Surg. Published online June 12, 2024. doi:10.1001/jamasurg.2024.1686 https://pubmed.ncbi.nlm.nih.gov/38865142/ - Maskal SM, Thomas JD, Miller BT, Fafaj A, Zolin SJ, Montelione K, Ellis RC, Prabhu AS, Krpata DM, Beffa LR, Costanzo A. Open retromuscular keyhole compared with Sugarbaker mesh for parastomal hernia repair: Early results of a randomized clinical trial. Surgery. 2024 Mar 1;175(3):813-21. https://pubmed.ncbi.nlm.nih.gov/37770344/ - Moreno-Matias J, Serra-Aracil X, Darnell-Martin A, Bombardo-Junca J, Mora-Lopez L, Alcantara-Moral M, Rebasa P, Ayguavives-Garnica I, Navarro-Soto S. The prevalence of parastomal hernia after formation of an end colostomy. A new clinico-radiological classification. Colorectal Dis. 2009 Feb;11(2):173-7. doi: 10.1111/j.1463-1318.2008.01564.x. Epub 2008 May 3. PMID: 18462232. https://pubmed.ncbi.nlm.nih.gov/18462232/ ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 6

You are planning to perform an APR on a patient with rectal cancer. How will you create your permanent stoma? Is there a role for prophylactic mesh? Post operatively at one year surveillance they have developed a parastomal hernia, when do you fix it and how? Join Drs. Abelson, Marcello and Aulet and special guest Dr. Paul Sturrock as they discuss key management considerations. Learning Objectives: 1. Describe the different types of parastomal hernia repairs 2. List indications for repair of parastomal hernias 3. Discuss the approach to managing parastomal hernias Articles: Steele S, et al. The ASCRS Textbook of Colon and Rectal Surgery, fourth ed. 2022. https://link.springer.com/book/10.1007/978-3-030-66049-9 J C Goligher, Extraperitoneal colostomy or ileostomy, British Journal of Surgery , Volume 46, Issue 196, September 1958, Pages 97–103, https://doi.org/10.1002/bjs.18004619602 ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 3

In this episode, Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill are joined by special guest Dr. Pat Murphy, who helps us delve into the evolving field of acute care surgery (ACS), exploring its history, challenges, and the nuances of defining full-time employment in this demanding specialty. The discussion highlights the origins of ACS as a response to unmet emergency surgical needs and its three foundational pillars: trauma surgery, emergency general surgery, and surgical critical care, with additional roles like surgical rescue evolving over time. Dr. Murphy share insights into the workload, including night shifts, call schedules, and the toll on surgeons' health, emphasizing the importance of fair compensation, equitable shift distribution, and transparency in job expectations. The episode underscores the value ACS surgeons bring to hospitals, likening them to essential infrastructure like firefighters, with their impact often unrecognized in traditional productivity metrics like RVUs. Dr. Murphy would like to thank the many collaborators who made this volume of work possible including the many acute care surgeons who have taken the time to participate in the research and their dedication to patient care and surgeon wellbeing Learning Objectives: 1) Define and understand the evolution of acute care surgery as a surgical subspecialty, including its historical development, key components (trauma, surgical critical care, emergency general surgery, surgical rescue), and its unique role within the surgical landscape. 2) Analyze the concept of "full-time equivalent" (FTE) for acute care surgeons, considering factors such as call schedules, shift length, service demands, and the impact of varying case volumes and intensities on workload. 3) Discuss the challenges of defining and measuring the value of acute care surgeons, considering factors beyond traditional productivity metrics (e.g., RVUs) such as the impact of surgical rescue, patient safety, and the value of 24/7 availability in preventing adverse outcomes. 4) Explore the importance of recognizing the unique demands and contributions of acute care surgeons, including the impact of high-stress environments, irregular schedules, and the importance of work-life balance and clinician well-being on long-term sustainability within the specialty. This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma

Jan 30

In their BTK debut, the Surgical Endoscopy team from Endeavor Health (formerly Northshore University Health System) discusses why it is important for surgeons to acquire basic and advanced endoscopic skills. There are an increasing number of ways to endoscopically intervene and solve problems that were traditionally relegated to open and minimally invasive surgery. The Surg Endo team presents a number of case-based scenarios that are going to set the stage for future discussions about the role of therapeutic endoscopy in surgical practice. Hosts: - Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) - Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) - Dr. H. Masson Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL) - Dr. Michael Ujiki, Professor and Louis Biegler Chair of Surgery, Endeavor Health (Evanston, IL), @UjikiMike ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jan 27

In this episode, Behind the Knife fellow Ayman Ali, and Dr. Patrick Georgoff introduce a new series on Behind the Knife – Artificial Intelligence for the Clinician. Over the course of a few episodes, we aim to go over all things AI, with a particular focus on how you can use AI today to enhance your quality of life as a clinician, with just enough detail to understand key concepts. This first episode features guest Dr. Monica Agrawal, an expert in artificial intelligence and a pioneer in large language models. She recently joined Duke after completing a PhD in Computer Science at MIT in the clinical machine learning group and is a co-founder of Layer Health, a healthcare AI company. With her expertise, we’ll define some key terms and give a brief introduction to what artificial intelligence is and is not, as well as some examples and use cases. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jan 23

Research is so critical to the field of surgery worldwide. But how does the world of academic surgery compare in the UK? Join BTK fellow Jon Williams and ASGBI partner Jared Wohlgemut for another installment of our BTK/ASGBI collaborative series where we take a deep dive investigating the many facets of surgical research–everything from getting started, funding, collaboration, mentorship, and sage advice from two incredibly successful academic surgeons. Professor Susan Moug represents the UK while Dr. Lesly Dossett represents the US in this excellent episode for any trainee or surgeon who is academically-inclined. After listening, you get to decide–who does it better?? UK or US? Professor Moug is an Honorary Professor at the University of Glasgow, Scotland. She is a Consultant Colorectal and Robotic surgeon at Golden Jubilee National University Hospital in Clydebank, and at the Royal Alexandra Hospital in Paisley, Scotland. She is also the Director of Research for the Association of Surgeons of Great Britain and Ireland since 2021, and the Surgical Specialty Lead for Colorectal Research at the Royal College of Surgeons of England. She has been awarded a Senior Fellowship from the Chief Scientist Office of the Scottish Government, and was the chief investigator for the Emergency Laparotomy in Frailty multicentre study, and the No-Laps follow-on study. Essentially, she is one of the leading researchers in emergency surgery in the UK, having been awarded over 1 million in grant funding for this under-researched and underfunded area. Dr. Dossett is an associate professor and surgical oncologist at the University of Michigan. After completing her undergraduate degree at Western Kentucky University, She completed both medical school and her general surgery residency at Vanderbilt University in Nashville, TN, during which she obtained an Agency for Healthcare Research and Quality training grant as well as a Masters in Public Health during research time. Following residency, she served as an active duty staff surgeon in the US Navy for several years before pursuing surgical oncology fellowship training at Moffitt Cancer Center. In 2016 she came on to University of Michigan as faculty and has since held numerous academic leadership roles both institutionally and nationally, including vice chair for faculty development, chief of the division of surgical oncology, and president of the Surgical Outcomes Club. Dr. Dossett has an impressive portfolio of research work focusing on implementation and de-implementation of comprehensive cancer care, which is funded through multiple NIH grants. If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative content. If you have any questions or comments, please feel free to reach out to us at hello@behindtheknife.org . ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing

Jan 20

Join University of Washington’s surgical palliative care team for another engaging role play episode, where we tackle the challenging goals-of-care conversation. Using the VitalTalk REMAP framework, we explore effective communication strategies, highlight common pitfalls, and simulate two real-world scenarios: an on-call surgeon discussing goals of care with a complex patient facing an emergent surgical issue, and a team member facilitating a family meeting about goals of care in the surgical ICU. Hosts: Dr. Katie O’Connell (@katmo15) is an associate professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is an assistant professor of surgery at the University of Washington. She is a trauma and emergency general surgeon and palliative care physician. Ali recently completed fellowships in palliative care at the University of Washington and Trauma and Critical Care fellowship at Parkland. Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY6 general surgery resident at the University of Washington, with an interest in surgical oncology. Dr. Virginia Wang is a PGY3 general surgery resident at the University of Washington. Learning Objectives: • Identify questions that elicit patients’ goals and values, particularly during emotionally charged conversations. • Name the three categories of patient values in the values triad. • Describe the importance of aligning with patients’ and families’ values and demonstrate techniques to achieve alignment. • Develop a treatment plan that reflects patients’ stated values. References: “REMAP.” VitalTalk. Accessed December 2nd. https://www.vitaltalk.org/guides/transitionsgoals-of-care/ ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing

Jan 19

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 18

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 17

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 16

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 15

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 14

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 13

Among patients with colorectal cancer and synchronous liver metastases, the subgroup with a primary cancer in the rectum is especially challenging. Compared with colon cancer, most patients with stage IV rectal cancer will have locally advanced primary tumors at increased risk for obstructive and/or post-operative complications resulting in delays in systemic therapy. In this episode from the HPB team at Behind the Knife, listen in on the discussion about treatment sequencing for synchronous liver metastasis from rectal cancer Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center. Learning Objectives · Develop an understanding of the three treatment sequences for resection of disease in patients with synchronous liver metastasis from a primary rectal cancer (reverse, combined, and classic approach) · Develop an understanding of the benefits, risks, and nuances of each of the three treatment sequences · Develop an understanding of which patient cases each treatment sequence is ideal for as well as which cases they are not suitable for. Papers Referenced (in the order they were mentioned in the episode): 1) Conrad C, Vauthey JN, Masayuki O, et al. Individualized Treatment Sequencing Selection Contributes to Optimized Survival in Patients with Rectal Cancer and Synchronous Liver Metastases. Ann Surg Oncol . 2017 Dec;24(13):3857-3864. https://pubmed.ncbi.nlm.nih.gov/28929463/ 2) Maki H, Ayabe RI, Nishioka Y, et al. Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer. Ann Surg Oncol . 2023 Sep;30(9):5390-5400. doi: 10.1245/s10434-023-13656-4. Epub 2023 Jun 7. Erratum in: Ann Surg Oncol. 2023 Sep;30(9):5405. https://pubmed.ncbi.nlm.nih.gov/37285096/ Additional Suggested Reading Mentha G, Majno PE, Andres A, Rubbia-Brandt L, Morel P, Roth AD. Neoadjuvant chemotherapy and resection of advanced synchronous liver metastases before treatment of the colorectal primary . Br J Surg. 2006 Jul;93(7):872-8. https://pubmed.ncbi.nlm.nih.gov/16671066/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jan 10

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 9

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 8

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 7

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 6

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss non-operative and operative management of enterocutaneous fistula. Come with us as we navigate through tips and tricks for preventing and managing enterocutaneous fistulas! Hosts: - Susan Galandiuk, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS4, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review causes of enterocutaneous (EC) fistulas. - Understand EC fistula prevention and management tenets. - Discuss surgical tips and tricks for tackling EC fistulas. References: - Ellison EC, Upchurch GR, et al. Fischer’s Mastery of Surgery . 8th ed, Vol 1. Philadelphia, PA: Wolters Kluwer; 2024:1175-1182. - Fazio VW, et al. Current Therapy in Colon and Rectal Surgery . 8th ed. Philadelphia, PA: Elsevier; 2017:404-411. - Mulholland MW, et al. Operative Techniques in Surgery . Vol 2. Philadelphia, PA: Wolters Kluwer; 2015:934-942. - Steele SR, et al. Illustrated Tips and Tricks in Colon and Rectal Surgery . Philadelphia, PA: Wolters Kluwer; 2021:263-269. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jan 3

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 2

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 1

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 31, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 30, 2024

A nearby house fire has brought several patients to your hospital via ambulance, where you are the sole provider on duty. These patients require urgent triage and stabilization before transfer to the regional burn center. You are very concerned about inhalation injury and are tasked with making complex clinical decisions in a high-pressure situation. What are the next steps? Join Drs. Kevin Foster, Tina Palmeri, Ryan Rihani, Tommy Tran, and Kiran Dyamenahalli as they explore the intricacies of managing smoke inhalation injury and more! Hosts: Tommy Tran, Tristar Skyline Medical Center Kiran Dyamenahalli, MGH Sumner Redstone Burn Center Kevin Foster, Arizona Burn Center Tina Palmeri, UC Davis Firefighters Burn Institute Regional Burn Center Ryan Rihani, UT Health Dunn Burn Center Tam Pham, Harborview Medical Center (Editor) Learning Objectives: Understand the etiology and common scenarios associated with inhalation injury Understand the effect of inhalation injury on morbidity and mortality Describe indications for invasive airway management (intubation, bronchoscopy, and mechanical ventilation). Describe complications of inhalation injury and their management. References: Fournier, M., Turgeon, A. F., Doucette, S., Morrisette, M., Archambault, P., & Bouchard, N. (2016). Nebulized heparin for inhalation injury in burn patients: A systematic review and meta-analysis. Critical Care , 20 (1), 1-10. https://doi.org/10.1186/s13054-016-1285-8 Norris, C., LaLonde, C., Slater, H., & Purser, D. (2005). Survival from inhalation injury. Burns , 31 (7), 803-815. https://doi.org/10.1016/j.burns.2005.04.003 Li, W., Tang, X., Chen, Y., & Zhao, Z. (2021). Update on smoke inhalation injury: Pathogenesis, diagnosis, and treatment. Journal of Thoracic Disease , 13 (4), 1797-1808. https://doi.org/10.21037/jtd-20-3328 Hahn, S. M., Kim, Y. H., Kim, K. H., & Lee, S. U. (2020). Advances in the diagnosis and treatment of smoke inhalation injury in burn patients. Acute and Critical Care , 35 (1), 1-10. https://doi.org/10.4266/acc.2020.00175 Bittner, E. A., Shank, E., Woodson, L., & Martyn, J. A. (2015). Acute and long-term outcomes of burn injuries: A focus on inhalation injury. Clinics in Chest Medicine , 36 (4), 549-560. https://doi.org/10.1016/j.ccm.2015.08.007 Romanowski, K. S., & Palmieri, T. L. (2019). Inhalation injury in burns: Pathophysiology, diagnosis, and treatment. Journal of Burn Care & Research , 40 (5), 517-523. https://doi.org/10.1093/jbcr/irz123 Dyamenahalli, K., Garg, G., Shupp, J. W., Kuprys, P. V., Choudhry, M. A., & Kovacs, E. J. (2019). Inhalation injury: Unmet clinical needs and future research. Journal of Burn Care & Research , 40 (5), 570-584. https://doi.org/10.1093/jbcr/irz055 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Dec 27, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 26, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 25, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 24, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 23, 2024

In this episode, podcast hosts Dr. Josh Roshal, Dr. Darian Hoagland, and Dr. Maya Hunt discuss the ins and outs of professional development time (PDT) and professional identity formation (PIF) during surgical training. Joined by insights from fellow CoSEF members, the team dives into key topics such as mentorship, timing, and making the most of this critical phase in residency. From rapid-fire tips to personal reflections, this episode offers a wealth of advice for trainees considering their PDT and PIF.. Episode Hosts: –Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, jaroshal@utmb.edu –Dr. Darian Hoagland, Beth Israel Deaconess Medical Center, @DHoaglandMD, dlhoagla@bidmc.harvard.edu –Dr. Maya Hunt, Indiana University, @dr_mayathehunt, mayahunt@iu.edu –CoSEF: @surgedfellows, cosef.org Guests: -Dr. Ariana Naaseh, Washington University in St. Louis, @ariananaaseh, a.naaseh@wustl.edu -Dr. Colleen McDermott, University of Utah, @ColleenMcDMD, Colleen.McDermott@hsc.utah.edu -Dr. Shahnur Ahmed, Indiana University, shahme@iu.edu -Dr. Xinyi “Cathy” Luo, Tulane University, @DoctorSoySauce, xluo@tulane.edu -Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, aa24@stanford.edu References: Smith SM, Chugh PV, Song C, Kim K, Whang E, Kristo G. Perspectives of Surgical Research Residents on Improving Their Reentry Into Clinical Training. J Surg Educ. 2024 Nov;81(11):1491-1497. doi: 10.1016/j.jsurg.2024.07.005. Epub 2024 Aug 31. PMID: 39217679. https://pubmed.ncbi.nlm.nih.gov/39217679/ Kochis MA, Cron DC, Coe TM, Secor JD, Guyer RA, Brownlee SA, Carney K, Mullen JT, Lillemoe KD, Liao EC, Boland GM. Implementation and Evaluation of an Academic Development Rotation for Surgery Residents. J Surg Educ. 2024 Nov;81(11):1748-1755. doi: 10.1016/j.jsurg.2024.08.015. Epub 2024 Sep 23. PMID: 39317122. https://pubmed.ncbi.nlm.nih.gov/39317122/ Gkiousias V. Scalpel Please! A Scoping Review Dissecting the Factors and Influences on Professional Identity Development of Trainees Within Surgical Programs. Cureus. 2021;13(12):e20105. doi:10.7759/cureus.20105 https://pubmed.ncbi.nlm.nih.gov/35003955/ Rivard SJ, Vitous CA, De Roo AC, et al. “The captain of the ship.” A qualitative investigation of surgeon identity formation. Am J Surg. 2022;224(1 Pt B):284-291. doi:10.1016/j.amjsurg.2022.01.010 https://pubmed.ncbi.nlm.nih.gov/35168761/ Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med J Assoc Am Med Coll. 2010;85(2):220-227. doi:10.1097/ACM.0b013e3181c88449 https://pubmed.ncbi.nlm.nih.gov/20107346/ Veazey Brooks J, Bosk CL. Remaking surgical socialization: work hour restrictions, rites of passage, and occupational identity. Soc Sci Med 1982. 2012;75(9):1625-1632.doi:10.1016/j.socscimed.2012.07.007 https://pubmed.ncbi.nlm.nih.gov/22863331/ Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. A schematic representation of the professional identity formation and socialization of medical students and residents: a guide for medical educators. Acad Med J Assoc Am Med Coll.2015;90(6):718-725.doi:10.1097/ACM.0000000000000700 https://pubmed.ncbi.nlm.nih.gov/25785682/ Huffman EM, Anderson TN, Choi JN, Smith BK. Why the Lab? What is Really Motivating General Surgery Residents to Take Time for Dedicated Research. J SurgEduc.2020;77(6):e39-e46.doi:10.1016/j.jsurg.2020.07.034 https://pubmed.ncbi.nlm.nih.gov/32768383/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 20, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 19, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 18, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 17, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 16, 2024

Your post op day #4 right pneumonectomy patient is suddenly coughing up large volumes of serosanguinous sputum! What are you worried about and what do you need to do? Join your Swedish thoracic surgery team, Drs. Chloe Hanson, Peter White, and Brian Louie as we discuss the management of this dangerous and frustrating surgical complication. Hosts: Chloe E. Hanson, M.D., PGY3 Brian E. Louie, MD, Thoracic Attending Peter T. White, MD, Thoracic Attending Learning Objectives: What is a bronchopleural fistula (BPF) and what different ways do they present? Describe the acute management of an early BPF. Describe the differences in operative considerations between an early and late BPF. Describe different options for closure of a pneumonectomy space. References: - Sugarbaker's Adult Chest Surgery, 3e Sugarbaker DJ, Bueno R, Burt BM, Groth SS, Loor G, Wolf AS, Williams M, Adams A. Sugarbaker D.J., & Bueno R, & Burt B.M., & Groth S.S., & Loor G, & Wolf A.S., & Williams M, & Adams A(Eds.),Eds. David J. Sugarbaker, et al. https://shc.amegroups.org/article/view/3787/html - Dal Agnol G, Vieira A, Oliveira R, Ugalde Figueroa PA. Surgical approaches for bronchopleural fistula. Shanghai Chest 2017;1:14. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Dec 13, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 12, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 11, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 10, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 9, 2024

Osteopathic education in surgery has undergone significant changes, especially with the transition to a single ACGME accreditation system in 2020. Despite initial concerns about equitable access and representation, studies have highlighted increasing competitiveness of osteopathic medical students in surgical residency matches and comparable outcomes between allopathic and osteopathic surgeons, affirming the quality of osteopathic training. In this episode, we talk with Dr. Kristen Conrad-Schnetz, recent president of the American College of Osteopathic Surgeons (ACOS) and General Surgery program director at Cleveland Clinic South Pointe Hospital, about osteopathy in general surgery. We delve into the role of osteopathic principles in surgical training and practice and the impact of transitioning to a single accreditation system. Dr. Conrad-Schnetz shares insights on overcoming misconceptions about DO surgeons and her vision for the future of osteopathic recognition in surgery. Join hosts Pooja Varman MD, Judith French PhD, and Jeremy Lipman MD, MHPE for this exciting conversation with Kristen Conrad-Schnetz, DO. Learning Objectives By the end of this episode, listeners will be able to 1. List the four tenets of osteopathic medicine 2. Identify how osteopathic principles and practices can be incorporated into surgical practice 3. Explain the significance of osteopathic recognition in residency programs 4. Discuss strategies for promoting equity for DO surgery residents References 1. Williamson TK, Martinez VH, Ojo DE, et al. An analysis of osteopathic medical students applying to surgical residencies following transition to a single graduate medical education accreditation system. Journal of Osteopathic Medicine. 2024;124(2):51-59. doi:10.1515/jom-2023-0118 https://pubmed.ncbi.nlm.nih.gov/37921195/ 2. Russell TA, Yoshida R, Men M, et al. Comparison of Outcomes for Patients Treated by Allopathic vs Osteopathic Surgeons. JAMA Surgery. Published online October 16, 2024. doi:10.1001/jamasurg.2024.4580 https://pubmed.ncbi.nlm.nih.gov/39412774/ 3. Etheart I, Krise SM, Burns JB, Conrad-Schnetz K. The Effect of Single Accreditation on Medical Student Match Rates in Surgical Specialties. Cureus. 2021;13(4):e14301. doi:10.7759/cureus.14301 https://pubmed.ncbi.nlm.nih.gov/33968513/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Dec 6, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 5, 2024

In this episode, we dive into the 2024 guidelines from the Surgical Infection Society (SIS). Using a case-based approach, we explore how the updated guidelines impact clinical decision-making in the management of intra-abdominal infections. Our expert guests break down best practices while emphasizing the importance of timely intervention, appropriate antibiotic selection, and the evolving role of local antibiograms in guiding therapy. Listeners will gain practical insights into the newest evidence-based recommendations, including when to shorten antibiotic courses, how to tailor therapy for individual patients, and the critical need for early source control. Whether you're a seasoned clinician or a trainee, this case-based discussion provides actionable takeaways for improving patient outcomes in surgical infections. Take Home Points: - Antibiotics and antibiotic resistance are continuously evolving. It’s essential to stay updated with current guidelines, consult your local antibiogram, and utilize available antimicrobial options to create an informed and effective treatment plan - Shorter course antibiotics for intra-abdominal infections are generally well tolerated, but careful patient selection is crucial for optimizing outcomes. - In cases of complicated appendicitis, antibiotics should be discontinued within 24-48 hours after effective source control is achieved. - Time is life – early administration of appropriate antibiotics and prompt, definitive source control are key to improving patient outcomes Hosts: - Patrick Georgoff, MD – Trauma Surgeon at Duke University, @georgoff - Nicole Petcka, MD – General Surgery Resident at Emory University, @npetcka2022 Guests: - Heather Evans, MD, MS – Chief of Surgery at the Ralph H. Johnson VA Medical Center, President of the Surgical Infection Society - Joe Forrester, MD, MSc – Assistant Professor of Surgery at Stanford University, Surgical Infection Society Therapeutics and Guidelines Committee Chair Resources: The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update Huston JM, Barie PS, Dellinger EP, Forrester JD, Duane TM, Tessier JM, Sawyer RG, Cainzos MA, Rasa K, Chipman JG, Kao LS, Pieracci FM, Colling KP, Heffernan DS, Lester J; Therapeutics and Guidelines Committee. The Surgical Infection Society Guidelines on the Management of Intra-Abdominal Infection: 2024 Update. Surg Infect (Larchmt). 2024 Aug;25(6):419-435. doi: 10.1089/sur.2024.137. Epub 2024 Jul 11. PMID: 38990709. https://pubmed.ncbi.nlm.nih.gov/38990709/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Dec 4, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 3, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 29, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 28, 2024

In this episode by the Emergency General Surgery team, we explore the inevitable in acute care surgery- complications. Once a taboo subject, we are now beginning to understand how surgeons and care teams are affected when things don't go as planned. The team discusses two articles that explore the impact of surgical complications on surgeons, both in the short and long term, as well as ways to rehabilitate and support surgeons when they face a challenging complication. Drawing on the article, as well as personal experience, this episode works towards the ongoing shift in surgical culture around outcomes and supports improved surgeon wellness. Hosts Dr. Ashlie Nadler Dr. Jordan Nantais, Dr. Graham Skelhorne-Gross Dr. Marika Sevigny References Zhu A, Deng S, Greene B, Tsang M, Palter VN, Jayaraman S. Helping the Surgeon Recover: Peer-to-Peer Coaching after Bile Duct Injury. J Am Coll Surg. 2021 Aug;233(2):213-222.e1. doi: 10.1016/j.jamcollsurg.2021.05.011. Epub 2021 Jun 7. PMID: 34111530. https://pubmed.ncbi.nlm.nih.gov/34111530/ Han K, Bohnen JD, Peponis T, Martinez M, Nandan A, Yeh DD, Lee J, Demoya M, Velmahos G, Kaafarani HMA. The Surgeon as the Second Victim? Results of the Boston Intraoperative Adverse Events Surgeons' Attitude (BISA) Study. J Am Coll Surg. 2017 Jun;224(6):1048-1056. doi: 10.1016/j.jamcollsurg.2016.12.039. Epub 2017 Jan 16. PMID: 28093300. https://pubmed.ncbi.nlm.nih.gov/28093300/ Learning objectives Understand the psychological impact of surgical complications on the care provider Explore the role of peer-to-peer mentoring in support and rehabilitation of surgeons Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 27, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 26, 2024

Behind the Knife ABSITE 2025 – Up-to-date and high yield learning to help you DOMINATE the exam. Don’t forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Be sure to check out our brand new free study aid , which includes all 32 review episodes, brief written summaries, high yield images, and flash cards. Simply create an account on our iOS or Android app or on our website and you will find the entire course in your Library. Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Google Play App Store: https://play.google.com/store/apps/details?id=com.btk.app Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2025 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/en-us/index.html If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 25, 2024

In this episode, Dr. Atul Gawande joins Dr. Patrick Georgoff to share his experiences as a surgeon, writer, and global health leader. From his innovative work at Ariadne Labs and Lifebox to his current role as Assistant Administrator for Global Health at USAID, Dr. Gawande discusses the challenges and rewards of creating large-scale impact. He reflects on balancing creativity in writing with precision in surgery, lessons learned from managing teams, and the critical importance of strengthening global health systems. Enjoy! Dr. Atul Gawande is the Assistant Administrator for Global Health at the U.S. Agency for International Development, where he oversees a bureau that manages more than $4 billion with a footprint of more than 900 staff committed to advancing equitable delivery of public health approaches around the world. The Bureau for Global Health focuses on work that improves lives everywhere--from preventing child and maternal deaths to controlling the HIV/AIDS epidemic, combating infectious diseases, and preparing for future outbreaks. Prior to joining the Biden-Harris Administration, he was a practicing surgeon at Brigham and Women’s Hospital in Boston and a professor at the Harvard Medical School and the Harvard T.H. Chan School of Public Health. He is the founder and was the chair of Ariadne Labs, a joint center for health systems innovation, and of Lifebox, a nonprofit making surgery safer globally. From 2018-2020, he was also the CEO of Haven (an Amazon, Berkshire Hathaway, and JP Morgan Chase healthcare venture). In addition, Atul was a longtime staff writer for The New Yorker magazine and has written four New York Times best-selling books: Complications, Better, The Checklist Manifesto, and Being Mortal. Visit https://www.usaid.gov/organization/atul-gawande to learn more about our special guest. To learn more about the Global Health Bureau, please visit https://www.usaid.gov/global-health . Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 21, 2024

A 67 year old woman with a history of hypertension, hyperlipidemia, diabetes, and a 25 pack year smoking history is referred your clinic and is referred for evaluation of her peripheral arterial disease. She reports pain with walking that has limited her doing some daily activities. How can you optimally manage this patient? Does she need an operation? In this episode, we will cover the basics of peripheral arterial disease, discuss the specifics of optimal medical management and dive into the nuances of when (or if) you should offer these patients an operation. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the definition, prevalence, and risk factors for peripheral arterial disease - Understand the specifics of optimal medical management of patients with peripheral arterial disease - Discuss the controversy regarding operative management of patients with claudication and review indications for an operation in patients with peripheral arterial disease - Review the appropriate anti-platelet and anti-coagulation strategies after interventions in patients with peripheral arterial disease References 1. Woo K, Siracuse JJ, Klingbeil K, Kraiss LW, Osborne NH, Singh N, Tan TW, Arya S, Banerjee S, Bonaca MP, Brothers T, Conte MS, Dawson DL, Erben Y, Lerner BM, Lin JC, Mills JL Sr, Mittleider D, Nair DG, O'Banion LA, Patterson RB, Scheidt MJ, Simons JP; Society for Vascular Surgery Appropriateness Committee. Society for Vascular Surgery appropriate use criteria for management of intermittent claudication. J Vasc Surg. 2022 Jul;76(1):3-22.e1. doi: 10.1016/j.jvs.2022.04.012. Epub 2022 Apr 22. PMID: 35470016. https://pubmed.ncbi.nlm.nih.gov/35470016/ 2. Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. Eur J Vasc Endovasc Surg. 2024 Jan;67(1):9-96. doi: 10.1016/j.ejvs.2023.08.067. Epub 2023 Nov 10. PMID: 37949800. https://pubmed.ncbi.nlm.nih.gov/37949800/ 3. Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, Chandra V, Drachman DE, Eaves JM, Ehrman JK, Evans JN, Getchius TSD, Gutiérrez JA, Hawkins BM, Hess CN, Ho KJ, Jones WS, Kim ESH, Kinlay S, Kirksey L, Kohlman-Trigoboff D, Long CA, Pollak AW, Sabri SS, Sadwin LB, Secemsky EA, Serhal M, Shishehbor MH, Treat-Jacobson D, Wilkins LR. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jun 11;149(24):e1313-e1410. doi: 10.1161/CIR.0000000000001251. Epub 2024 May 14. PMID: 38743805. https://pubmed.ncbi.nlm.nih.gov/38743805/ 4. Belch JJ, Dormandy J; CASPAR Writing Committee; Biasi GM, Cairols M, Diehm C, Eikelboom B, Golledge J, Jawien A, Lepäntalo M, Norgren L, Hiatt WR, Becquemin JP, Bergqvist D, Clement D, Baumgartner I, Minar E, Stonebridge P, Vermassen F, Matyas L, Leizorovicz A. Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. J Vasc Surg. 2010 Oct;52(4):825-33, 833.e1-2. doi: 10.1016/j.jvs.2010.04.027. Epub 2010 Aug 1. Erratum in: J Vasc Surg. 2011 Feb;53(2):564. Biasi, B M [corrected to Biasi, G M]. PMID: 20678878. https://pubmed.ncbi.nlm.nih.gov/20678878/ 5. Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, Diaz R, Alings M, Lonn EM, Anand SS, Widimsky P, Hori M, Avezum A, Piegas LS, Branch KRH, Probstfield J, Bhatt DL, Zhu J, Liang Y, Maggioni AP, Lopez-Jaramillo P, O'Donnell M, Kakkar AK, Fox KAA, Parkhomenko AN, Ertl G, Störk S, Keltai M, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Tonkin AM, Lewis BS, Felix C, Yusoff K, Steg PG, Metsarinne KP, Cook Bruns N, Misselwitz F, Chen E, Leong D, Yusuf S; COMPASS Investigators. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017 Oct 5;377(14):1319-1330. doi: 10.1056/NEJMoa1709118. Epub 2017 Aug 27. PMID: 28844192. https://pubmed.ncbi.nlm.nih.gov/28844192/ 6. Bonaca MP, Bauersachs RM, Anand SS, Debus ES, Nehler MR, Patel MR, Fanelli F, Capell WH, Diao L, Jaeger N, Hess CN, Pap AF, Kittelson JM, Gudz I, Mátyás L, Krievins DK, Diaz R, Brodmann M, Muehlhofer E, Haskell LP, Berkowitz SD, Hiatt WR. Rivaroxaban in Peripheral Artery Disease after Revascularization. N Engl J Med. 2020 May 21;382(21):1994-2004. doi: 10.1056/NEJMoa2000052. Epub 2020 Mar 28. PMID: 32222135. https://pubmed.ncbi.nlm.nih.gov/32222135/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 18, 2024

In this BTK episode, the Hernia Content Team from Carolinas Medical Center discusses the evolution of training in hernia surgery. The team reviews residency and fellowship training requirements for hernia surgery and compares the training paradigm in the United States with other examples from around the world. As the field of hernia surgery continues to mature, so will training the next generation of hernia specialists. Hosts: - Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL) - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center (Charlotte, NC), @VedraAugenstein (Twitter) - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center (Charlotte, NC), @THeniford (Twitter) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 14, 2024

The pancreatic anastomosis is often regarded as the “Achilles Heel” of the Whipple operation, as technical failure and leakage is a significant source of perioperative morbidity and mortality. In this episode from the HPB team at Behind the Knife listen in as we discuss the standard techniques for the anastomosis, alternative techniques for the pancreatic anastomosis in patients with aberrant anatomy and/or physiology, key factors to consider when selecting the ideal approach/technique for the anastomosis, and mitigation strategies for leaks. Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He previously completed his general surgery residency at Massachusetts General Hospital, and will be returning to MGH as faculty at the conclusion of his fellowship. Monica M. Dua (@MonicaDuaMD) is a Clinical Professor of Surgery and the Associate Program Director of the HPB Surgery Fellowship at Stanford University. She also serves as also serves as the regional HPB Surgeon at the VA Palo Alto Health Care System. Learning Objectives · Develop an understanding of the standard technical approaches to the pancreatic anastomosis during a Whipple (pancreatoduodenectomy) operation · Develop an understanding of the alternative technical approaches to the pancreatic anastomosis during the Whipple when the standard approaches may not be feasible · Develop an understanding of the key anatomic and physiologic factors in the decision making when selecting the optimal approach for the pancreatic anastomosis · Develop an understanding of possible mitigation strategies in the event of a pancreatic anastomotic leak. Suggested Reading Jon Harrison, Monica M. Dua, William V. Kastrinakis, Peter J. Fagenholz, Carlos Fernandez-del Castillo, Keith D. Lillemoe, George A. Poultsides, Brendan C. Visser, Motaz Qadan. “Duct tape:” Management strategies for the pancreatic anastomosis during pancreatoduodenectomy. Surgery . Volume 176, Issue 4, 2024, Pages 1308-1311, https://pubmed.ncbi.nlm.nih.gov/38796390/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 11, 2024

We’re excited to bring you the second episode in our BTK/ASGBI collaborative series, where we compare and contrast various aspects of surgery in the US and the UK, debating who does it better. In today’s episode, BTK fellow Jon Williams and ASGBI hosts Kellie Bateman and Jared Wohlgemut welcome the Christian Macutkiewicz from the UK and Scott Steele to discuss surgeon careers--from getting your first faculty job to broadening your impact to compensation structures. Dr. Macutkiewicz is the President-Elect of the Association of Surgeons of Great Britain and Ireland. He is a General and HPB Surgeon in Manchester, England. He completed a Bachelor of Science in Biochemistry at the University of Birmingham, before studying medicine at the University of Manchester, and received an MD doctorate at the University of Manchester for research into sepsis. He underwent surgical training in North West Deanery, before completing an HPB and Liver Transplant Fellowship in Leeds. He has been a consultant surgeon in Nottingham, Leeds and most recently in Manchester since 2018. He also works privately at Spire Manchester Hospital. Dr. Steele needs no introduction as a founder of BTK, but otherwise he is president of the Cleveland Clinic main campus and chair of the department of colorectal surgery. After graduating from West Point, Dr. Steele received his medical degree from University of Wisconsin. He then underwent general surgery residency training at Madigan Army Medical Center in Tacoma, WA followed by colorectal surgery fellowship training at University of Minnesota Medical Center. Dr. Steele then served in the military as an active duty surgeon until 2015, including several deployments and further faculty time at Madigan where he additionally served as Associate Program Director for general surgery. He then served as Division Chief of colorectal surgery at University Hospitals in Cleveland and associate director of surgical services at the Digestive Health Institute, prior to being named Chair of the department of colorectal surgery at the Cleveland Clinic in 2016, a position that he continues to hold today. So, which country would you rather work in to carry out your illustrious surgical career? Give this episode a listen and decide for yourself! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 7, 2024

The dreaded esophageal injury. Do you still have nightmares about mock oral board scenarios torturing you with the ins and outs of how to manage traumatic esophageal injury? Think you remember all the nuances? Whether you do or you don’t, this episode should serve as a good refresher for all levels while offering some pearls for management of this tricky scenario. Hosts: - Michael Cobler-Lichter, MD, PGY4/R2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (X/twitter) - Dylan Tanzer, MD, 2nd-year Trauma/Surgical Critical Care Fellow University of Miami/Jackson Memorial Hospital/Ryder Trauma Center - Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending: Loma Linda University Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 5 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Learning Objectives: - Describe the diagnostic workup of a suspected traumatic esophageal injury - Identify when someone with suspected esophageal injury needs immediate surgical management - Describe appropriate surgical techniques for repair of both cervical and thoracic esophageal injuries Quick Hits: 1. Don’t forget the primary survey. Unstable patients should be in the OR, as should patients with hard signs of vascular or aerodigestive injury 2. If there is concern for esophageal injury but no immediate indication for the OR, this should be further investigated with CTA of the affected area. Clinical exam has poor sensitivity. 3. The esophagus should be primarily repaired if the defect is able to come together without tension after debridement. Don’t forget a well-vascularized buttress 4. If you cannot perform a primary repair, your procedure of choice should be lateral esophagostomy with feeding jejunostomy and gastrostomy for decompression. Repair over T-tube can be considered for injuries with small amounts of tissue loss References 1. Biffl WL, Moore EE, Feliciano DV, Albrecht RA, Croce M, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Diagnosis and Management of Esophageal Injuries. J Trauma Acute Care Surg 2015;79(6):1089-95. https://pubmed.ncbi.nlm.nih.gov/26680145/ 2. Sperry JL, Moore EE, Coimbra R, Croce M, Davis JW, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Penetrating Neck Trauma. J Trauma Acute Care Surg 2013;75(6):936-40. https://pubmed.ncbi.nlm.nih.gov/24256663/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Nov 4, 2024

You have a patient with another episode of acute uncomplicated diverticulitis. This is the third episode. Do they need antibiotics? Is surgery the next step? What is their risk of recurrence with or without surgery? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jason Hall MD, MPH as they discuss high yield papers discussing diverticulitis. Learning Objectives: 1. Describe the impact on quality of life for patients who undergo surgery or non-operative management of diverticulitis 2. Discuss the indications for surgery in patients with diverticulitis 3. Describe ongoing clinical trials in management of diverticulitis **Video Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-diverticulitis References: Santos A, Mentula P, Pinta T, et al. Quality-of-Life and Recurrence Outcomes Following Laparoscopic Elective Sigmoid Resection vs Conservative Treatment Following Diverticulitis: Prespecified 2-Year Analysis of the LASER Randomized Clinical Trial. JAMA Surg. 2023;158(6):593–601. doi:10.1001/jamasurg.2023.0466 https://pubmed.ncbi.nlm.nih.gov/37074706/ Bolkenstein HE, Consten ECJ, van der Palen J, van de Wall BJM, Broeders IAMJ, Bemelman WA, Lange JF, Boermeester MA, Draaisma WA; Dutch Diverticular Disease (3D) Collaborative Study Group. Long-term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis: 5-year Follow-up Results of a Multicenter Randomized Controlled Trial (DIRECT-Trial). Ann Surg. 2019 Apr;269(4):612-620. doi: 10.1097/SLA.0000000000003033. PMID: 30247329. https://pubmed.ncbi.nlm.nih.gov/30247329/ Hall J, Hardiman K, Lee S, Lightner A, Stocchi L, Paquette IM, Steele SR, Feingold DL; Prepared on behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Treatment of Left-Sided Colonic Diverticulitis. Dis Colon Rectum. 2020 Jun;63(6):728-747. doi: 10.1097/DCR.0000000000001679. PMID: 32384404. https://pubmed.ncbi.nlm.nih.gov/32384404/ Hall JF, Roberts PL, Ricciardi R, Read T, Scheirey C, Wald C, Marcello PW, Schoetz DJ. Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence? Dis Colon Rectum. 2011 Mar;54(3):283-8. doi: 10.1007/DCR.0b013e3182028576. PMID: 21304297. https://pubmed.ncbi.nlm.nih.gov/21304297/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 31, 2024

We are seeing a 42F in the emergency room who underwent a laparoscopic sleeve gastrectomy 11 days ago. The operation was uneventful, and she had a negative airleak test. She had an uneventful postoperative course and was discharged on POD 1. Her medical history is significant for hypertension and hyperlipidemia, and he has no other surgical history. She has been able to keep up with her clear liquid diet. She complains that this morning she experienced abdominal and palpitations. You note her vitals show a mildly elevated blood pressure and her latest heart rate is 120s. Join Drs. Matthew Martin, Adrian Dan, Crystall Johnson-Mann, and Paul Wisniowski on a discussion about initial evaluation and management of bariatric patients with internal hernias. Show Hosts: Matthew Martin Adrian Dan Crystal Johnson-Mann Paul Wisniowski Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 28, 2024

In this episode, we have a discussion about the intersection of health design/architecture and surgery with Dr. Andrew Ibrahim, a trained architect and practicing general surgeon and health services researcher. We discuss how hospitals, ICUs, operating rooms, and trauma bays are designed and the evidence behind them. Host: Cody Mullens, general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens) Guest: Dr. Andrew Ibrahim. Associate Professor of Surgery at the University of Michigan, Maud T. Lane Research Professor, Co-Director for the Center for Healthcare Outcomes and Policy. (@AndrewMIbrahim) Guide to hospital design on Dr. Ibrahim’s website: https://www.surgeryredesign.com/resources Paper on measuring hospital design and quality of care using clinical data: https://shmpublications.onlinelibrary.wiley.com/doi/full/10.1002/jhm.12987 Science paper: https://www.science.org/doi/10.1126/science.6143402 CHEST paper: https://secure.jbs.elsevierhealth.com/action/getSharedSiteSession?redirect=https%3A%2F%2Fjournal.chestnet.org%2Farticle%2FS0012-3692%2810%2960225-5%2Ffulltext&rc=0 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 24, 2024

In this episode, Dr. Scott Butsch from the Cleveland Clinic’s Bariatric and Metabolic Institute discusses the evolving landscape of obesity medicine. He covers the history of obesity treatments, from behavioral interventions to groundbreaking medical therapies like GLP-1 receptor agonists and their future potential. The conversation also explores the challenges of bias, accessibility, and the integration of medications with surgical options for effective, long-term obesity management. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 21, 2024

In this, the fourth of 4 in our “What’s Your Worth” series, Matt and Mark discuss various compensation models including salary and hybrid models (e.g., productivity, quality-based, incentive-based) and fee-for-service. In addition, other variables that can be included in your contract when comparing jobs are covered (time away, professional fees, benefits, vacation). Finally, our guests cover aspects to think about when the job is not working out and you may need to leave an organization. Matthew J. Donnelly, Esq,, Executive Director, Professional Staff Affairs, Cleveland Clinic, Cleveland, OH. https://my.clevelandclinic.org/about/overview/leadership/executive/donnelly-matt ; Linkedin: https://www.linkedin.com/in/matthew-j-donnelly/ Mark Elinsky, Director, Professional Staff Compensation and Analytics, Cleveland Clinic, Cleveland, OH Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 18, 2024

Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 17, 2024

In the third episode in our 4 part “What’s Your Worth” series, Lauren covers the hospital-side of finances, going through the world of financial literacy. In this episode, basic definitions and importance of income statements, metrics of financial performance, and others including revenue and expenses are reviewed. She also provides an inside view as to considerations that hospitals have to take into account for the overall financial portfolio and how that may play into determining salaries, wages, and benefits. Lauren Klein, MAcc, CPA, Executive Director, Financial Operations, Main Campus Submarket, Cleveland Clinic, Cleveland, OH. Linkedin: https://www.linkedin.com/in/lauren-klein-cpa-67787213/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 16, 2024

Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 15, 2024

Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 14, 2024

This second episode of our 4 part "What’s Your Worth” series picks up what Dr. Maykel left off. Strategies regarding contracts and what can be negotiated into your contract are reviewed. In addition, gender-equity differences are discussed, as well as strategies to approach your contract negotiations depending on the stage in your career. Justin A. Maykel, MD - Chief, Division of Colorectal Surgery, UMASS Medical Center, Worcester, MA. https://www.ummhealth.org/about-us/our-caregivers/caregiver-justin-maykel-md-colorectal-surgeon-chief-division-colorectal-surgery X; @JustinMaykel Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 11, 2024

Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General. Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios. El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito. La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen. Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web ( behindtheknife.org ). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material. Si los comentarios son positivos, traduciremos todo nuestro curso al español. presentadores de podcast: - Auri P. Garcia Gonzalez, MD PhD nació en San Juan, Puerto Rico, y se trasladó a los Estados Unidos en el 2012 para sus estudios graduados. Actualmente, es estudiante de post-grado en cirugía general en Duke University. - Diego Schaps, MD, MPH es un residente de cirugía general en Duke y nació en Miami, en el estado de la Florida. Sus padres nacieron en El Salvador. Disclaimer: Los productos de contenido de Behind the Knife son únicamente para fines educativos. No diagnosticamos, tratamos ni ofrecemos consejos específicos para pacientes. ------ Behind the Knife is the world's leading surgical podcast and surgical education platform. Our mission is to create innovative surgical education content that is accessible to all. We are very excited to expand into the spanish audience and bring you 4 sample episodes of our General Surgery Oral Board Review Course which will be released over the course of the next week. Today, you'll hear a sample scenario from this comprehensive audio review course which includes 100 scenarios. The course has an exciting and entirely unique format. Each of the 100 scenarios includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are five to seven minutes long and include a variety of tactics and styles. If you're able to achieve this level of performance in your preparation, you are sure to pass the oral exam with flying colors. The second part introduces high yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy to understand teaching that covers the most confusing topics that we face as general surgeons. We are confident you will find this unique dual format approach a highly effective way to prepare for the test. Our content is available on our iOS and Android apps and website ( behindtheknife.org ). Please check the show notes for more information. We would love to hear your feedback by emailing hello@behindtheknife.org and appreciate your help spreading the word to your colleagues if you enjoy the material. If feedback is positive, we will translate our entire course to Spanish. Hosts: - Auri P. Garcia Gonzalez, MD PhD was born and raised in San Juan, Puerto Rico and moved to the US in 2012 for graduate studies. At present, she is a surgical resident at Duke University. - Diego Schaps, MD, MPH is a general surgery resident at Duke and was born in Miami, Florida. His parents were born in El Salvador. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 10, 2024

Our first episode in our 4 part "What’s Your Worth” series introduces some of the basics of identifying all that factors that go into determining your worth as a surgeon. Topics vary from your “value" (ie., contribution margin, profit margin), revenue structure, hospital costs, and value based case. Further, Dr. Maykel covers how physician salaries are determined, average salaries across a spectrum of disciplines, and resources to find out more. Justin A. Maykel, MD - Chief, Division of Colorectal Surgery, UMASS Medical Center, Worcester, MA. https://www.ummhealth.org/about-us/our-caregivers/caregiver-justin-maykel-md-colorectal-surgeon-chief-division-colorectal-surgery X; @JustinMaykel Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 7, 2024

In this episode, we review key components of the landmark MAGIC and FLOT-4 trials that investigated perioperative chemotherapy in the treatment of locally advanced gastric cancer. We discuss limitations of both trials and the evolving clinical landscape of gastric cancer treatment. Hosts : - Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist/HPB surgeon at Brooke Army Medical Center. - Daniel Nelson, DO, FACS (@usarmydoc24) is a Surgical Oncologist/HPB surgeon at Kaiser Permanente Los Angeles Medical Center. - Connor Chick, MD (@connor_chick) is a Surgical Oncology Senior Fellow at Ohio State. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology Junior Fellow at MD Anderson Cancer Center. - Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center. Learning Objectives: 1. Understand background, methodology, results, and interpretation of the MAGIC trial. 2. Understand background, methodology, results, and interpretation of the FLOT trial. 3. Be able to discuss the evolution of chemotherapeutic regimens in the treatment of locally advanced gastric cancer and rationale for their use. 4. Be able to describe key limitations for the above regimens. 5. Discuss the the evolving clinical landscape for chemotherapy in gastroesophageal junction tumors. Links to Papers Referenced in this Episode: Journal Articles: Cunningham, D., Allum, W. H., Stenning, S. P., Thompson, J. N., Van de Velde, C. J., Nicolson, M., ... & Chua, Y. J. (2006). Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. New England Journal of Medicine , 355 (1), 11-20. https://pubmed.ncbi.nlm.nih.gov/16822992/ Al-Batran, S. E., Homann, N., Pauligk, C., Goetze, T. O., Meiler, J., Kasper, S., ... & Hofheinz, R. D. (2019). Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. The Lancet , 393 (10184), 1948-1957. https://pubmed.ncbi.nlm.nih.gov/30982686/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Oct 3, 2024

Is the medical publishing industry a scam? As the open access model has grown, pay-to-publish has helped large publishers maintain profit margins similar to that of large tech companies. The problem? They do so by exploiting the blood, sweat, and tears of academics and the institutions that support them. Join Dr. Patrick Georgoff (@georgoff, Duke Surgery), Dr. Ayman Ali (BTK education fellow, Duke Surgery), and special guest Dr. Allan Detsky for an engaging discussion. Paper discussed: The Changing Medical Publishing Industry: Economics, Expansion, and Equity ( https://link.springer.com/article/10.1007/s11606-023-08307-z ) DR. ALLAN S. DETSKY, MD, PhD, FRCPC, CM is Professor, Institute of Health Policy, Management and Evaluation, and Department of Medicine at the University of Toronto; former Physician-in-Chief, Mount Sinai Hospital(1997-2009); and former Head of the Division of General Internal Medicine at The Toronto Hospital and University of Toronto (1987-1997). Dr. Detsky received his B.S. from Massachusetts Institute of Technology, his M.D. from Harvard Medical School, and his Ph.D. (in Economics) from Massachusetts Institute of Technology in 1978. He has served on the editorial board of the New England Journal of Medicine, and as a member of the Drug Quality and Therapeutics Committee for the Province of Ontario where he spearheaded the effort to formally include cost-effectiveness considerations into the Canadian drug reimbursement process. Dr. Detsky has received 2 Tony nominations as a producer (Jesus Christ Superstar 2012, Come From Away 2017 and an Olivier Award for Best Musical in 2018. In June 2018, he was appointed by the Governor General to the Order of Canada. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Sep 30, 2024

Welcome to the first episode of our new collaborative series with the Association of Surgeons in Great Britain and Ireland! During this series, BTK fellow Jon Williams and ASGBI hosts Kellie Bateman and Jared Wohlgemut compare and contrast the surgeon profession between the United States and the United Kingdom, debating who does what better. In this episode, we take a deep dive into surgical training in the US and the UK, from fostering student interest to trainee operating to specialization and certification. Dr. Jeremy Lipman represents the US while Dr. Jon Lund represents the UK in this thought-provoking conversation. Dr. Lipman is a colorectal surgeon at the Cleveland Clinic and the director of graduate medical education for all training programs at the Cleveland Clinic. Additionally, he is an Associate Dean for Graduate Medical Education and Professor of Surgery at Case Western Reserve University. After going to Boston College for his bachelor degree, he obtained his medical degree from Drexel University College of Medicine in Philadelphia. Subsequently he completed his general surgery residency training at Case Western and his colorectal surgery fellowship at Cleveland Clinic. After practicing at MetroHealth Medical Center where he served many training and education leadership roles, he returned to Cleveland Clinic as faculty where he remains today. Dr. Lund is Professor and Head of the Department of Surgery at University of Nottingham at Derby, and Consultant Colorectal Surgeon at Royal Derby Hospital. He is Chair of the Joint Committee on Surgical Training, and before that was Surgical Director of the Intercollegiate Surgical Curriculum Programme, the online training management system used by all trainees and trainers in Surgery in the UK. He has recently been appointed as Dean of education at the Royal College of Surgeons of Edinburgh. So, who trains surgeons better? UK or US? Give the episode a listen and decide for yourself! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Sep 26, 2024

In this episode, podcast hosts Dr. Josh Roshal, Dr. Darian Hoagland, and Dr. Maya Hunt dive into two important papers that provide guidance on navigating the hidden curriculum of the surgical residency match process. Joined by fellow CoSEF members Dr. Ariana Naaseh and Dr. John Woodward, the discussion revolves around practical tips for finding your perfect surgical residency and filtering out the noise during the application process. Journal Club Hosts: –Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, jaroshal@utmb.edu –Dr. Darian Hoagland, Beth Israel Deaconess Medical Center, @DHoaglandMD, dlhoagla@bidmc.harvard.edu –Dr. Maya Hunt, Indiana University, @dr_mayathehunt, mayahunt@iu.edu –CoSEF: @surgedfellows, cosef.org Journal Club Authors: -Dr. Ariana Naaseh, Washington University in St. Louis, @ariananaaseh, a.naaseh@wustl.edu -Dr. John Woodwad, University at Buffalo, @JohnWoodward76, jmwoodwa@buffalo.edu Medical Students: -Rachel Kalbfell (MS4), Washington University in St. Louis, @rachelkalbfell, rkalbfell@wustl.edu -Keith Makhecha (MS4), Indiana University, kmakhech@iu.edu R eferences: 1. Woodward JM, Lund S, Brian R, Anand A, Moreci R, Navarro SM, Zarate Rodriguez J, Naaseh A, Tate K, Roshal J, Silvestri C, Gan CY, Sathe T, Thornton SW, Cloonan M, Weaver L, Oh MH, Godley F, L’Huillier JC. Find Your Perfect Match for Surgical Residency: Six Steps to Building Your BRANDD from the Collaboration of Surgical Education Fellows. Annals of Surgery. 2024;5(3). doi:10.1097/AS9.0000000000000466. 2. Naaseh A, Roshal J, Silvestri C, Woodward JM, Thornton SW, L’Huillier JC, Hunt M, Sathe TS, Hoagland DL, Godley F IV, Jindani R, Tieken KR, Rodriguez JGZ, Anand A, Chen JH, Navarro SM, Lund S. Filter Out the Noise: How to Narrow Your Search for the Perfect Match by the Collaboration of Surgical Education Fellows (CoSEF). Journal of Surgical Education. 2024;81(10):1394-1399. doi:10.1016/j.jsurg.2024.07.010 https://pubmed.ncbi.nlm.nih.gov/39178489/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Sep 23, 2024

Low urine output – when is it a cause for alarm? Emma Burke is joined by Dr. Bryan Tucker to discuss quick hits on acute kidney injury as part of the Med/Surg Consult series. Host: - Emma Burke, MD – General Surgery Resident at Baylor College of Medicine, @emmaburke017 Guest: - Bryan Tucker, DO – Nephrologist at Baylor College of Medicine, @bmtucker3 Learning Objectives: - Define acute kidney injury (AKI) using KDIGO guidelines. - Develop a framework for initial workup of perioperative AKI. - Discuss the importance of in urine output in AKI management. - Identify AKI risk factors and preventative measures for high-risk surgical patients. References: - KDIGO AKI Guidelines: https://kdigo.org/guidelines/acute-kidney-injury/ Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. DOMINATE THE DAY

Sep 19, 2024

Welcome to another episode of our medicine-surgery consult series! If your case was just cancelled because you and your patient did not know to hold their new GLP-1 agonist and you’re wondering what to do in the interim, this may be the perfect time to tune into a quick refresher of diabetes quick-hits as it pertains to surgical teams. You’ve just finished rolling a patient up to the OR in the middle of the night after a gunshot wound to the chest, and now you need to deal with something even more intimidating – finishing admission orders on your patient with chronic, poorly controlled diabetes on 7 different medications. Join Dr. Katherine Neal and Ayman Ali as they go over some general principles and tips and tricks in this ever-growing and complicated patient cohort! Hosts: Katherine Neal, MD. Assistant Professor of Medicine, Duke Hospital. Ayman Ali, MD. General Surgery PGY-3, Duke University School of Medicine. Learning Objectives: General principles of in-patient diabetes management Review of common medications and their side effects Learn some common pitfalls and how to avoid them Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. DOMINATE THE DAY

Sep 16, 2024

You're the new intern on your first night of night float. First page, right off the bat – AFib with rates into the 150s. What's your next move?! Dr. Nathan Anderson takes the anxiety out of approaching Atrial Fibrillation in the post-operative patient. Join him and Dr. Elizabeth Maginot as they discuss this very common post-operative you're guaranteed to see on the wards. Hosts : - Dr. Nathan Anderson, Internal Medicine Associate Professor and Hospitalist, University of Nebraska - Dr. Elizabeth Maginot, General Surgery Resident and BTK Surgical Education Fellow, University of Nebraska Medical Center, Twitter: @e_magination95 Learning Objectives : - Discuss the underlying pathophysiological mechanisms that contribute to the development of atrial fibrillation in the postoperative setting. - Critically approach the different management options for atrial fibrillation in the post-cardiac and non-cardiac surgery settings, including rate versus rhythm control, indications for cardioversion, and the role of anticoagulation. - Identify common risk factors for atrial fibrillation in the post-operative setting. - Discuss long-term management and follow-up strategies for patients who develop atrial fibrillation after surgery. References : 1. Bhave PD, Goldman LE, Vittinghoff E, Maselli J, Auerbach A. Incidence, predictors, and outcomes associated with postoperative atrial fibrillation after major noncardiac surgery. AmericanHeart Journal . 2012;164(6):918-924. doi:10.1016/j.ahj.2012.09.004 https://pubmed.ncbi.nlm.nih.gov/23194493/ 2. Gialdini G, Nearing K, Bhave PD, et al.. Perioperative Atrial Fibrillation and the Long-term Risk ofIschemic Stroke. JAMA . 2014;312(6):616. doi:10.1001/jama.2014.9143 https://pubmed.ncbi.nlm.nih.gov/25117130/ 3. Snow V, Weiss KB, LeFevre M, McNamara R, Bass E, Green LA, Michl K, Owens DK, Susman J, Allen DI, Mottur-Pilson C; AAFP Panel on Atrial Fibrillation; ACP Panel on Atrial Fibrillation.Management of newly detected atrial fibrillation: a clinical practice guideline from the AmericanAcademy of Family Physicians and the American College of Physicians. Ann Intern Med. 2003 Dec16;139(12):1009-17. doi: 10.7326/0003-4819-139-12-200312160-00011. PMID: 14678921. https://pubmed.ncbi.nlm.nih.gov/14678921/ 4. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NewEngland Journal of Medicine . 2002;347(23):1825-1833. doi:10.1056/nejmoa021328 https://pubmed.ncbi.nlm.nih.gov/12466506/ Learn more about our Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship course and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. DOMINATE THE DAY

Sep 12, 2024

Parastomal hernias are some of the toughest cases in abdominal wall reconstruction. Join Drs. Ajita Prabhu, Lucas Beffa, Sara Maskal and Ryan Ellis as they talk through their approach to these difficult cases. Hosts: - Ajita Prabhu, MD, Cleveland Clinic, @aprabhumd1 - Lucas Beffa, MD, Cleveland Clinic, @BeffaLukeMD - Ryan Ellis, MD, Cleveland Clinic, @EllisMD2020 - Sara Maskal, MD, Cleveland Clinic Learning Objectives: - Review anatomy of parastomal abdominal wall hernias - Review perioperative pitfalls and tips for staying out of trouble - Review common surgical approaches to repair References: - Maskal SM, Ellis RC, Miller BT. Parastomal hernia repair, trying to optimize the impossible reconstruction. Hernia. 2024 Apr 28:1-6. https://pubmed.ncbi.nlm.nih.gov/38678529/ - Maskal SM, Thomas JD, Miller BT, Fafaj A, Zolin SJ, Montelione K, Ellis RC, Prabhu AS, Krpata DM, Beffa LR, Costanzo A. Open retromuscular keyhole compared with Sugarbaker mesh for parastomal hernia repair: Early results of a randomized clinical trial. Surgery. 2024 Mar 1;175(3):813-21. https://pubmed.ncbi.nlm.nih.gov/37770344/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Sep 9, 2024

A patient with a large TBSA burn injury is transferred to a regional burn center. You are faced with some difficult clinical decisions as the resuscitation proves to be challenging. Join Drs. Tam Pham, Rob Cartotto, Julie Rizzo, Alex Morzycki and Jamie Oh as they discuss the clinical challenges in titrating and troubleshooting during acute burn resuscitation. Hosts: · Dr. Tam Pham: UW Medicine Regional Burn Center · Dr. Robert Cartotto: University of Toronto, Ross Tilley Burn Centre · Dr. Julie Rizzo: Brooke Army Medical Center · Dr. Alex Morzycki: UW Medicine Regional Burn Center · Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: · Understand the role of colloids as complement/rescue to standard crystalloid fluid titration. · Identify the fluid threshold associated with development of abdominal compartment syndrome · Understand the role of continuous renal replacement therapy for patients with acute kidney injury during the resuscitation phase. · List specific patient populations who may experience a more difficult resuscitation. References: 1. Ivy ME, Atweh NA, Palmer J, et al. Intra-abdominal hypertension and abdominal compartment syndrome in burn patients. J Trauma 2000 https://pubmed.ncbi.nlm.nih.gov/11003313/ 2. Cartotto R, Johnson LS, Savetamal A, et al. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. J Burn Care Res 2023 https://pubmed.ncbi.nlm.nih.gov/38051821/ 3. Greenhalgh DG, Cartotto R, Taylor SL, et al. Burn Resuscitation practices in North America: results of the Acute Burn ResUscitation Prospective Trial (ABRUPT). Ann Surg 2023 https://pubmed.ncbi.nlm.nih.gov/34417368/ 4. Cartotto R, Callum J. A review of the use of human albumin in burn patients. J Burn Care Res 2012 https://pubmed.ncbi.nlm.nih.gov/23143614/ 5. Cruz MV, Carney BC, Luker JN, et al. Plasma ameliorates endothelial dysfunction in burn injury. J Surg Res 2019 https://pubmed.ncbi.nlm.nih.gov/30502286/ 6. Falhstrom K, Boyle C, Makic MBF. Implementation of a nurse-driven burn resuscitation protocol: a quality improvement project. Critical Care Nurses 2013 https://pubmed.ncbi.nlm.nih.gov/23377155/ 7. Salinas J, Chung KK, Mann EA, et al. Computerized decision support system improves fluid resuscitation following severe burns: an original study. Crit Care Med 2011 https://pubmed.ncbi.nlm.nih.gov/21532472/ 8. Kenney CL, Singh P, Rizzo J, et al. Impact of alcohol and methamphetamine use on burn resuscitation. J Burn Care Res 2023 https://pubmed.ncbi.nlm.nih.gov/37227949/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Sep 5, 2024

Are you ready to DOMINATE surgery? Well let's go! Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos. Go beyond rote memorization and learn what really matters. We are talking practical, high-yield, and engaging content all available at your fingertips. Get the information you need to know FAST. Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered. Today's episode includes 2 sample episodes from this course. Learn more and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship More Behind the Knife Student Resources: https://app.behindtheknife.org/students Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. DOMINATE THE DAY

Sep 2, 2024

Are you ready to DOMINATE surgery? Well let's go! Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos. Go beyond rote memorization and learn what really matters. We are talking practical, high-yield, and engaging content all available at your fingertips. Get the information you need to know FAST. Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered. Today's episode includes 2 sample episodes from this course. Learn more and preview a full chapter here: https://app.behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship More Behind the Knife Student Resources: https://app.behindtheknife.org/students Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. DOMINATE THE DAY

Aug 29, 2024

Join for the fifth episode in the Association of Out Surgeons and Allies (AOSA) series for a comprehensive discussion of what the general surgeon needs to know prior to operating on a patient who has previously undergone gender affirming surgery. Host: Dan Scheese, MD Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center Guests: Dr. Megan Lane (She/her) megalane@med.umich.edu Dr. Lane is a plastic surgery resident at the University of Michigan who is planning on going into Gender Affirming Surgery and general reconstruction. She completed a research fellowship in the National Clinician Scholars Program and focused primarily on patient-reported outcomes in gender affirming surgery. Dr. Amy Suwanabol pasuwan@med.umich.edu Dr. Suwanabol is a colorectal surgeon at the University of Michigan and the Ann Arbor VA. She assists the gender affirming surgeons at the University of Michigan in performing robotic-assisted vaginoplasty. Her research focuses on optimizing quality of life among surgical patients and their families, surgeon well-being, and cancer survivorship. Dr. Monica Llado-Farrulla lladorfar@ohsu.edu Dr. Llado-Farrulla was born and raised in Puerto-Rico, completed general surgery residency followed by plastic surgery residency at Tulane and Penn, respectively. She pursued a year of training in advanced gender surgery and is now currently at OHSU. Her practice largely focuses on facial feminization, chest affirming surgeries, phalloplasty, autologous breast reconstruction, and limb salvage. Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 26, 2024

Have you ever been confused about the concept of brain death, or struggled to explain brain death to a patient’s family or your fellow clinicians? Join the Behind the Knife Surgical Palliative Care team and our special guest, neurologist & neurointensivist Dr. Sarah Wahlster, as we explore the 2023 Pediatric & Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline and what this updated guideline means for our practice in surgical palliative care! Hosts: Dr. Katie O’Connell (@katmo15) is an Associate Professor of Surgery at the University of Washington in the division of Trauma, Burn, and Critical Care Surgery. She is a trauma surgeon, palliative care physician, Director of Surgical Palliative Care, and founder of the Advance Care Planning for Surgery Clinic at Harborview Medical Center in Seattle, WA. Dr. Virginia Wang is a PGY-3 General Surgery resident at the University of Washington. Guest: Dr. Sarah Wahlster (@SWahlster) is an Associate Professor of Neurology at the University of Washington. She is a neurologist, neurointensivist, and Program Director of the Neurocritical Care Fellowship at Harborview Medical Center in Seattle, WA. Learning Objectives: · Understand the concept of assent and how it can be helpful in communicating with families of patients who have sustained brain death · Explain the main steps required for diagnosis of brain death (prerequisites, clinical exam, apnea testing, ancillary testing) · Understand key differences between the 2023 guideline and previous (2010 & 2011) guidelines · Be able to name the 3 accepted modalities of ancillary testing for brain death · Know basic communication best practices with families of patients who have sustained brain death from the surgical palliative care perspective (consistency of language & messaging; avoidance of phrases such as “life-sustaining treatment”, “comfort-focused measures”) References: 1. Greer, D. M., Kirschen, M. P., Lewis, A., Gronseth, G. S., Rae-Grant, A., Ashwal, S., Babu, M. A., Bauer, D. F., Billinghurst, L., Corey, A., Partap, S., Rubin, M. A., Shutter, L., Takahashi, C., Tasker, R. C., Varelas, P. N., Wijdicks, E., Bennett, A., Wessels, S. R., & Halperin, J. J. (2023). Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline. Neurology, 101(24), 1112–1132. https://doi.org/10.1212/WNL.0000000000207740 2. Lewis, A., Kirschen, M. P., & Greer, D. (2023). The 2023 AAN/AAP/CNS/SCCM Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Practice Guideline: A Comparison With the 2010 and 2011 Guidelines. Neurology. Clinical practice, 13(6), e200189. https://doi.org/10.1212/CPJ.0000000000200189 3. AAN Interactive Brain Death/Death by Neurologic Criteria Evaluation Tool – https://www.aan.com/Guidelines/BDDNC 4. AAN Brain Death/Death by Neurologic Criteria Checklist – https://www.aan.com/Guidelines/Home/GetGuidelineContent/1101 5. Kirschen, M. P., Lewis, A., & Greer, D. M. (2024). The 2023 American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine Pediatric and Adult Brain Death/Death by Neurologic Criteria Determination Consensus Guidelines: What the Critical Care Team Needs to Know. Critical care medicine, 52(3), 376–386. https://doi.org/10.1097/CCM.0000000000006099 6. Greer, D. M., Shemie, S. D., Lewis, A., Torrance, S., Varelas, P., Goldenberg, F. D., Bernat, J. L., Souter, M., Topcuoglu, M. A., Alexandrov, A. W., Baldisseri, M., Bleck, T., Citerio, G., Dawson, R., Hoppe, A., Jacobe, S., Manara, A., Nakagawa, T. A., Pope, T. M., Silvester, W., … Sung, G. (2020). Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project. JAMA, 324(11), 1078–1097. https://doi.org/10.1001/jama.2020.11586 7. Lele, A. V., Brooks, A., Miyagawa, L. A., Tesfalem, A., Lundgren, K., Cano, R. E., Ferro-Gonzalez, N., Wongelemegist, Y., Abdullahi, A., Christianson, J. T., Huong, J. S., Nash, P. L., Wang, W. Y., Fong, C. T., Theard, M. A., Wahlster, S., Jannotta, G. E., & Vavilala, M. S. (2023). Caseworker Cultural Mediator Involvement in Neurocritical Care for Patients and Families With Non-English Language Preference: A Quality Improvement Project. Cureus, 15(4), e37687. https://doi.org/10.7759/cureus.37687 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 22, 2024

Our oral board review course includes 100 scenarios that meticulously cover 115 SCORE core topics. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing. Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium **Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 19, 2024

Need a dose of inspiration? You found it here. This interview with Dr. Ammar Darwish will have you in awe. Dr. Darwish is a general and trauma surgery at Manchester University NHS Foundation Trust and Medical Director at The David Nott Foundation ( https://davidnottfoundation.com/ ). Dr. Darwish volunteers for intensely dangerous but highly impactful surgical humanitarian missions in conflict zones around the world. In fact, he has been deployed to over 50 global humanitarian missions in the last 15 years. He is passionate about helping victims of conflict and natural disaster by better equipping and training doctors who care for them. Want to learn more about the Nott Foundation? Good! You should. Check out their website for more: https://davidnottfoundation.com/ Interview with Dr. David Knott: https://app.behindtheknife.org/podcast/war-doctor-david-nott-on-surgery-in-war-zones Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 15, 2024

Join our Emergency General Surgery team as we talk about the dreaded difficult duodenum. We discuss two cases on a common disease that has now become a rarity in surgical management. We cover principles of combined assessment and resuscitation, diagnosis and helpful adjuncts, and multidisciplinary and surgical management. Hosts: Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross We have come a long way from managing duodenal emergencies with vagotomies since the widespread use of proton pump inhibitors. But surgeons and trainees still need to gain competence in managing duodenal emergencies, despite the dearth of operative interventions often encountered. We discuss the two most common presentations related to duodenal ulcers - bleeding and perforation. We focus on resuscitation, damage-control surgery, and the role of non-surgical management options. Learning Objectives: - Learn to investigate and resuscitate patients with upper gastrointestinal bleeding - Develop an approach to the management of upper gastrointestinal bleeding - Understand the risks and benefits of various surgical techniques for dealing with perforated duodenal ulcers References: Tarasconi, A., Coccolini, F., Biffl, W.L. et al. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg 15, 3 (2020). https://doi.org/10.1186/s13017-019-0283-9 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 12, 2024

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss the controversial management of colon cancer of the splenic flexure. What procedure do you perform? Does it matter? Tune in to hear the discussion! Hosts: - Susan Galandiuk MD, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky MD, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas MD, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon DO, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review surgical procedure options for splenic flexure cancer. - Understand the importance of confirming the location of the tumor with imaging and/or endoscopically, perioperatively. - Discuss surgical principles of operating in the left upper quadrant. References: de’Angelis, et al. Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. Surg Endosc. 2021 (35) :661–672. https://pubmed.ncbi.nlm.nih.gov/32072288/ Degiuli M, et al. Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group. Dis Colon Rectum. 2020 Oct;63(10):1372-1382. https://pubmed.ncbi.nlm.nih.gov/32969880/ Manceau G, et al. What Is the Optimal Elective Colectomy for Splenic Flexure Cancer: End of the Debate? A Multicenter Study From the GRECCAR Group With a Propensity Score Analysis. Dis Colon Rectum. 2022 Jan 1;65(1):55-65. https://pubmed.ncbi.nlm.nih.gov/34882628/ Okazaki T, et al. Two Types of Variational Arteries' Courses From the Superior Mesenteric Artery to Supply the Splenic Flexure: Gross Anatomical Study. Dis Colon Rectum. 2024 Jan 1;67(1):120-128. https://pubmed.ncbi.nlm.nih.gov/37493262/ Pang AJ, Marinescu D, Morin N, Vasilevsky CA, Boutros M. Segmental resection of splenic flexure colon cancers provides an adequate lymph node harvest and is a safe operative approach - an analysis of the ACS-NSQIP database. Surg Endosc. 2022 Aug;36(8):5652-5659. https://pubmed.ncbi.nlm.nih.gov/34973078/ Rusli SM, et al. Laparoscopic D3 oncological resection in splenic flexure cancer: Technical details and its impact on long-term survival. Colorectal Dis. 2023 Mar;25(3):431-442. https://pubmed.ncbi.nlm.nih.gov/36281503/ Sakamoto K, et al. Drainage pattern of the splenic flexure vein and its accompanying arteries using three-dimensional computed tomography angiography: a single-centre study of 600 patients. Colorectal Dis. 2023 Aug;25(8):1679-1685. https://pubmed.ncbi.nlm.nih.gov/37221647/ Vargas, HD. Gaining Mesenteric Length following Colorectal Resection: Essential Maneuvers to Avoid Anastomotic Tension. Clin Colon Rectal Surg. 2023 Jan 13;36(1):37-46. https://pubmed.ncbi.nlm.nih.gov/36643828/ Vogel JD, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer. Dis Colon Rectum. 2022 Feb 1;65(2):148-177. https://pubmed.ncbi.nlm.nih.gov/34775402/ Video References “Splenic Flexure Cancers.” Lahey Hospital & Medical Center. Disease of the Colon and Rectum Journal Club. February 28, 2022. https://www.youtube.com/watch?v=87HXHQYMxe4&list=PLMBNyGA6TZajQn4UlDyKxrLakFZb7SC_2&index=23 Varela, C. and Yang, S. Laparoscopic-Assisted Colonic Resection for Splenic-Flexure Cancer With D3 Lymphadenectomy, Diseases of the Colon & Rectum 66(6):p e295-e297, June 2023. https://journals.lww.com/dcrjournal/pages/collectiondetails.aspx?TopicalCollectionID=138&ParentCollection=109 *** TRUELEARN LINK: https://truelearn.referralrock.com/l/BTKPODCAST/ Discount code: BTKPODCAST Using the discount code, you can get a discount of $25 off our Residency (General surgery, anesthesiology, OBGYN, Psychiatry, Peds, Neurology, Emergency Medicine, Internal Medicine, and Family Medicine), USMLE, andCOMLEX SmartBank subscriptions of 90-days or more. The code can also be applied for 15% off our allied healthSmartBanks (PA, Nurse Practitioner, Pharmacy, PT, OT, etc.). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Aug 8, 2024

Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as colorectal surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 51 scenarios here: https://behindtheknife.teachable.com/p/btk-colorectal-surgery-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 5, 2024

Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://app.behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 1, 2024

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here: https://app.behindtheknife.org/course-details/vascular-surgery-oral-board-audio-review Our Vascular Surgery Oral Board Book is available on Amazon here: https://www.amazon.com/dp/B0CZ8ZBF83 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 29, 2024

Pregnancy leads to many physiologic changes, and thyroid and parathyroid disorders alter that physiology even more leading to complex laboratory interpretation and decision-making impacting both mother and fetus. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Vennila Padmanaban from The Ohio State University. Hear about normal and abnormal thyroid and parathyroid physiology and treatment of patients with thyroid cancer. The group discusses several articles focusing on current guidelines from the American Thyroid Association as well as other key studies. Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Vennila Padmanaban, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Twitter handles: Barbra Miller - @OSUEndosurgBSM John Phay – @JohnPhayMD Priya Dedhia – @priyaknows Vennila Padmanaban - @vennilapadmanMD Learning objectives: 1) Understand normal changes in thyroid and parathyroid physiology during pregnancy 2) Describe the impact of thyroid and parathyroid dysregulation on maternal and fetal health 3) Compare and contrast management of thyroid and parathyroid disorders during pregnancy vs. non-pregnancy 4) Recognize the importance of multidisciplinary care of patients with thyroid and parathyroid disorders References: 1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457. Erratum in: Thyroid. 2017 Sep;27(9):1212. doi: 10.1089/thy.2016.0457.correx. PMID: 28056690 https://pubmed.ncbi.nlm.nih.gov/28056690/ 2. Jee SB, Sawal A. Physiological Changes in Pregnant Women Due to Hormonal Changes. Cureus. 2024 Mar 5;16(3):e55544. doi: 10.7759/cureus.55544. PMID: 38576690; PMCID: PMC10993087 https://pubmed.ncbi.nlm.nih.gov/38576690/ 3. Patel, Kepal N. MD; Yip, Linwah MD; Lubitz, Carrie C. MD, MPH; Grubbs, Elizabeth G. MD; Miller, Barbra S. MD; Shen, Wen MD; Angelos, Peter MD; Chen, Herbert MD; Doherty, Gerard M. MD; Fahey, Thomas J. III MD; Kebebew, Electron MD; Livolsi, Virginia A. MD; Perrier, Nancy D. MD; Sipos, Jennifer A. MD; Sosa, Julie A. MD; Steward, David MD; Tufano, Ralph P. MD; McHenry, Christopher R. MD; Carty, Sally E. MD. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Annals of Surgery 271(3):p e21-e93, March 2020. DOI: 10.1097/SLA.0000000000003580 https://pubmed.ncbi.nlm.nih.gov/32079830/ 4. Appelman-Dijkstra NM, Pilz S. Approach to the Patient: Management of Parathyroid Diseases Across Pregnancy. J Clin Endocrinol Metab. 2023 May 17;108(6):1505-1513. doi: 10.1210/clinem/dgac734. PMID: 36546344; PMCID: PMC10188304 https://pubmed.ncbi.nlm.nih.gov/36546344/ 5. Eremkina A, Bibik E, Mirnaya S, Krupinova J, Gorbacheva A, Dobreva E, Mokrysheva N. Different treatment strategies in primary hyperparathyroidism during pregnancy. Endocrine. 2022 Sep;77(3):556-560. doi: 10.1007/s12020-022-03127-3. Epub 2022 Jul 12. PMID: 35821184 https://pubmed.ncbi.nlm.nih.gov/35821184/ TRUELEARN LINK: https://truelearn.referralrock.com/l/BTKPODCAST/ Discount code: BTKPODCAST Using the discount code, you can get a discount of $25 off our Residency (General surgery, anesthesiology, OBGYN, Psychiatry, Peds, Neurology, Emergency Medicine, Internal Medicine, and Family Medicine), USMLE, andCOMLEX SmartBank subscriptions of 90-days or more. The code can also be applied for 15% off our allied healthSmartBanks (PA, Nurse Practitioner, Pharmacy, PT, OT, etc.). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 25, 2024

Does the adult thymus have a purpose and function? Are there any long-term health effects of thymectomy? Tune in to another Swedish Thoracic surgery journal review where we discuss the recent paper out of the NEJM which reports on the health consequences of thymus removal in adults. This paper has been widely picked up by the media and our patients frequently bring it into the office. Listen as we discuss the study population, methods, and potential applications of this paper. Learning Objectives: - Review the purpose and function of the thymus. - Discuss the population, methods, and results of this trial. - Discuss the application of this paper and how it may or may not impact clinical practice for thoracic surgeons. Hosts: Chloe E. Hanson, MD, PGY-3 Kelly Daus MD, PGY-4 Peter White, MD, Thoracic Surgery Attending Brian Louie, MD, Thoracic Surgery Attending Reference Material: Kooshesh KA, Foy BH, Sykes DB, Gustafsson K, Scadden DT. Health Consequences of Thymus Removal in Adults. N Engl J Med. 2023;389(5):406-417. https://pubmed.ncbi.nlm.nih.gov/37530823/ Lin TM, Chang YS, Hou TY, et al. Risk of incident autoimmune diseases in patients with thymectomy. Ann Clin Transl Neurol. 2020;7(7):1072-1082. https://pubmed.ncbi.nlm.nih.gov/32478484/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 22, 2024

Did you know that 13% of trauma patients who go home with an opioid prescription will develop opioid dependence? Multimodal pain regimens not only reduce opioid consumption, but also improve pain control. On this episode of the BIG T TRAUMA series, we explore a multimodal approach to pain management...and tackle some surgical dogma along the way. Hosts: Patrick Georgoff, MD, Trauma Surgeon, Duke University, @georgoff Teddy Puzio, MD, Trauma Surgeon, University of Texas Houston Gabby Hatton, MD, Trauma Surgery fellow, University of Texas Houston References: 1. Rate and Risk Factors Associated With Prolonged Opioid Use After Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2020: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767637 2. Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey. Injury Prevention 2017: https://pubmed.ncbi.nlm.nih.gov/27597400/ 3. Ketamine For Acute Pain After Trauma (KAPT): A Pragmatic, Randomized Clinical Trial. J Trauma 2024: https://pubmed.ncbi.nlm.nih.gov/38689402/ 4. EAST PMG: Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma (2023): https://www.east.org/education-resources/practice-management-guidelines/details/efficacy-and-safety-of-nonsteroidal-antiinflammatory-drugs-nsaids-for-the-treatment-of-acute-pain-af 5. Systematic Review and Meta-Analysis of the Association Between Non-Steroidal Anti-Inflammatory Drugs and Operative Bleeding in the Perioperative Period. JACS 2021: https://pubmed.ncbi.nlm.nih.gov/33515678/ 6. Is the use of nonsteroidal anti-inflammatories after bowel anastomosis in trauma safe? J Trauma 2023: https://pubmed.ncbi.nlm.nih.gov/36728125/ 7. University of Texas at Houston Multimodal Pain Guideline: https://med.uth.edu/surgery/acute-trauma-pain-multimodal-therapy/ 8. ACS TRAUMA QUALITY PROGRAMS BEST PRACTICES GUIDELINES FOR ACUTE PAIN MANAGEMENT IN TRAUMA PATIENTS: https://www.facs.org/media/exob3dwk/acute_pain_guidelines.pdf Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 18, 2024

A 70 year old healthy female is referred to you with a 5.7 cm abdominal aortic aneurysm. As an astute clinician you are aware that current guidelines support surgical repair for her AAA. What if there was new data to suggest this patient may not benefit from repair? What would be the optimal size threshold that she would benefit from AAA repair? Tune into this episode of Behind the Knife, where the vascular surgery subspecialty team discusses a paper that challenges current size threshold guidelines for AAA repair. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the current size threshold guidelines for surgical repair of abdominal aortic aneurysms - Understand the limitations of the aforementioned guidelines - Understand the methodology, findings, limitations, and clinical applications of the manuscript “Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration.” References 1. Columbo JA, Scali ST, Jacobs BN, et al. Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration. Journal of Vascular Surgery. 2024;79(5):1069-1078.e8. doi:10.1016/j.jvs.2024.01.017 https://pubmed.ncbi.nlm.nih.gov/38262565/ 2. Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. Journal of Vascular Surgery. 2018;67(1):2-77.e2. doi:10.1016/j.jvs.2017.10.044 https://pubmed.ncbi.nlm.nih.gov/29268916/ 3. Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. Editor’s Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. European Journal of Vascular and Endovascular Surgery. 2024;67(2):192-331. doi:10.1016/j.ejvs.2023.11.002 https://pubmed.ncbi.nlm.nih.gov/38307694/ 4. The UK Small Aneurysm Trial Participants, Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet 1998;352 (9141) 1649- 1655 https://pubmed.ncbi.nlm.nih.gov/9853436/ 5. Lederle FAWilson SEJohnson GR et al. Aneurysm Detection and Management Veterans Affairs Cooperative Study Group, Immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 2002;346 (19) 1437- 1444 https://pubmed.ncbi.nlm.nih.gov/12000813/ 6. United Kingdom EVAR Trial Investigators; Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D. Endovascular repair of aortic aneurysm in patients physically ineligible for open repair. N Engl J Med. 2010 May 20;362(20):1872-80. doi: 10.1056/NEJMoa0911056. Epub 2010 Apr 11. PMID: 20382982. https://pubmed.ncbi.nlm.nih.gov/20382982/ 7. Lederle FA, Johnson GR, Wilson SE, Ballard DJ, Jordan WD Jr, Blebea J, Littooy FN, Freischlag JA, Bandyk D, Rapp JH, Salam AA; Veterans Affairs Cooperative Study #417 Investigators. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002 Jun 12;287(22):2968-72. doi: 10.1001/jama.287.22.2968. PMID: 12052126. 8. Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, Adams JL, Chang RW. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022 Jan;75(1):109-117. doi: 10.1016/j.jvs.2021.07.125. Epub 2021 Jul 26. PMID: 34324972. https://pubmed.ncbi.nlm.nih.gov/34324972/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 15, 2024

Take a listen into the wild and fascinating world of lung transplantation! One of the biggest challenges for any transplant is organ preservation to provide the best possible recovery and outcome for recipients. That’s especially important for lung transplant, which remains one of the most complex and challenging areas in the field of transplantation. This episode takes a deep dive into the lung transplant landscape and discusses new technologies and innovations that are revolutionizing the field. Jon Williams is joined by Dr. Elliot Wakeam, MD, a thoracic surgeon and lung transplant expert from University of Toronto to discuss the advent of ex-vivo lung perfusion (EVLP) systems and how that and other preservation techniques may impact the future of lung transplantation. Also, Dr. Wakeam provides unique perspectives as faculty from one of the best lung transplant programs in the world. If you have any questions or comments, or find the episode interesting and want to learn more, feel free to reach out to us at hello@behindtheknife.org . Dominate the Day! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 11, 2024

As we move towards a model of Competency-Based Surgical Education, individualization of training may be needed. How can we get the right education to the right trainee at the right time? How can we link education to actual patient outcomes? Precision education aims to do just that, while leveraging technology, data, and analytics to decrease burden on assessors. While this approach offers a lot of promise to advance surgical education, it can be difficult to conceptualize how this would be implemented in practice. We’re joined by an expert in the field of precision medical education, Dr. Jesse Burk-Rafel, to break down what precision education is and how it might integrate into our current system of surgical education Join hosts Nicole Brooks MD, Judith French PhD, and Jeremy Lipman MD, MHPE for this exciting conversation with Jesse Burk-Rafel MD. Learning Objectives 1. Listeners will define precision education. 2. Listeners will describe examples of how precision medical or surgical education is being used currently. 3. Listeners will explain barriers that must be addressed with the implementation of precision surgical education, including bias and issues with data sharing. 4. Listeners will consider how precision surgical education will evolve, including possible use within their own institution to completement competency-based surgical education. References Desai SV, Burk-Rafel J, Lomis KD, et al. Precision Education: The Future of Lifelong Learning in Medicine. Academic Medicine . 2024;99(4). https://pubmed.ncbi.nlm.nih.gov/38277444/ Richardson J, Santen SA, Mejicano GC, et al. Learner Assessment and Program Evaluation: Supporting Precision Education. Academic Medicine . 2024;99(4). https://pubmed.ncbi.nlm.nih.gov/38166211/ Perrone KH, Abdelaal AE, Pugh CM, Okamura AM. Haptics: The Science of Touch As a Foundational Pathway to Precision Education and Assessment. Academic Medicine . 2024;99(4). https://pubmed.ncbi.nlm.nih.gov/38109654/ Sukhera J. Precision Education and Equity: A Participatory Framework to Advance Equitable Assessment. Academic Medicine . 2024;99(4). https://pubmed.ncbi.nlm.nih.gov/38109658/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 8, 2024

In this Journal Review episode, the Hernia Content Team from Carolinas Medical Center reviews the definition and meaning of a hernia center. In a subspecialty field that is in its relative infancy, the specialization of care at hernia centers is a relatively new concept. The team reviews two relevant publications on hernia centers that help to provide guidance on this topic for the hernia community. Hosts: - Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center (Charlotte, NC), @SAyusoMD (Twitter) - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center (Charlotte, NC), @THeniford (Twitter) - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center (Charlotte, NC), @VedraAugenstein (Twitter) - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL), No Twitter handle - Dr. Brittany Mead, GI & MIS Fellow, Carolinas Medical Center (Charlotte, NC), No Twitter handle References: -Shulkin et al, Characterizing Hernia Centers in the United States: What Defines a Hernia Center?, Hernia, 2022 https://pubmed.ncbi.nlm.nih.gov/33871743/ -Köckerling et al, Accreditation and Certification Requirements for Hernia Centers and Surgeons: the ACCESS Project, Hernia, 2019 https://pubmed.ncbi.nlm.nih.gov/33871743/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jul 1, 2024

VTE prophylaxis is more than just some squeezy leg socks and a one-size fits all dose of enoxaparin! Ever wonder how VTE prophylaxis is similar to constipation? Have you or a loved one been hurt by a hospital administrator telling you that VTE is a never event? Come with us, and our special guest Dr. Bryan Cotton, on this journey to the frontier of research attempting to debunk this myth and improve patient care by reducing VTE rates in trauma patients. Hosts: - Michael Cobler-Lichter, MD, PGY4/R2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (X/twitter) - Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow University of Pennsylvania Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency @urrechisme (X/twitter) - Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending: Loma Linda University Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship - Brandon Parker, DO, Assistant Professor of Surgery, 5 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @BrandonParkerDO (X/twitter) - Bryan Cotton, MD, MPH, FACS, Professor of Surgery, 20 years in practice University of Texas Health Science Center at Houston/Red Duke Trauma Institute at Memorial Herman Hospital @bryanacotton1 (X/twitter) Learning Objectives: - Describe the rationale for the addition of aspirin to chemoprophylactic regimens for VTE - Identify appropriate screening systems for trauma patients at high risk for VTE - Describe the rationale for monitoring anti factor Xa levels in the trauma population receiving VTE chemoprophylaxis - List the major conclusions of the two studies discussed regarding the addition of aspirin to VTE chemoprophylaxis regimens in trauma patients, and the change in antithrombin activity levels over time in relation to enoxaparin responsiveness in polytrauma patients Quick Hits: 1. On adjusted analysis, the standard VTE PPX plus aspirin group had a lower OR of developing VTE, though limitations of this study highlight need for future prospective work 2. Trauma patients often suffer from decreased activity of antithrombin 3, which may mediate the relatively higher rates of VTE in this population. 3. Trauma patients who went on to develop VTE were more likely to not achieve satisfactory anti Xa levels, with a VTE rate of 30% in the never-responder group, the group for which Xa levels were never higher than 0.2 4. Ex vivo supplementation of antithrombin seems to improve enoxaparin responsiveness. Remember, enoxaparin and heparin are HELPING AT3, not the other way around References 1. Lammers D, Scerbo M, Davidson A, et al. Addition of aspirin to venous thromboembolism chemoprophylaxis safely decreases venous thromboembolism rates in trauma patients. Trauma Surg Acute Care Open. 2023;8(1):e001140. doi:10.1136/tsaco-2023-001140 https://pubmed.ncbi.nlm.nih.gov/37936904/ 2. Vincent LE, Talanker MM, Butler DD, et al. Association of Changes in Antithrombin Activity Over Time With Responsiveness to Enoxaparin Prophylaxis and Risk of Trauma-Related Venous Thromboembolism. JAMA Surg. 2022;157(8):713-721. doi:10.1001/jamasurg.2022.2214 https://pubmed.ncbi.nlm.nih.gov/35731524/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 27, 2024

Most surgeons know about malpractice lawsuits, but did you know that residents and even medical students can be involved in them? Join us for a discussion of what happens when patients sue their treatment teams -- and what happens when those teams involve trainees. Host: Nina Clark, MD, MS Guests: Cindy Hamra, JD, MA is an associate dean in the GME Office at the University of Washington School of Medicine, where she leads the operational, administrative and finance functions. UW School of Medicine is sponsors clinical training for over 1600 medical and dental residents in fellows in over 200 programs. UW Medicine, through the School of Medicine, is the largest sponsor of GME programs in the five-state WWAMI region (Washington, Wyoming, Alaska, Montana and Idaho). Lisa Hammel, JD is the senior director of clinical risk management for UW medicine. Prior to that, she spent over 20 years as a defense attorney primarily working in medical malpractice and professional liability defense. References: American College of Surgeons: https://www.facs.org/for-medical-professionals/news-publications/journals/rise/articles/litigation-overview/ AMA: https://www.ama-assn.org/medical-residents/residency-life/resident-medical-liability-lawsuits-why-and-how-often-they-happen JAMA Surgery: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5833625/ & https://jamanetwork.com/journals/jamasurgery/article-abstract/2670456 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 24, 2024

Join Drs. Scott Steele and Dan Scheese as they engage in an in-depth conversation with Dr. Michael Valente about the intricate world of appendiceal masses, including carcinoid, adenocarcinoma, and mucinous neoplasms. Despite the complexity of the subject, this episode skillfully deconstructs the topic through the analysis of three distinct cases, illuminating the latest terminology, diagnostic approaches, and management strategies. Hosts: Scott Steele, MD (@ScottRSteeleMD) Dan Scheese, MD (@DanScheese13) Guest: Michael Valente, MD (@DrMikeValente) is an Associate Professor of Surgery at the Cleveland Clinic and Program Director of the colon and rectal residency program. Dr. Valente's specialty and research interests include cancer of the appendix, peritoneum, colon, rectum and anus, cytoreductive surgery/HIPEC, complex re-operative surgery, inflammatory bowel disease, advanced endoscopic techniques, laparoscopic and minimally invasive colorectal surgery, and surgical education. Dr. Valente has published numerous peer-reviewed journal articles and book chapters and has presented his research interests both nationally and internationally. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 20, 2024

M&M - we all do it, but what is its purpose? Join Jason and Nina as they talk to two experts about why we present at all, and what we can do to better reach the educational and quality improvement goals of morbidity and mortality conference. Hosts: Jason Bingham, Nina Clark Panelists Keith Lillemoe, MD Chief of Surgery, Massachusetts General Hospital Professor of Surgery at the Harvard Medical School Luise Pernar, MD, MHPE Bariatric Surgeon Associate Professor of Surgery, Boston University Chobanian and Avedisian School of Medicine References https://jamanetwork.com/journals/jamasurgery/article-abstract/2810740 https://pubmed.ncbi.nlm.nih.gov/26649585/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 17, 2024

It’s that time of year (again!)- when medical students- both US and International- are preparing their residency applications. This year, we have been focusing on the special challenges International Medical Graduates face when applying to US surgical residency positions. In our previous episode, we discussed how residents can make their applications stand out to program directors. Today, we will explore the unique challenges, experiences, and the future of IMGs with special guest Dr. Hasan Alam. Guests: Hasan Alam, MD- Chair of the Department of Surgery and Professor of Surgery (Trauma and Critical Care) and Cell and Developmental Biology- Northwestern University Previous DOMINATE the Match Episodes: Episode 2- “Choose Me” (Personal Statements and Letters of Recommendations) https://behindtheknife.org/podcast/dominate-the-match-episode-2-choose-me/ Episode 3- “The Interview” https://behindtheknife.org/podcast/dominate-the-match-episode-3-the-interview/ Episode 4- “Rank and Match” https://behindtheknife.org/podcast/dominate-the-match-episode-4-rank-and-match/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 13, 2024

It’s that time of year (again!)- when medical students- both US and International- are preparing their residency applications. In this episode, we will focus on the special challenges International Medical Graduates face when applying to US surgical residency positions and discuss tips and tricks for making IMG residency applicants standout to program directors in the US. Guests: David Hughes, MD - Clinical Associate Professor of Endocrine Surgery and General Surgery Residency Program Director- University of Michigan Krishnan Raghavendran, MBBS - Professor of Acute Care Surgery and Critical Care- University of Michigan Link to video: You can watch Dr. Hughes’s full presentation here: https://youtu.be/iQ0CzH7xHwE Previous DOMINATE the Match Episodes: Episode 2- “Choose Me” (Personal Statements and Letters of Recommendations) https://behindtheknife.org/podcast/dominate-the-match-episode-2-choose-me/ Episode 3- “The Interview” https://behindtheknife.org/podcast/dominate-the-match-episode-3-the-interview/ Episode 4- “Rank and Match” https://behindtheknife.org/podcast/dominate-the-match-episode-4-rank-and-match/ Residency Program Lists: - FREIDA Residency and Fellowship Database: https://freida.ama-assn.org/ - Doximity: https://www.doximity.com/residency/?utm_campaign=marketing_resnav_competitor_broad_20210520&utm_source=google&utm_medium=cpc&gclid=CjwKCAjwt52mBhB5EiwA05YKo1J47BLAtTPtsJBmVvXGP2pDXLLqgDIwM0pgkSYjoBhFUOO1ktXDYRoC2bkQAvD_BwE Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 10, 2024

Laparoscopic cholecystectomy was introduced approximately 30 years ago and quickly became the gold standard due to multiple benefits over open cholecystectomy. It ushered in the laparoscopic revolution but also increased the number of bile duct injuries. Through the dedicated efforts of many the rate of bile duct injury has been reduced, now mirroring open cholecystectomy. The robotic surgery revolution is well underway and unsurprisingly this technology has been applied to cholecystectomy. Given the devastating nature of bile duct injury and the history of increased injury with the last major shift in operative approach, we examine the current literature on the comparative safety of robotic-assisted cholecystectomy vs. laparoscopic cholecystectomy. 1. Andrew Wright, UW Medical Center – Montlake and Northwest, @andrewswright 2. Nick Cetrulo, UW Medical Center - Northwest, @Trules25 3. Nicole White, UW Medical Center - Northwest 4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm 5. Ben Vierra, UW General Surgery Resident PGY-2 @benvierra95 Learning objectives: 1. Examine the history of the laparoscopic cholecystectomy and review the efforts to reduce bile duct injury (SAGES Safe Cholecystectomy Task Force and Multi-Society Practice Guideline) 2. Review literature on causes and prevention of bile duct injury 3. Review a recent article on robotic cholecystectomy vs laparoscopic cholecystectomy outcomes 4. Describe precautions that might mitigate expected increase in bile duct injury as a new approach is applied References 1. https://www.sages.org/publications/guidelines/safe-cholecystectomy-multi-society-practice-guideline/ 2. https://www.sages.org/safe-cholecystectomy-program/ 3. MacFadyen BV Jr, Vecchio R, Ricardo AE, Mathis CR. Bile duct injury after laparoscopic cholecystectomy. The United States experience. Surg Endosc. 1998 Apr;12(4):315-21. doi: 10.1007/s004649900661. PMID: 9543520. https://pubmed.ncbi.nlm.nih.gov/9543520/ 4. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006231. doi: 10.1002/14651858.CD006231. PMID: 17054285. https://pubmed.ncbi.nlm.nih.gov/17054285/ 5. Way LW, Stewart L, Gantert W, Liu K, Lee CM, Whang K, Hunter JG. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg. 2003 Apr;237(4):460-9. doi: 10.1097/01.SLA.0000060680.92690.E9. PMID: 12677139; PMCID: PMC1514483. https://pubmed.ncbi.nlm.nih.gov/12677139/ 6. Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy. JAMA Surg. 2023;158(12):1303–1310. doi:10.1001/jamasurg.2023.4389 https://pubmed.ncbi.nlm.nih.gov/37728932/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 6, 2024

Join for the forth episode in the Association of Out Surgeons & Allies (AOSA) series for a discussion on gender affirming care and gender affirming surgery. Host: Dan Scheese, MD Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center Guests: 1. Dr. Megan Lane (She/her) megalane@med.umich.edu Dr. Lane is a Plastic Surgery resident at the University of Michigan who is planning on going into Gender Affirming Surgery and general reconstruction, she completed a research fellowship in the National Clinician Scholars Program and focused primarily on patient-reported outcomes in gender affirming surgery. 2. Dr. Scott Chaiet (he/him/his/himself) chaiet@surgery.wisc.edu Dr. Chaiet is double board certified by the American Board of Otolaryngology and the American Board of Facial Plastic & Reconstructive Surgery and is currently at the University of Wisconsin. His areas of expertise include rhinoplasty and facial gender surgery. He also practices reconstructive surgery including facial paralysis reanimation. His gender affirming practice includes all areas of the face and Adam’s apple except for hair. 3. Dr. Amy Suwanabol pasuwan@med.umich.edu Amy Suwanabol is a colorectal surgeon at the University of Michigan and the Ann Arbor VA. She assists the gender affirming surgeons at the University of Michigan in performing robotic assisted vaginoplasty. Her research focuses on optimizing quality of life among surgical patients and their families, surgeon well being, and cancer survivorship. 4. Dr. Monica Llado-Farrulla lladofar@ohsu.edu Dr. Llado-Farulla was born and raised in Puerto Rico, completed a residency in general surgery and then plastic surgery at Tulane and Penn, respectively. She pursued a year of training in advanced gender surgery and is now currently at OHSU, her practice largely focuses on facial feminization, chest affirming surgeries, phalloplasty, autologous breast reconstruction, and limb salvage. 5. Dr. Michele “Mike” Fascelli (he/him/his) FASCELM2@ccf.org Dr. Fascelli is a practicing reconstructive urologist at Cleveland Clinic. He comppleted his urology training at the Cleveland Clinic in Ohio and then fellowship in urogenital gender affirming surgery with the urology team at OHSU with Dr. Llado-Farulla. He is now the Director of Urogenital Reconstruction and Co-Director of the Gender Affirming Surgery Program at Cleveland Clinic. He is very committed to LGBTQIA+ urologic access and actively works to protect and expand care to the rainbow community, and to our trans and gender diverse patients. His practice is currently focused on queer urologic health concerns and genital gender surgery (i.e. vaginoplasty, metoidioplasty and phalloplasty). Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Jun 3, 2024

Interested in cardiac surgery? The training paradigm for cardiac surgery has changed significantly over the past decade and we know may students often struggle when deciding what pathway is best for them. For this episode, we assembled a robust team of attendings, fellows, and residents to discuss their journey as well as some of the research that has been conducted about these different pathways to help guide students navigating this decision. Hosts: - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 Guests: - Nick Teman, MD- Assistant Professor of Thoracic and Cardiovascular Surgery, University of Virginia, @nickteman - Jolian Dahl, MD, MSc- Integrated Thoracic Surgery Resident (PGY-6), University of Virginia, @JolianDahl - Lyndsey Wessels, MD- Traditional Thoracic Surgery Resident (CT-1), University of Virginia, @LyndseyWessels Articles Referenced: - Pathways to Certification: https://www.abts.org/ABTS/CertificationWebPages/Pathways%20to%20Certification.aspx - Narahari AK, Patel PD, Chandrabhatla AS, Wolverton J, Lantieri MA, Sarkar A, Mehaffey JH, Wagner CM, Ailawadi G, Pagani FD, Likosky DS. A Nationwide Evaluation of Cardiothoracic Resident Research Productivity. Ann Thorac Surg. 2024 Feb;117(2):449-455. doi: 10.1016/j.athoracsur.2023.08.011. Epub 2023 Aug 26. PMID: 37640148; PMCID: PMC10842395 https://pubmed.ncbi.nlm.nih.gov/37640148/ - Bougioukas L, Heiser A, Berg A, Polomsky M, Rokkas C, Hirashima F. Integrated cardiothoracic surgery match: Trends among applicants compared with other surgical subspecialties. J Thorac Cardiovasc Surg. 2023 Sep;166(3):904-914. doi: 10.1016/j.jtcvs.2021.11.112. Epub 2022 Mar 22. PMID: 35461707. https://pubmed.ncbi.nlm.nih.gov/35461707/ For episode ideas/suggestions/feedback feel free to email Jessica Millar at: millarje@med.umich.edu Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 30, 2024

Bariatric surgery is an evolving field with new procedures, or variations of old ones, being developed to meet the needs of patients with obesity. The single anastomosis duodenoileal bypass (SADI) and one anastomosis gastric bypass (OAGB) are two such procedures which have recently entered the mainstream conversation. In this episode we will give a brief overview of the SADI and OAGB, go over some short and long term studies evaluating safety and efficacy, and discuss current sentiments about these options and how they may fit into bariatric practice. Show Hosts: Matthew Martin, MD Adrian Dan, MD Crystal Johnson-Mann, MD Paul Wisniowski, MD Article #1: Chao 2024 - Outcomes of SADI and OAGB Compared to RYGB from the Metabolic and Bariatric Surgery Quality Improvement Program: The North American Experience Roux-en-Y gastric bypass (RYGB) and duodenal switch are well described procedure for weight loss; however, associated postoperative complications have led to the development of simpler techniques Single anastomosis duodenoileal bypass (SADI) - modification of the duodenal switch where by a loop of ileum of the bilopancreatic limb approximately 200-300cm from the ileal cecal valve is anastomosed to the distal duodenal cuff of a tubularized stomach One anastomosis gastric bypass (OAGB) – modification of the RYGB where a loop of jejunum of the bilopancreatic limb approximately 150-200cm from the ligament of treitz is anastomosed to the distal end of a gastric pouch. There is increasing interest in these procedures given the perceived reduced risk reduction associated with one fewer anastomosis Currently, there is insufficient data on the safety of these procedures compared to the established RYGB. The article utilizes the MBSAQIP database to evaluate each procedure against the RYGB Matched groups: SADI vs RYGB and OAGB vs RYGB Matched against age, sex, BMI, operative time, and ASA classification 30-day outcomes included complications and health care utilization Results were analyzed with univariate comparative analysis, and significant outcomes were examined with logistic regression SADI vs RYGB: SADI independently associated INCREASED odds with staple line leak, sepsis, organ space infection, and pneumonia. OAGB vs RYGB: OAGB independently associated with REDUCED odds of SSI, transfusion requirement/GI bleed, ICU admission, bowel obstruction, and healthcare utilization (reoperation, readmissions, and reinterventions) No significant differences in mortality Limitation: Article generally reviews technical complications of procedures. Unable to address significant bariatric outcomes such as weight loss and metabolic profile, as well as long term outcomes. https://pubmed.ncbi.nlm.nih.gov/38170422/ Article #2: Maud 2019 - Efficacy and safety of OAGB vs RYGB for obesity (YOMEGA trial): A multicentre, randomized, open label, non-inferiority trial Limited long-term evidence on OAGB Mostly arising from retrospective analyses and one meta-analysis Two randomized clinical trials but with poor power and questionable methodology. This is a randomized non-inferiority trial of in patients undergoing bariatric surgery Randomized into 2 groups: OAGB vs RYGB with 117 patients per group Patients were followed for 2 years with a loss to follow up of 21% in OAGB and 24% in RYGB cohorts The primary outcome was weight loss with a noninferiority threshold of 7% assuming 60% weight loss at 2 years. Secondary outcomes included complications and metabolic outcomes Groups were compared with Student’s T and Wilcoxon tests for quantitative data, and chi-squared and Fischer’s exact for qualitative endpoints. Cohorts were analyzed with the intention to treat, and missing data on the primary endpoint was imputed with prediction-based modeling. Highlighted Outcomes Mean percent excess BMI loss of 87.9% in OAGB group compared to 85.8% in RYGB group demonstrating non-inferiority in terms of weight loss Increased number of serious adverse events (SAE) in the OAGB group, but no difference in the proportion of patients with at least 1 SAE OAGB demonstrated 70% complete or partial remission of diabetes compared to 44% in RYGB but underpowered to demonstrate significant difference. Equal rates of gastritis and esophagitis based on endoscopic biopsy results at 2 years. There were increased nutritional complications in the OAGB groups with 21% vs 0% in RYGB and high rates of diarrhea/anal fissures 14% vs 0%, respectively. This suggests a greater malabsorptive effect of OAGB. There was equal satisfaction in quality of life between RYGB and OAGB on two validated surveys with >80% satisfaction rates. Limitations Data was imputed for the primary end point High rates of loss to follow up in both cohorts Use of “severe adverse events” instead of Clavien-Dindo classification Comparison of specific institutional/surgeon technique of OAGB vs RYGB https://pubmed.ncbi.nlm.nih.gov/30851879/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 27, 2024

Join Drs. Jason Bingham (@BinghamMd) and Patrick Georgoff (@georgoff) for a thought-provoking discussion with titans of hernia surgery Drs. Todd Heniford (@THeniford) and Michael Rosen (@MikeRosenMD). You don't want to miss this one! This episode goes deep, touching on some of the most vexing questions in the world of abdominal wall reconstruction. Highlights: Hernia is chronic disease process. Surgeons should act like it and patients need to understand this. Follow-up data is hard to come by and therefore limited. Studies must be interpreted with this in mind. Hernia surgery is sexy, which is both exciting and concerning. "Technology is not useful until it is boring." New techniques and devices can hurt patients. Complicated hernias should be sent to hernia centers. Otherwise, general surgeons are more than capable of doing the repair. Link to paper: https://jamanetwork.com/journals/jamasurgery/fullarticle/2816986 Link to ACHQC: https://achqc.org/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 23, 2024

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastric cancer. Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center - Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center - Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastric cancer, including presentation, work-up, staging, and treatment modalities as well as high yield topics including the Siewert classification system. We also briefly discuss trials establishing peri-operative chemotherapy regimens for gastric cancer and the controversy of D1 vs. D2 lymphadenectomy. Links to Papers Referenced in this Episode Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer. NEJM 2006 Jul;355(1):11-20. https://www.nejm.org/doi/full/10.1056/NEJMoa055531 Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesphageal junction adenocarcinoma (FLOT4): a randomized, phase2/3 trial Lancet 2019 May;393(10184):1948-1957. https://pubmed.ncbi.nlm.nih.gov/30982686/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 20, 2024

Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Philip Fleshner as they discuss the management of small bowel strictures in Crohn’s disease. Learning Objectives 1. Discuss the role for J-pouch in a patient with inflammatory bowel disease 2. Identify the key steps in creation of the J-pouch and technical considerations. 3. Describe post operative complications and management in patients with a J-pouch Video Link: https://www.youtube.com/watch?v=_PMFaQHah5A Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 16, 2024

How is each release of the TAR contributing to the final tension on the anterior and posterior fascia? Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan C. Ellis as they discuss their group’s recent cohort study of tensiometry in 100 TARs. Hosts: - Michael Rosen, Cleveland Clinic - Benjamin T. Miller, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan C. Ellis, Cleveland Clinic, @ryanellismd Learning objectives: - Review the steps of a TAR - Understand the changes in tension on the anterior and posterior fascia with each step of the TAR - Think about the application this data has to similar operations References: Miller BT, Ellis RC, Petro CC, Krpata DM, Prabhu AS, Beffa LRA, Huang LC, Tu C, Rosen MJ. Quantitative Tension on the Abdominal Wall in Posterior Components Separation With Transversus Abdominis Release. JAMA Surg. 2023 Dec 1;158(12):1321-1326. doi: 10.1001/jamasurg.2023.4847. PMID: 37792324; PMCID: PMC10551814. https://pubmed.ncbi.nlm.nih.gov/37792324/ Miller BT, Ellis RC, Walsh RM, Joyce D, Simon R, Almassi N, Lee B, DeBernardo R, Steele S, Haywood S, Beffa L, Tu C, Rosen MJ. Physiologic tension of the abdominal wall. Surg Endosc. 2023 Dec;37(12):9347-9350. doi: 10.1007/s00464-023-10346-w. Epub 2023 Aug 28. PMID: 37640951. https://pubmed.ncbi.nlm.nih.gov/37640951/ Ramirez OM, Ruas E, Dellon AL. "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990 Sep;86(3):519-26. doi: 10.1097/00006534-199009000-00023. PMID: 2143588. https://pubmed.ncbi.nlm.nih.gov/2143588/ Hope WW, Williams ZF, Rawles JW 3rd, Hooks WB 3rd, Clancy TV, Eckhauser FE. Rationale and Technique for Measuring Abdominal Wall Tension in Hernia Repair. Am Surg. 2018 Sep 1;84(9):1446-1449. PMID: 30268173. https://pubmed.ncbi.nlm.nih.gov/30268173/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 13, 2024

Welcome to Humanism in Surgery, a new series where we take a deep dive into the extremes of humanity within the field of surgery. As surgeons, there are times when we feel deeply human and times when we feel we have lost our humanity. These experiences impact us immensely and shape our careers in important ways. It's time these stories are told! For those of you who are fans of NPR, think of this as Story Core for surgery. Today, Dr. Patrick Georgoff is joined by Dr. Tamara Fitzgerald, Associate Professor of Pediatric Surgery at Duke University, and Dr. Ted Pappas, Professor of Surgery and Master Surgeon at Duke University. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 9, 2024

A patient with a large TBSA burn injury presents to a local emergency department and you are the only surgeon on duty that evening. With snow covered roads and poor visibility, the patient requires initial stabilization prior to transfer to the regional burn center. You are faced with some difficult clinical decisions as you begin their resuscitation. Join Drs. Tam Pham, Rob Cartotto, Julie Rizzo, Alex Morzycki and Jamie Oh as they discuss the clinical challenges in initiating burn resuscitation, pitfalls in long-distance transport, and more. Hosts: · Dr. Tam Pham: UW Medicine Regional Burn Center · Dr. Robert Cartotto: University of Toronto, Ross Tilley Burn Centre · Dr. Julie Rizzo: Brooke Army Medical Center · Dr. Alex Morzycki: UW Medicine Regional Burn Center · Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: · Describe initial fluid strategies, including the recommendations of the Advanced Burn Life Support (ABLS) course, traditional resuscitation formulas, and the Rule of 10. · Describe logistical and medical challenges of long-distance transport to a regional burn center. · Understand recent advances learned from recent conflicts in military burn casualty care. · List options for intravenous access. · Understand endpoints of resuscitation, including adjuncts which may help guide fluid titration. 1. Cartotto R, Johnson LS, Savetamal A, et al. American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. J Burn Care Res 2023 https://pubmed.ncbi.nlm.nih.gov/38051821/ 2. Renz EM, Cancio LC, Barillo DJ, et al. Long-Range Transport of War-Related Burn Casualties. J Trauma 2008 https://pubmed.ncbi.nlm.nih.gov/18376156/ 3. Adibfar A, Camacho F, Rogers AD, Cartotto R. The Use of Vasopressors During Acute Burn Resuscitation. Burns 2021 https://pubmed.ncbi.nlm.nih.gov/33293152/ 4. Chung KK, Wolf SE, Cancio LC, et al. Resuscitaiton of Severely Burned Military Casualties: Fluid Begets More Fluid. J Trauma 2009 https://pubmed.ncbi.nlm.nih.gov/19667873/ 5. Chung KK, Salinas J, Renz EM, et al. Simple Derivation of the Initial Fluid Rate for the Resuscitation of Severely Burned Adult Combat Casualties: in Silico Validation of the Rule of 10, J Trauma 2009 https://pubmed.ncbi.nlm.nih.gov/20622619/ Joint Trauma System Clinical Practice Guideline (CPG)-Burn Care, updated 2022 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 6, 2024

Your patient was in a terrible car crash and is currently intubated with multiple traumatic injuries that will need surgery. Family has just arrived and all they’ve heard is that he has a broken leg. How do you share this serious news with family? What do you do when they become angry, cry or bombard you with questions that you don’t have answers to? Join the surgical palliative care team from the University of Washington as we role play a difficult conversation with a standardized patient. We will identify common challenges that arise and discuss key skills to navigate these situations. Hosts : Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow. Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 general surgery resident and current surgical oncology research fellow at the University of Washington. Dr. Virginia Wang is a PGY2 general surgery resident at the University of Washington. Learning Objectives: · Identify common pitfalls encountered during difficult conversations · Learn how to synthesize complex medical information and construct a succinct headline statement to deliver a digestible take-home message · Develop skills to respond to emotional cues using empathetic statements References: · “Responding to Emotion.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/responding-to-emotion-respecting/ · “Serious News.” Vitaltalk. Accessed March 4, 2024. https://www.vitaltalk.org/guides/serious-news/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

May 2, 2024

Circulating tumor DNA, more commonly referred to as ctDNA, has emerged as an attractive and potentially highly sensitive biomarker for patients with colorectal cancer. But what exactly is ctDNA, does it have any prognostic value for patients with colorectal liver metastasis, and how can it be incorporated into the management of said patients? In this episode from the HPB team at Behind the Knife, listen in on the discussion about ctDNA and its role in the perioperative management of colorectal liver metastasis. Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center Learning Objectives: -Develop an understanding of what circulating tumor DNA (ctDNA) is. -Develop an understanding of what makes ctDNA unique from other “tumor markers” like CEA. -Develop an understanding of the prognostic value of ctDNA for colorectal liver metastasis (CRLM). -Develop an understanding of the current role of ctDNA in the perioperative treatment of patients with CRLM. -Develop an understanding of how ctDNA can be incorporated into future treatment algorithms for patients undergoing hepatic resection for CRLM. Papers Referenced (in the order they were mentioned in the episode): 1) Newhook TE, Overman MJ, Chun YS, et al. Prospective Study of Perioperative Circulating Tumor DNA Dynamics in Patients Undergoing Hepatectomy for Colorectal Liver Metastases . Ann Surg . 2023;277(5):813-820. https://pubmed.ncbi.nlm.nih.gov/35797554/ 2) Nishioka Y, Chun YS, Overman MJ, et al. Effect of Co-mutation of RAS and TP53 on Postoperative ctDNA Detection and Early Recurrence after Hepatectomy for Colorectal Liver Metastases . J Am Coll Surg . 2022;234(4):474-483. https://pubmed.ncbi.nlm.nih.gov/35290266/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 29, 2024

Taking a lactating patient the OR? Prescribing antibiotics? What about a CT scan with IV contrast? Pump and dump, right? WRONG. It's time to get educated! Today, we review the finer points of caring for our lactating patients. In this episode Dr. Patrick Georgoff is joined by Dr. Austin Eckhoff, general surgery resident at Duke University, Dr. Annie Dotson, family medicine and breastfeeding medicine physician at Duke University, and Dr. Katrina Mitchell, breast surgeon at Ridley Tree Cancer Center in Santa Barbara, CA. Resources: https://www.bfmed.org/ https://www.e-lactancia.org/ https://physicianguidetobreastfeeding.org/ - - TRASH THE PUMP & DUMP: https://physicianguidetobreastfeeding.org/trash-the-pump-and-dump/trash-pump-dump/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 25, 2024

The American Board of Surgery In-Training Examination will officially be switching from reporting percentile scores by year level to percent of questions correct. What does this change mean for residents? Podcast hosts Dr. Ananya Anand, Dr. Joe L’Huillier, and Dr. Rebecca Moreci are joined by three fellow CoSEF members for this discussion: Dr. Gus Godley, Dr. Colleen McDermott, and Dr. Josh Roshal. Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, ananya_anand@stanford.edu –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101, josephlh@buffalo.edu –Dr. Rebecca Moreci, Louisiana State University, @md_moreci, morecir@med.umich.edu –COSEF: @surgedfellows Special guests: -Dr. Gus Godley, University of Chicago, frederick.godley@uchicagomedicine.org, @GusGodley -Dr. Colleen McDermott, University of Utah, colleen.mcdermott@hsc.utah.edu -Dr. Josh Roshal, Brigham and Women’s Hospital, jaroshal@utmb.edu, @Joshua_Roshal Learning Objectives: Listeners will: – Understand the changes to the ABSITE score reporting by the American Board of Surgery – Describe both positive impacts and limitations of this change from the resident perspective – List possible ideas for further refinements to standardized exams in medicine References: -Yeo HL, Dolan PT, Mao J, Sosa JA. Association of Demographic and Program Factors With American Board of Surgery Qualifying and Certifying Examinations Pass Rates. JAMA Surg. Jan 1 2020;155(1):22-30. doi:10.1001/jamasurg.2019.4081 https://pubmed.ncbi.nlm.nih.gov/31617872/ -Sathe TS, Wang JJ, Yap A, Zhao NW, O’Sullivan P, Alseidi A. Proposed Reforms to the American Board of Surgery In-Training Examination (ABSITE). https://www.ideasurg.pub/proposed-absite-reforms/ -Miller AT, Swain GW, Midmar M, Divino CM. How Important Are American Board of Surgery In-Training Examination Scores When Applying for Fellowships? J Surg Educ. 2010;67(3):149-151. doi:10.1016/j.jsurg.2010.02.007 https://pubmed.ncbi.nlm.nih.gov/20630424/ -Savoie KB, Kulaylat AN, Huntington JT, Kelley-Quon L, Gonzalez DO, Richards H, Besner G, Nwomeh BC, Fisher JG. The pediatric surgery match by the numbers: Defining the successful application. J Pediatr Surg. 2020;55(6):1053-1057. doi:10.1016/j.jpedsurg.2020.02.052 https://pubmed.ncbi.nlm.nih.gov/32197826/ -Alnahhal KI, Lyden SP, Caputo FJ, Sorour AA, Rowe VL, Colglazier JJ, Smith BK, Shames ML, Kirksey L. The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations. Annals of Vascular Surgery. 2023;94:195-204. doi:10.1016/j.avsg.2023.04.018 https://pubmed.ncbi.nlm.nih.gov/37120072/ -Williams M, Kim EJ, Pappas K, Uwemedimo O, Marrast L, Pekmezaris R, Martinez J. The impact of United States Medical Licensing Exam (USMLE) step 1 cutoff scores on recruitment of underrepresented minorities in medicine: A retrospective cross‐sectional study. Health Sci Rep. 2020;3(2):e2161. doi:10.1002/hsr2.161 https://pubmed.ncbi.nlm.nih.gov/32318628/ -Lucey CR, Saguil A. The Consequences of Structural Racism on MCAT Scores and Medical School Admissions: The Past Is Prologue. Academic Medicine. 2020;95(3):351. doi:10.1097/ACM.0000000000002939 https://pubmed.ncbi.nlm.nih.gov/31425184/ -Natanson H, Svrluga S. The SAT is coming back at some colleges. It’s stressing everyone out. Washington Post. https://www.washingtonpost.com/education/2024/03/18/sat-test-policies-confuse-students/ . Published March 19, 2024. Accessed April 5, 2024. -de Virgilio C, Yaghoubian A, Kaji A, Collins JC, Deveney K, Dolich M, Easter D, Hines OJ, Katz S, Liu T, Mahmoud A, Melcher ML, Parks S, Reeves M, Salim A, Scherer L, Takanishi D, Waxman K.. Predicting Performance on the American Board of Surgery Qualifying and Certifying Examinations: A Multi-institutional Study. Archives of Surgery. 2010;145(9):852-856. doi:10.1001/archsurg.2010.177 https://pubmed.ncbi.nlm.nih.gov/20855755/ -Weighted test content from the ABS: https://www.absurgery.org/wp-content/uploads/2023/01/GS-ITE.pdf -USMLE program announces upcoming policy changes | USMLE. Accessed April 9, 2024. https://www.usmle.org/usmle-program-announces-upcoming-policy-changes Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 22, 2024

The ABSITE score report is changing… what does it mean? CEO of the American Board of Surgery Dr. Jo Buyske discusses ABSITE and MUCH more. Hosts: Dr. Scott Steele, Dr. Nina Clark, Dr. Jessica Millar Guest: Dr. Jo Buyske, President/CEO of the American Board of Surgery Resources: Announcement - ABSITE Percentiles: https://www.absurgery.org/wp-content/uploads/2024/02/ABSITE-Percentiles.pdf ABSITE Data Tools: https://sandbox.absurgery.org/default.jsp?publicdata Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Apr 18, 2024

In this episode our team dives into the diagnosis, workup and management of malignant pleural mesothelioma. Listen as we debate the pros and cons of surgical management of this disease with extrapleural pneumonectomy versus pleural decortication and discuss the nuances of choosing the right approach for the right patient. Learning Objectives - Describe the workup and staging of a patient with malignant pleural mesothelioma - List the subtypes of malignant pleural mesothelioma, characteristics of resectable disease, and patient factors which impact surgical candidacy - Describe the approach to an extrapleural pneumonectomy and pleural decortication - Analyze which surgical approach is best for various subsets of patients - Describe the adjuvant treatment for malignant pleural mesothelioma Hosts Kelly Daus MD, Adam Bograd MD, Peter White MD, Brian Louie MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes: https://app.behindtheknife.org/listen

Apr 15, 2024

Can appendicitis wait until the morning? Join Drs. Ashlie Nadler, Jordan Nantais, Graham Skelhorne-Gross, and Marika Sevigny from our Emergency General Surgery Team as they discuss the role of deferring appendectomies from overnight to the next morning. Paper 1: Patel SV, Zhang L, Mir ZM, Lemke M, Leeper WR, Allen LJ, Walser E, Vogt K. Delayed Versus Early Laparoscopic Appendectomy for Adult Patients With Acute Appendicitis: A Randomized Controlled Trial. Ann Surg. 2024 Jan 1;279(1):88-93. https://pubmed.ncbi.nlm.nih.gov/37436871/ -Non-inferiority randomized controlled trial comparing delayed appendectomy group with surgery taking place after 0600 the morning following a decision to operate versus the immediate appendectomy group with surgery taking place between 8pm and 4am and within 6 hours of a decision to operate -A priori non-inferiority margin of 15% for 30-day complications -Intention-to-treat analysis with risk difference -12% in favor of the delayed group (p < 0.001) -Superiority as on per protocol analysis -Underpowered at 91% due to early closure of study due to loss of reliable day time emergency triage operating time Paper 2: Jalava K, Sallinen V, Lampela H, Malmi H, Steinholt I, Augestad KM, Leppäniemi A, Mentula P. Role of preoperative in-hospital delay on appendiceal perforation while awaiting appendicectomy (PERFECT): a Nordic, pragmatic, open-label, multicentre, non-inferiority, randomised controlled trial. Lancet. 2023 Oct 28;402(10412):1552-1561. https://pubmed.ncbi.nlm.nih.gov/37717589/ -Non-inferiority randomized controlled trial comparing appendectomy within 8 hours versus 24 hours -No difference in rate of perforation on intention-to-treat or per protocol analyses Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes: https://app.behindtheknife.org/listen

Apr 11, 2024

Before 1952, open heart surgery was considered science fiction. The heart was off limits to surgeons despite more than half a million Americans dying annually from heart disease. Doing nothing was the strategy. However, the status quo would soon change thanks to a few brave and imaginative surgeons who dared to break the most rigid of medical taboos: Do not touch the human heart. We sat down with Dr. Gerald Imber, author of the new book “ Cardiac Cowboys: The Heroic Invention of Heart Surgery” to discuss how five men raced to invent an entirely new field of surgery. Guests: Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Nick Teman, MD - Associate Professor of Cardiac Surgery and Critical Care- University of Virginia Gerald Imber - Assistant Clinical Professor of Plastic surgery at the Weill-Cornell Medical Center, Attending Surgeon at New York-Presbyterian Hospital, and Director of a private clinic in New York City, NY; Author of “ Wendell Black, MD”, “Genius on the Edge: The Bizarre Double Life of Dr. William Stewart Halsted”, and “Cardiac Cowboys: The Heroic Invention of Heart Surgery”. Want to hear more from Dr. Imber- be sure to check out his podcast series, Cardiac Cowboys , based on Dr. Imber’s book. You can listen to an introduction of the Cardiac Cowboys series here : https://shorturl.at/rKLM8 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes: https://app.behindtheknife.org/listen

Apr 8, 2024

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss Management of Advanced and Malignant Polyps. Come with us as we navigate through sessile serrated lesions, pathology reports, and rectal polyp nuances. Hosts: - Susan Galandiuk, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review colorectal cancer screening for the average risk patient. - Understand what a malignant polyp is defined as and management strategies. - Discuss the pathology review and re-review processes. References: - Church J, et al. Keeping the Cecum Clean: A Randomized, Prospective, Placebo-Controlled Trial of Loperamide as Part of Preparation for Colonoscopy. Diseases of the Colon & Rectum 56(1):p 120-125, January 2013. https://pubmed.ncbi.nlm.nih.gov/23222289/ - Fan C, et al. Management of Serrated Polyps of the Colon. Curr Treat Options Gastroenterol 16(1):182-202, March 2018. https://pubmed.ncbi.nlm.nih.gov/29445907/ - Gupta S, et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. The American Journal of Gastroenterology 115(3): 415-434, March 2020. https://pubmed.ncbi.nlm.nih.gov/32039982/ - Hyman N, Waye JD. Endoscopic four quadrant tattoo for the identification of colonic lesions at surgery. Gastrointest Endosc 37:56–58, 1991. https://pubmed.ncbi.nlm.nih.gov/1706283/ - Kaltenbach T, et al. Endoscopic Removal of Colorectal Lesions—Recommendations by the US Multi-Society Task Force on Colorectal Cancer. Gastrointestinal Endoscopy 91(3): 486-519, March 2020. https://pubmed.ncbi.nlm.nih.gov/32067745/ - Keswani R, et al. AGA Clinical Practice Update on Strategies to Improve Quality of Screening and Surveillance Colonoscopy: Expert Review. Gastroenterology, 161(2): 701 – 711, Aug 2021. https://pubmed.ncbi.nlm.nih.gov/34334168/ - Shaukat A, et al. Endoscopic Recognition and Management Strategies for Malignant Colorectal Polyps: Recommendations of the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology, 159(5): 1916 - 1934.e2, Nov 2020. https://pubmed.ncbi.nlm.nih.gov/33159840/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent epispdes here: https://app.behindtheknife.org/listen

Apr 4, 2024

Join for the third episodes in the Association of Out Surgeons & Allies (AOSA) series for a discussion on LGBTQIA+ healthcare providers and their patients. Host: Nina Clark, MD Guests: - Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center - Dr. James Taylor, Assistant Professor of Colorectal Surgery at Montefiore Medical Center - Dr. Alex Bonte, General Surgery PGY4 at Hackensack University Medical Center in Hackensack NJ. - Dr. Paige Tannhauser, General Surgery PGY3 (completed) at Allegheny General Hospital in Pittsburgh PA, and currently finishing up a post-doctoral research fellowship at the University of Virginia. Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Resources Mentioned This Episode: "Gender Unicorn" schema for terminology: https://transstudent.org/gender/ LGBTQ Healthcare Directory: https://lgbtqhealthcaredirectory.org/ CDC Recommendations in LGBTQ Health: https://www.cdc.gov/lgbthealth/index.htm WPATH Resources: https://www.wpath.org/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Apr 1, 2024

Listen to another episode by the Hernia Team from Carolinas Medical Center as they discuss their approach to open preperitoneal ventral hernia repair. Although uncommonly performed, a preperitoneal approach offers several advantages including the ability to achieve large mesh overlap without the need for myofascial release. The team discusses their tips and tricks for utilizing the preperitoneal space in even the most challenging hernia cases. Hosts: - Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD (Twitter) - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford (Twitter) - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein (Twitter) - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL) Learning Objectives: - Review standard methods of herniorraphy in open abdominal wall reconstruction - Introduce the concept of open preperitoneal ventral hernia repair - Discuss the advantages as well as the standard tips and tricks for performing an open preperitoneal repair - Review outcomes for preperitoneal hernia repair over time Podcast Video Clip: https://www.youtube.com/watch?v=3pMvB0rnokQ References: - Novitsky et al, Open Preperitoneal Retrofascial Mesh Repair for Multiply Recurrent Ventral Incisional Hernias, JACS, 2006 https://pubmed.ncbi.nlm.nih.gov/36280505/ - Heniford et al, Preperitoneal Ventral Hernia Repair: A Decade Long Prospective Observational Study with Analysis of 1023 Patient Outcomes, Annals of Surgery, 2020 https://pubmed.ncbi.nlm.nih.gov/30080725/ - Katzen et al, Open Preperitoneal Ventral Hernia Repair: Prospective Observational Outcomes of Quality Improvement Outcomes Over 18 Years and 1,842 Patients, Surgery, 2023 https://pubmed.ncbi.nlm.nih.gov/36280505/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other recent episodes here: https://app.behindtheknife.org/listen

Mar 28, 2024

Eat when you can, sleep when you can, and don’t F with the pancreas! What happens when that third rule goes wrong, and why do people say pancreas injuries are like eating crawfish? Whether you love the pancreas or just the mention of the P-word strikes fear in your heart, or if you just want the answer to the aforementioned questions, join Drs. Cobler-Lichter, Kwon, and Meizoso, as they guide you through all this and more! Hosts: - Michael Cobler-Lichter, MD, PGY3, University of Miami/Jackson Memorial Hospital/Ryder Trauma Center, @mdcobler (twitter) - Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow, University of Miami/Jackson Memorial Hospital/Ryder Trauma Center -Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 4 years in practice, University of Miami/Jackson Memorial Hospital/Ryder Trauma Center, @jpmeizoso (twitter) Learning Objectives: - Describe the AAST grading system for pancreatic injuries - Come up with a treatment plan for each grade of pancreatic injury - Identify commonly associated injuries with pancreatic trauma - List potential complications of pancreatic trauma and/or surgery Quick Hits: 1. Pancreas injuries do not all require a trip to the operating room. Low grade injuries should be managed with a trial of nonoperative management if there are no other operative indications 2. CT is the best initial imaging modality, although it has low sensitivity. If there is high concern for a pancreas injury based on mechanism or associated injuries, further investigation is required. 3. Pancreas injuries are like crawfish: suck the head and eat the tail. 4. Injuries to the left of the SMV can generally be treated with distal pancreatectomy and splenectomy, whereas injuries to the right of the SMV are usually drained. 5. Its important to identify and address any concomitant injuries, with duodenal injuries being the most common in higher grade injuries. 6. In the case of the dreaded grade 5 injury, the safe answer is to come back and do your reconstruction at a later time. References 1. https://www.westerntrauma.org/western-trauma-association-algorithms/management-of-pancreatic-injuries/ 2. Bassi, Claudio et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery, Volume 161, Issue 3, 584 – 591 https://pubmed.ncbi.nlm.nih.gov/28040257/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 25, 2024

Join us for another episode of our Global Surgery series, where we have a special focus on trauma care in resource-limited settings. Traumatic injury remains one of the largest burdens of disease and causes of mortality internationally. The WHO estimates that 4.4 million lives are lost to traumatic injuries per year, accounting for approximately 8% of all deaths. Notably, traumatic injuries are the top killer of children, adolescents, and young adults, compounding the patient-years lost. Trauma is ubiquitous–accidents and injuries happen all over the globe, and thus differences in trauma incidence and mortality is often a function of health systems and infrastructure. Jon Williams is joined by Dr. Anthony Charles. Dr. Charles is a trauma surgeon at University of North Carolina, Chapel Hill. Additionally, he holds professorships in the medical school and school of public health at UNC, as well as serving as the director of the adult ECMO program and the director of global surgery at the UNC Institute of Global Health and Infectious Diseases. He leads the Malawian Surgical Initiative, designed to train and support local surgeons in the country of Malawi where he has established a longstanding partnership with UNC. Having been raised in Nigeria, Dr. Charles completed medical school at the University of Lagos, and subsequently underwent general surgery residency training in London at North Middlesex University Hospital and subsequently at Charles Drew University in Los Angeles. Upon completion of trauma and critical care fellowship at University of Michigan, he took a faculty position at UNC where he has remained since and grown the global surgery presence to what it is today. Key Points: Often, the pivotal first step in developing global surgery trauma initiatives is increasing trained personnel, and so training initiatives are very meaningful and provide sustainability to the effort. Growing a health system’s ability to provide trauma care helps develop improved care for all aspects of disease. The resources, training, and infrastructure required benefits healthcare at large. Improvement of trauma care extends well beyond in-hospital care–injury prevention and pre-hospital care/triage/transport are even more impactful. It takes more than surgeons to improve trauma care globally. Thus, clinician and non-clinician training and oversight is critical, and foundational concepts of care of the trauma patient must be familiar to all. Local governing bodies need to understand the importance of trauma care to invest in it. Traumatic injuries and mortality are a health burden, but even more so an economic burden to a country. This is what is compelling to investment in trauma care. We now have over 725 episodes! The easiest way to find specific topics or episodes is on our website https://app.behindtheknife.org/home or on our new Apple/Android app. You can search or browse by topic, podcast series, etc., making it much easier to navigate than podcast players. iOS: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android: https://play.google.com/store/apps/details?id=com.btk.app PREMIUM BUNDLE: https://app.behindtheknife.org/bundle/95 Please email hello@behindtheknife.org to learn more about our premium bundle and institutional discounts. Premium Bundle Includes: General Surgery Oral Board Audio Review Trauma Surgery Video Atlas Colorectal Surgery Oral Board Audio Review Surgical Oncology Surgery Oral Board Audio Review Vascular Surgery Surgery Oral Board Audio Review Cardiothoracic Surgery Surgery Oral Board Audio Review

Mar 21, 2024

Join us for a new edition of our global surgery series! On this episode, Dr. Jon Williams is joined by Dr. Sudha Jayaraman and Dr. Justina Seyi-Olajide to discuss how we define global surgery today and how health infrastructure interacts with global surgical care. Dr. Jayaraman is a trauma and acute care surgeon at University of Utah, and the director of the Center for Global Surgery. After attending UC Davis for medical school, Dr. Jayaraman completed general surgery residency at UCSF, during which time she obtained a masters in public health in developing countries from the London School of Hygiene and Tropical Medicine. During this time, her efforts were dedicated to researching and implementing trauma systems development in Uganda. After residency she then completed a trauma and critical care fellowship at Brigham and Women’s, during which she received the Harvard Medical School Health Disparities Fellowship to continue her trauma systems work in Rwanda. Her ongoing work investigating injury burden and trauma systems in low and middle income countries has been well funded by the NIH, DOD, and others and published in numerous forums, as she is a well-renowned expert in this field. Dr. Justina Seyi-Olajide is a pediatric surgeon at the Lagos University Teaching Hospital in Lagos, Nigeria. She completed her medical school training at the Ahmadu Bello University in Zaria, Nigeria and subsequently her general surgical and pediatric surgical training at the Lagos University Teaching Hospital, earning the Fellowship of West African College of Surgeons in Pediatric Surgery and the Alinta Nwako prize for best graduating pediatric surgical trainee. Dr. Seyi-Olajide’s vision is to provide equitable pediatric surgical care in resource-limited settings, and has been highly influential for developing initiatives such as the National Surgical, Obstetric, Anesthesia and Nursing Plan for Nigeria. Additionally, she is a member of the Global Initiative for Children’s Surgery and is well published for her original research on topics regarding access to pediatric surgical care in low and middle income countries. Have any feedback for the global surgery content, or have any suggestions for future episodes? Please feel free to reach out to us at hello@behindtheknife.org. We now have over 725 episodes! The easiest way to find specific topics or episodes is on our website https://app.behindtheknife.org/home or on our new Apple/Android app. You can search or browse by topic, podcast series, etc., making it much easier to navigate than podcast players. iOS: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android: https://play.google.com/store/apps/details?id=com.btk.app PREMIUM BUNDLE: https://app.behindtheknife.org/bundle/95 Please email hello@behindtheknife.org to learn more about our premium bundle and institutional discounts. Premium Bundle Includes: General Surgery Oral Board Audio Review Trauma Surgery Video Atlas Colorectal Surgery Oral Board Audio Review Surgical Oncology Surgery Oral Board Audio Review Vascular Surgery Surgery Oral Board Audio Review Cardiothoracic Surgery Surgery Oral Board Audio Review

Mar 18, 2024

With the increasing popularity of artificial intelligence, its uses are quickly becoming not only a part of everyday life, but also training in surgery. Those of us without much understanding of the technology might be intimidated by this nebulous topic, or worry that we won’t be able to comprehend the advancements to come to the field. Luckily, we’re joined by a leading expert in the use of AI in surgery, Dr. Dan Hashimoto. He breaks down some examples of how AI is being used in surgical education, the role surgeons should play in these advancements, and some tips for how we can critically appraise work in the field of AI if we don’t understand the technology ourselves. Join hosts Nicole Brooks, MD, Judith French, PhD and Jeremy Lipman, MD, MHPE for this exciting conversation. Learning Objectives 1. Listeners will describe how AI is being applied to surgical education. 2. Listeners will identify the roles surgeons without training in AI can play in developing the use of AI in surgery. 3. Listeners will explain the regulatory and ethical considerations that must be addressed with the implementation of AI in surgical education. 4. Listeners will consider principles for critically evaluating research or technology in AI for application or use in their own educational or surgical practice. References Laplante S, Namazi B, Kiani P, Hashimoto DA, Alseidi A, Pasten M, Brunt LM, Gill S, Davis B, Bloom M, Pernar L, Okrainec A, Madani A. Validation of an artificial intelligence platform for the guidance of safe laparoscopic cholecystectomy. Surg Endosc . 2023 Mar;37(3):2260-2268. doi: 10.1007/s00464-022-09439-9. Epub 2022 Aug 2. PMID: 35918549. https://pubmed.ncbi.nlm.nih.gov/35918549/ Hashimoto DA, Varas J, Schwartz TA. Practical Guide to Machine Learning and Artificial Intelligence in Surgical Education Research. JAMA Surg . 2024 Jan 3. doi: 10.1001/jamasurg.2023.6687. Epub ahead of print. PMID: 38170510. https://pubmed.ncbi.nlm.nih.gov/38170510/ We now have over 725 episodes! The easiest way to find specific topics or episodes is on our website https://app.behindtheknife.org/home or on our new Apple/Android app. You can search or browse by topic, podcast series, etc., making it much easier to navigate than podcast players. iOS: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android: https://play.google.com/store/apps/details?id=com.btk.app PREMIUM BUNDLE: https://app.behindtheknife.org/bundle/95 Please email hello@behindtheknife.org to learn more about our premium bundle and institutional discounts. Premium Bundle Includes: General Surgery Oral Board Audio Review Trauma Surgery Video Atlas Colorectal Surgery Oral Board Audio Review Surgical Oncology Surgery Oral Board Audio Review Vascular Surgery Surgery Oral Board Audio Review Cardiothoracic Surgery Surgery Oral Board Audio Review

Mar 14, 2024

The Fellowship of the Snow kept it interesting this year…both on and off the slopes! On this episode, Patrick Georgoff discusses the Western Trauma Association’s updated resuscitative thoracotomy algorithm with Ron Tesoriero, the results of a WTA multicenter trial exploring chest tube irrigation for the prevention of retained hemothorax with Thomas Carver, and prehospital blood administration with Juan Duchesne. ** Algorithms and papers are pending final review and are therefore not available to link to this episode. Ron Tesoriero, MD: Associate Professor of Surgery, Director of the Acute Care Surgery Fellowship, and Co-Director of the SICU at UCSF. Thomas Carver, MD: Associate Professor of Surgery, Director of the Acute Care Surgery Fellowship, and Senior Medical Director of Critical Care Services at the Medical College of Wisconsin. Juan Duchesne, MD: Professor of Surgery and Chief of Trauma and Acute Care Surgery at Tulane university. Resuscitative Thoracotomy: The Who (Episode 475): https://app.behindtheknife.org/podcast/big-t-trauma-series-ep-14-ed-thoracotomy-the-who Resuscitative Thoracotomy: The How (Episode 476): https://app.behindtheknife.org/podcast/big-t-trauma-series-ep-15-ed-thoracotomy-the-how Innovation Lifeflow (Episode 642): https://app.behindtheknife.org/podcast/innovations-in-surgery-lifeflow We now have over 725 episodes! The easiest way to find specific topics or episodes is on our website https://app.behindtheknife.org/home or on our new Apple/Android app. You can search or browse by topic, podcast series, etc., making it much easier to navigate than podcast players. iOS: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android: https://play.google.com/store/apps/details?id=com.btk.app PREMIUM BUNDLE: https://app.behindtheknife.org/bundle/95 Please email hello@behindtheknife.org to learn more about our premium bundle and institutional discounts. Premium Bundle Includes: General Surgery Oral Board Audio Review Trauma Surgery Video Atlas Colorectal Surgery Oral Board Audio Review Surgical Oncology Surgery Oral Board Audio Review Vascular Surgery Surgery Oral Board Audio Review Cardiothoracic Surgery Surgery Oral Board Audio Review

Mar 11, 2024

In this episode of Behind the Knife the vascular surgery subspecialty team discusses a few case scenarios of patients with dialysis associated hand ischemia (or steal syndrome). Although a rare, steal syndrome can be detrimental to patients with end stage renal disease and result in not only risk of losing dialysis access but even their limb. What options do you have to fix this problem? In this episode, we will cover the who is at risk of this, and what options you have to fix it. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. David Schectman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review high-yield topics regarding hemodialysis access - Understand the incidence of and the relevant risk factors for dialysis associated steal syndrome - Review the spectrum of presenting symptoms and relevant workup for dialysis associated steal syndrome - Understand surgical treatment options for dialysis associated steal syndrome References Please review the journal article below for helpful pictures and depictions of the operations we describe in this episode. - Al Shakarchi J, et al. Surgical techniques for haemodialysis access-induced distal ischaemia. J Vasc Access. 2016 Jan-Feb;17(1):40-6. https://pubmed.ncbi.nlm.nih.gov/26349875/ Other helpful references - Kordzadeh A, Parsa AD. A Systematic review of distal revascularization and interval ligation for the treatment of vascular access-induced ischemia. J Vasc Surg 2019; 70:1364. https://pubmed.ncbi.nlm.nih.gov/31153703/ - Huber TS, Larive B, Imprey PB, et al. Access-related hand ischemia and the Hemodialysis Fistula Maturation Study. J Vasc Surg 2016;64:1050. https://pubmed.ncbi.nlm.nih.gov/27478007/ - Sidawy An, Spergel LM, Besarab A, et al. The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access. J Vasc Surg 2008; 48:2S. https://pubmed.ncbi.nlm.nih.gov/19000589/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Mar 7, 2024

Join BTK eduction fellows, Drs. Nina Clark and Jon Williams along with guests Drs. Sharmila Dissanaike and Paula Ferrada for a discussion on whether it’s time for a paradigm shift toward a circulation-first approach to trauma resuscitation. Hosts: Nina Clark, MD and Jon Williams, MD Guests: Sharmila Dissanaike, MD - Texas Tech University Health Sciences Center, Lubbock, TX Paula Ferrada, MD - Inova, Fairfax, VA References: Ferrada P, Dissanaike S. Circulation First for the Rapidly Bleeding Trauma Patient-It Is Time to Reconsider the ABCs ofTrauma Care. JAMA Surg. 2023 Aug 1;158(8):884-885. doi: 10.1001/jamasurg.2022.8436. PMID: 37195675. https://pubmed.ncbi.nlm.nih.gov/37195675/ Ferrada P, Ferrada R, Jacobs L, Duchesne J, Ghio M, Joseph B, Taghavi S, Qasim ZA, Zakrison T, Brenner M,Dissanaike S, Feliciano D. Prioritizing Circulation to Improve Outcomes for Patients with Exsanguinating Injury: ALiterature Review and Techniques to Help Clinicians Achieve Bleeding Control. J Am Coll Surg. 2024 Jan 1;238(1):129-136. doi: 10.1097/XCS.0000000000000889. Epub 2023 Nov 28. PMID: 38014850; PMCID: PMC10718219. https://pubmed.ncbi.nlm.nih.gov/38014850/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Mar 4, 2024

Join the Behind the Knife Surgical Oncology Team as we discuss “One versus Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal Tumor: A Randomized Trial,” the randomized trial guiding duration of imatinib treatment for gastrointestinal stromal tumors (GIST). Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center. - Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson. - Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center. - Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center. Learning Objectives: In this episode, we discuss the article “One versus Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal Tumor: A Randomized Trial” published in JAMA in 2012. This study demonstrated that 3 years of imatinib led to improved recurrence-free and overall survival compared to 1 year. Links to Paper Referenced in this Episode https://jamanetwork.com/journals/jama/fullarticle/1105116 ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Feb 29, 2024

Though relatively rare, lateral abdominal wall hernias present a unique challenge to surgeons. Join Drs. Ajita Prabhu, Lucas Beffa, Sara Maskal and Ryan Ellis as they talk through their approach to these difficult cases. Hosts: · Ajita Prabhu, MD, Cleveland Clinic, @aprabhumd1 · Lucas Beffa, MD, Cleveland Clinic, @BeffaLukeMD · Ryan Ellis, MD, Cleveland Clinic, @EllisMD2020 · Sara Maskal, MD, Cleveland Clinic Learning Objectives: · Review anatomy of lateral abdominal wall hernias · Review pitfalls of operating in the retroperitoneum · Review surgical approaches to repair defects based on algorithmic assessment References: · Montelione KC, Petro CC, Krpata DM, Lau B, Shukla P, Olson MA, Tamer R, Rosenblatt S, Rosen MJ, Prabhu AS. Open Retromuscular Lateral Abdominal Wall Hernia Repair: Algorithmic Approach and Long-Term Outcomes at a Single Center. J Am Coll Surg. 2023 Jan 1;236(1):220-234. doi: 10.1097/XCS.0000000000000419. Epub 2022 Dec 15. PMID: 36106747. https://pubmed.ncbi.nlm.nih.gov/36106747/ · Beffa LR, Margiotta AL, Carbonell AM. Flank and Lumbar Hernia Repair. Surg Clin North Am. 2018 Jun;98(3):593-605. doi: 10.1016/j.suc.2018.01.009. Epub 2018 Mar 12. PMID: 29754624. https://pubmed.ncbi.nlm.nih.gov/29754624/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Feb 26, 2024

Do the words “Is there a doctor on board” fill you with anxiety? For Dr. Thomas Doyle, responding to in flight medical events is just another day at the office. As the medical director for STAT-MD, him and his team provide on the ground consultation for passengers experiencing medical events at 35,000 feet. In this episode we talk about what events are most common, what equipment is on board, what are the rules/regulations around providing medical assistance, and what ground consultation services like STAT-MD can help offer to you so you’re never alone if you hear that phrase “Is there a doctor on board?” Guests: Thomas J. Doyle, MD, MPH- Clinical Associate Professor of Emergency Medicine- University of Pittsburgh Medical Center; Medical Director, STAT-MD Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Major John McClellan, MD - Acute Care and Trauma Surgeon- University of North Carolina Chapel Hill Want to learn more from Dr. Doyle about in-flight medical events- you can check out one of his previous lectures here: https://www.upmcphysicianresources.com/cme-courses/emergencies-at-35000-feet-is-there-a-medical-provider-on-board **Introducing Behind the Knife's Trauma Surgery Video Atlas - https://app.behindtheknife.org/premium/trauma-surgery-video-atlas/show-content The Trauma Surgery Video Atlas contains 24 scenarios that include never-before-seen high-definition operative footage, rich, original illustrations, and practical, easy-to-read pearls that will help you dominate the most difficult trauma scenarios. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes here: https://app.behindtheknife.org/listen

Feb 22, 2024

You have a patient referred to you for a history of anal dysplasia and found to have an anal lesion on colonoscopy. How do you evaluate this? What are the risk factors? How will you perform surveillance afterwards? Does everyone need HRA? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Lisa Breen as they discuss high yield papers discussing Anal Dysplasia. Learning Objectives 1. Describe the different types of anal dysplasia and pathologic categorization 2. Describe high risk populations for development of anal squamous cell cancer 3. Discuss the different options and recommendations for surveillance and treatment of anal dysplasia Video Link: https://www.youtube.com/watch?v=YdOjV1Gcqvk **Introducing Behind the Knife's Trauma Surgery Video Atlas - https://app.behindtheknife.org/premium/trauma-surgery-video-atlas/show-content The Trauma Surgery Video Atlas contains 24 scenarios that include never-before-seen high-definition operative footage, rich, original illustrations, and practical, easy-to-read pearls that will help you dominate the most difficult trauma scenarios. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes here: https://app.behindtheknife.org/listen

Feb 19, 2024

You get called to see a consult in the middle of the night. It is a middle-aged woman with a bariatric history, and she says her stomach is smaller but doesn’t know the name of the operation. She developed worsening abdominal pain after dinner and it’s been getting worse. She’s not peritonitic, but she’s clearly in discomfort. Is it cholecystitis, diverticulitis, pancreatitis, marginal ulcer, or an internal hernia? What do you do? Join Drs. Matthew Martin, Adrian Dan, and Paul Wisniowski on a discussion about initial evaluation and management of bariatric patients with internal hernias. Show Hosts: Matthew Martin Adrian Dan Paul Wisniowski Video companion: https://app.behindtheknife.org/video/clinical-challenges-in-bariatric-surgery-internal-hernia Show Notes 1. Initial Evaluation a. Focused history and physical, labs, and imaging i. Presenting symptoms may vary and include: nausea, emesis, and abdominal pain ranging from vague to severe. ii. A basic lab panel can aid in developing the diagnosis and guide resuscitation. iii. CT of the abdomen and pelvis with IV and oral contrast can assist in identifying intra-abdominal pathology iv. Reviewing the previous operative report is beneficial to have a framework of the anatomy, i.e. type of bariatric surgery, and configuration of small bowel limbs (ante- vs retro-gastric and ante- vs retro-colic). 1. According to a 2019 study, 40-60% of closed defects had reopened at time of re-exploration v. If the patient is peritonitic with abdominal pain, they should be treated similarly to any patient with an acute abdomen with emergent exploration. b. CT Imaging i. A mesenteric swirl sign with twisting of the soft tissue and mesenteric vessels with surrounding fat attenuation has been shown to have a sensitivity of 78-100% and specificity of 80-90%. Other findings include: a Bird’s beak, dilation of roux or biliopancreatic limbs, SMV narrowing, and displacement of JJ limb to the RUQ and can be used to support the diagnosis of internal hernia ii. An experienced radiologist familiar with bariatric anatomy has been shown to have a positive predictive value to 81% and negative predictive value to 96% at radiologically diagnosing internal hernia. iii. A CT scan can provide insight for a suspected diagnosis but it cannot rule out internal hernia c. Nasogastric/Esophageal Tube i. Use judiciously based on patient’s presenting symptoms ii. Placement should be done by the surgical team iii. This may mitigate the risk of aspiration during intubation. 2. Operative Management a. Entry should be dependent on the comfort of the operating surgeon. i. Veress entry into the abdomen with dilated bowels may lead to increased injuries. ii. Optiview allows for direct visualization of each layer of the abdominal wall. Focusing on twisting the trochar and limiting perpendicular pressure. iii. Hasson entry also allows for direct visualization but may be limiting in bariatric patients with thick abdominal walls b. Exploration – a systematic approach i. Start with evaluation of the gastric pouch and run the roux limb to the jejunojejunostomy, and examine Petersen’s and mesojejunal defects. ii. Follow the biliopancreatic limb to the ligament of Treitz iii. Lastly, identify the terminal ileum at the sail of Treves and run backwards to the jejunojejunostomy iv. This will allow for examination of all possible defect and possible intussusception at the jejunostomy c. Defect Management i. All defects should be closed, with studies demonstrating reduced rates of internal hernia when defects are closed with a running suture. There is no strong evidence to support the use of a specific suture material. 1. The use of suture is superior to other methods of closure such as metallic clips, fibrin glue, mesh, or abrasive pads. 2. A barbed suture can be considered. d. In a patient with unfavorable anatomy or those unable to tolerate pneumoperitoneum surgeons should consider early conversion to open exploration 3. Postoperative Care a. Patients are started on ERAS protocol with limited narcotic use, same day mobilization, early oral nutrition with advancement, and no nasogastric tubes or foley catheters b. Patients with bowel resection and those with suspected postoperative ileus may benefit from judicious advancement of diet. 4. Pregnancy a. Pregnant patients with history of anastomotic bariatric surgery are at increased risk of internal hernia especially in 3rd trimester due to loss of intra-abdominal space b. Evaluation of a pregnant patient should include abdominal imaging. i. In a non-acute setting, an MRI abd/pelvis can be considered. ii. Patients with abdominal pain presenting to the Emergency Department should undergo CT imaging. iii. The risk of radiation to a fetus, especially beyond the 1st trimester, is limited. Based on the CDC guidelines, a human embryo and fetus are sensitive to ionizing radiation at doses greater than 0.1Gray. The amount of radiation from a typical CT range from 0.015 to 0.034Gray depending if it is multiphasic or not; well below the guideline level. c. It is important to discuss with women of child bearing age the risk of internal hernia during pregnancy with anastomotic bariatric surgery 5. Outpatient Presentation a. Half of patients with internal hernia will present in outpatient setting often >6 months after initial operation with complaints of intermittent nausea, vomiting, and abdominal pain b. Workup includes: CT abd/pelvis with IV and oral contrast, Upper GI series, EGD, and a RUQ ultrasound based on their symptoms c. If diagnostic testing is equivocal, proceed with diagnostic laparoscopy to mitigate the risk of internal hernia with bowel ischemia. **Introducing Behind the Knife's Trauma Surgery Video Atlas - https://app.behindtheknife.org/premium/trauma-surgery-video-atlas/show-content The Trauma Surgery Video Atlas contains 24 scenarios that include never-before-seen high-definition operative footage, rich, original illustrations, and practical, easy-to-read pearls that will help you dominate the most difficult trauma scenarios. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more recent episodes here: https://app.behindtheknife.org/listen

Feb 15, 2024

We know cardiac surgery can seem a bit daunting on the surface. However, most surgeons will come across cardiac surgery patients at some point whether in the OR, ICU, ED, etc. As the FIRST cardiac surgery specialty team for Behind the Knife, we are excited to bring you episodes focused on high-yield topics to help you navigate common cardiac surgery challenges, discuss relevant literature to help you in practice, and help our listeners feel more comfortable around cardiac surgery patients. In this episode we’ll discuss mitral valve disease. We’ll review important physiologic differences in patients with mitral valve disease, the most common surgical approaches to address mitral valve disease, and how to work up and address acute mitral regurgitation due to acute papillary muscle rupture. Hosts: - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 - Aaron William, MD- Cardiothoracic Surgery Fellow, Duke University, @AMWilliamsMD - Nick Teman, MD- Assistant Professor of Thoracic and Cardiovascular Surgery, University of Virginia, @nickteman Learning objectives: - Understand the physiologic differences that occur with mitral valve stenosis and regurgitation. - Understand the basic principles of mitral valve repair and replacement strategies. - Understand the presentation, work-up, and acute management of acute mitral valve regurgitations due to acute papillary muscle rupture/MI. For episode ideas/suggestions/feedback feel free to email Jessica Millar at: millarje@med.umich.edu **Introducing Behind the Knife's Trauma Surgery Video Atlas - https://app.behindtheknife.org/premium/trauma-surgery-video-atlas/show-content The Trauma Surgery Video Atlas contains 24 scenarios that include never-before-seen high-definition operative footage, rich, original illustrations, and practical, easy-to-read pearls that will help you dominate the most difficult trauma scenarios.

Feb 12, 2024

Our Cardiothoracic Oral Board Audio Review includes 43 high-yield scenarios designed for Cardiothoracic Surgeons by Cardiothoracic Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as cardiothoracic surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://app.behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 8, 2024

Our Cardiothoracic Oral Board Audio Review includes 43 high-yield scenarios designed for Cardiothoracic Surgeons by Cardiothoracic Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as cardiothoracic surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://app.behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 5, 2024

REBOA is one spicy meatball! On this episode, Drs. Nina Clark and Patrick Georgoff discuss the landmark UK-REBOA trial with Dr. Karim Brohi. This is the first randomized controlled trial studying REBOA and provides invaluable information about its potential indications. Dr. Karim Brohi is a trauma and vascular surgeon at the Royal London Major Trauma Centre and director of the London Major Trauma System, which is the largest integrated urban trauma system in the world and manages over 33,000 injuries a year. He studied at University College of London where he obtained degrees in both computer science and medicine. Dr. Brohi went on to train in general surgery, vascular surgery, and anesthesia/critical care in the UK and trauma surgery in Cape Town and San Francisco. He is a prolific researcher and has led multiple large clinical trials. Link to UK-REBOA paper: https://jamanetwork.com/journals/jama/article-abstract/2810757 BIG T Trauma episode 290 covers potential indications, placement, and complications of REBOA: https://behindtheknife.org/podcast/big-t-trauma-series-ep-2-reboa/ ***TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/premium/trauma-surgery-video-atlas ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Feb 1, 2024

Surgical resection of bilateral colorectal liver metastasis (CLM) can pose a significant challenge to even the most experienced HPB surgeon. Is surgical resection justified, if so, in which patients? What’s the best surgical approach for curative intent resection of all lesions, and does ablation play a role? In this episode from the HPB team at Behind the Knife, listen in on the discussion about the surgical management of patients with bilateral colorectal liver metastasis. Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center Learning Objectives: · Develop an understanding of patient selection for surgical resection of bilateral colorectal liver metastasis (CLM). · Develop an understanding of the use of Two Stage Hepatectomy (TSH) versus Parenchymal Sparing Hepatectomy (PSH) in the treatment of bilateral CLM. · Develop an understanding of if and when to use ablative procedures for resection of bilateral CLM. · Develop an understanding of selection and management of patients who suffer recurrence after resection of bilateral CLM. Suggested Readings · Omichi K, Shindoh J, Cloyd JM, Mizuno T, Chun YS, Conrad C, Aloia TA, Tzeng CD, Vauthey JN. Liver resection is justified for patients with bilateral multiple colorectal liver metastases: A propensity-score-matched analysis . Eur J Surg Oncol. 2018 Jan;44(1):122-129. doi: 10.1016/j.ejso.2017.11.006. Epub 2017 Nov 24. PMID: 29208318; PMCID: PMC5742306. https://pubmed.ncbi.nlm.nih.gov/29208318/ · Kawaguchi Y, Kopetz S, Tran Cao HS, Panettieri E, De Bellis M, Nishioka Y, Hwang H, Wang X, Tzeng CD, Chun YS, Aloia TA, Hasegawa K, Guglielmi A, Giuliante F, Vauthey JN. Contour prognostic model for predicting survival after resection of colorectal liver metastases: development and multicentre validation study using largest diameter and number of metastases with RAS mutation status. Br J Surg. 2021 Aug 19;108(8):968-975. doi: 10.1093/bjs/znab086. PMID: 33829254; PMCID: PMC8378514. https://pubmed.ncbi.nlm.nih.gov/33829254/ · Nishioka Y, Paez-Arango N, Boettcher FO, Kawaguchi Y, Newhook TE, Chun YS, Tzeng CD, Tran Cao HS, Lee JE, Vreeland TJ, Vauthey JN. Neither Surgical Margin Status nor Somatic Mutation Predicts Local Recurrence After R0-intent Resection for Colorectal Liver Metastases. J Gastrointest Surg. 2022 Apr;26(4):791-801. doi: 10.1007/s11605-021-05173-0. Epub 2021 Nov 1. PMID: 34725784. https://pubmed.ncbi.nlm.nih.gov/34725784/ · Passot G, Chun YS, Kopetz SE, Zorzi D, Brudvik KW, Kim BJ, Conrad C, Aloia TA, Vauthey JN. Predictors of Safety and Efficacy of 2-Stage Hepatectomy for Bilateral Colorectal Liver Metastases . J Am Coll Surg. 2016 Jul;223(1):99-108. doi: 10.1016/j.jamcollsurg.2015.12.057. Epub 2016 Jan 18. PMID: 26968325; PMCID: PMC4925205. https://pubmed.ncbi.nlm.nih.gov/26968325/ · Donadon M, Cescon M, Cucchetti A, Cimino M, Costa G, Pesi B, Ercolani G, Pinna AD, Torzilli G. Parenchymal-Sparing Surgery for the Surgical Treatment of Multiple Colorectal Liver Metastases Is a Safer Approach than Major Hepatectomy Not Impairing Patients' Prognosis: A Bi-Institutional Propensity Score-Matched Analysis. Dig Surg. 2018;35(4):342-349. doi: 10.1159/000479336. Epub 2017 Oct 14. PMID: 29032372. https://pubmed.ncbi.nlm.nih.gov/29032372/ · Lillemoe HA, Kawaguchi Y, Passot G, Karagkounis G, Simoneau E, You YN, Mehran RJ, Chun YS, Tzeng CD, Aloia TA, Vauthey JN. Surgical Resection for Recurrence After Two-Stage Hepatectomy for Colorectal Liver Metastases Is Feasible, Is Safe, and Improves Survival. J Gastrointest Surg. 2019 Jan;23(1):84-92. doi: 10.1007/s11605-018-3890-y. Epub 2018 Aug 6. PMID: 30084064; PMCID: PMC6329635. https://pubmed.ncbi.nlm.nih.gov/30084064/ · Panettieri E, Kim BJ, Kawaguchi Y, Ardito F, Mele C, De Rose AM, Vellone M, Chun YS, Tzeng CD, Aloia TA, Giuliante F, Vauthey JN. Survival by Number and Sites of Resections of Recurrence after First Curative Resection of Colorectal Liver Metastases. J Gastrointest Surg. 2022 Dec;26(12):2503-2511. doi: 10.1007/s11605-022-05456-0. Epub 2022 Sep 20. PMID: 36127553. https://pubmed.ncbi.nlm.nih.gov/36127553/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent Hepatobiliary Surgery episodes here: https://app.behindtheknife.org/podcast-category/hepatobiliary

Jan 29, 2024

2023 was an exciting year for Surgical Palliative Care research! Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington to discuss two seminal randomized controlled trials in the Surgical Palliative Care space. Hosts: · Dr. Katie O’Connell (@katmo15) is an Assistant Professor of Surgery at the University of Washington. She is a trauma surgeon, palliative care physician, Director of Surgical Palliative Care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. · Dr. Ali Haruta is a PGY7 Hospice & Palliative Care fellow at the University of Washington, formerly a UW General Surgery resident and Parkland Trauma/Critical Care fellow. · Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 General Surgery resident and current Surgical Oncology fellow at the University of Washington. · Dr. Virginia Wang is a PGY2 General Surgery resident at the University of Washington. Learning Objectives: · Discuss the current state of the RCT literature in Palliative Care & Surgical Palliative Care · Understand the primary outcomes of the Shinall and Aslakson trials as related to perioperative specialty palliative care intervention · Identify limitations in existing surgical palliative care RCTs & further opportunities for study · Identify underlying differences between medical oncology and surgical oncology patient populations References: 1. Shinall MC, Martin SF, Karlekar M, et al. Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial. JAMA Surg. 2023;158(7) :747–755. doi:10.1001/jamasurg.2023.1396 https://pubmed.ncbi.nlm.nih.gov/37163249/ 2. Aslakson RA, Rickerson E, Fahy B, et al. Effect of Perioperative Palliative Care on Health-Related Quality of Life Among Patients Undergoing Surgery for Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(5) :e2314660. doi:10.1001/jamanetworkopen.2023.14660 https://pubmed.ncbi.nlm.nih.gov/37256623/ 3. Ingersoll LT, Alexander SC, Priest J, et al. Racial/ethnic differences in prognosis communication during initial inpatient palliative care consultations among people with advanced cancer. Patient Educ Couns. 2019;102(6) :1098-1103. doi:10.1016/j.pec.2019.01.002 https://pubmed.ncbi.nlm.nih.gov/30642715/ 4. Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA. 2009;302(7) :741-749. doi:10.1001/jama.2009.1198 https://pubmed.ncbi.nlm.nih.gov/19690306/ 5. Corn BW, Feldman DB, Hull JG, O'Rourke MA, Bakitas MA. Dispositional hope as a potential outcome parameter among patients with advanced malignancy: An analysis of the ENABLE database. Cancer. 2022;128(2) :401-409. doi:10.1002/cncr.33907 https://pubmed.ncbi.nlm.nih.gov/34613617/ 6. El-Jawahri A, LeBlanc TW, Kavanaugh A, et al. Effectiveness of Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia: A Randomized Clinical Trial. JAMA Oncol. 2021;7(2) :238-245. doi:10.1001/jamaoncol.2020.6343 https://pubmed.ncbi.nlm.nih.gov/33331857/ 7. More about the metrics from both the Shinall and Aslakson studies: a. FACT-G – https://www.facit.org/measures/fact-g b. FACIT-Pal – https://www.facit.org/measures/facit-pal c. PROMIS-29 – https://heartbeat-med.com/resources/promis-29/ d. PROPr (PROMIS-Preference) score – https://www.proprscore.com/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical palliative care episodes here: https://app.behindtheknife.org/podcast-category/palliative-care

Jan 25, 2024

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 4 outlines the complex perineal and soft tissue, urological, bone and vascular reconstructions that may be required as part of these multi-visceral resections, as well as how to approach challenging postoperative complications. Each episode in this series features a different international guest surgeon. In episode 4, the RPA team are joined by A/Prof Gabrielle van Ramshorst from the Ghent University Hospital, Belgium. Technical descriptions: Ho K, Warrier S, Solomon MJ, Lee K. A prepelvic tunnel for the rectus abdominis myocutaneous flap in perineal reconstruction. J Plast Reconstr Aesthet Surg. 2006;59(12):1415-9. doi: 10.1016/j.bjps.2006.01.050. Epub 2006 Jun 22. PMID: 17113532. https://pubmed.ncbi.nlm.nih.gov/17113532/ Jacombs AS, Rome P, Harrison JD, Solomon MJ. Assessment of the selection process for myocutaneous flap repair and surgical complications in pelvic exenteration surgery. Br J Surg. 2013 Mar;100(4):561-7. doi: 10.1002/bjs.9002. Epub 2012 Nov 27. PMID: 23188415. https://pubmed.ncbi.nlm.nih.gov/23188415/ References: Witte DYS, van Ramshorst GH, Lapid O, Bouman MB, Tuynman JB. Flap Reconstruction of Perineal Defects after Pelvic Exenteration: A Systematic Description of Four Choices of Surgical Reconstruction Methods. Plast Reconstr Surg. 2021 Jun 1;147(6):1420-1435. doi: 10.1097/PRS.0000000000007976. PMID: 33973948. https://pubmed.ncbi.nlm.nih.gov/33973948/ van Ramshorst GH, Young JM, Solomon MJ. Complications and Impact on Quality of Life of Vertical Rectus Abdominis Myocutaneous Flaps for Reconstruction in Pelvic Exenteration Surgery. Dis Colon Rectum. 2020 Sep;63(9):1225-1233. doi: 10.1097/DCR.0000000000001632. PMID: 33216493. https://pubmed.ncbi.nlm.nih.gov/33216493/ Sutton PA, Brown KGM, Ebrahimi N, Solomon MJ, Austin KKS, Lee PJ. Long-term surgical complications following pelvic exenteration: Operative management of the empty pelvis syndrome. Colorectal Dis. 2022 Dec;24(12):1491-1497. doi: 10.1111/codi.16238. Epub 2022 Jul 19. PMID: 35766998. https://pubmed.ncbi.nlm.nih.gov/35766998/ Johnson YL, West MA, Gould LE, Drami I, Behrenbruch C, Burns EM, Mirnezami AH, Jenkins JT. Empty pelvis syndrome: a systematic review of reconstruction techniques and their associated complications. Colorectal Dis. 2022 Jan;24(1):16-26. doi: 10.1111/codi.15956. Epub 2021 Oct 25. PMID: 34653292. https://pubmed.ncbi.nlm.nih.gov/34653292/ Persson P, Chong P, Steele CW, Quinn M. Prevention and management of complications in pelvic exenteration. Eur J Surg Oncol. 2022 Nov;48(11):2277-2283. doi: 10.1016/j.ejso.2021.12.470. Epub 2022 Jan 1. PMID: 35101315. https://pubmed.ncbi.nlm.nih.gov/35101315/ Lee P, Tan WJ, Brown KGM, Solomon MJ. Addressing the empty pelvic syndrome following total pelvic exenteration: does mesh reconstruction help? Colorectal Dis. 2019 Mar;21(3):365-369. doi: 10.1111/codi.14523. Epub 2019 Jan 16. PMID: 30548166. https://pubmed.ncbi.nlm.nih.gov/30548166/ Video Link: https://www.youtube.com/watch?v=GBC-ZD0B7UM ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Jan 22, 2024

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 3 outlines the radical technical approaches to posterior and laterally invasive tumours, including en bloc iliac vascular resection and reconstruction, as well as radical sacrectomy techniques. Each episode in this series features a different international guest surgeon. In episode 3, the RPA team are joined by Dr Oliver Peacock from the University of Texas MD Anderson Cancer Centre, USA. Episode Video Link: https://www.youtube.com/watch?v=y25IYUiARgQ Technical descriptions and videos: Shaikh I, Holloway I, Aston W, Littler S, Burling D, Antoniou A, Jenkins JT; Complex Cancer Clinic St Mark's Hospital London. High subcortical sacrectomy: a novel approach to facilitate complete resection of locally advanced and recurrent rectal cancer with high (S1-S2) sacral extension. Colorectal Dis. 2016 Apr;18(4):386-92. doi: 10.1111/codi.13226. PMID: 26638828. https://pubmed.ncbi.nlm.nih.gov/26638828/ Brown KGM, Solomon MJ, Austin KKS, Lee PJ, Stalley P. Posterior high sacral segmental disconnection prior to anterior en bloc exenteration for recurrent rectal cancer. Tech Coloproctol. 2016 Jun;20(6):401-404. doi: 10.1007/s10151-016-1456-0. Epub 2016 Mar 21. PMID: 27000857. https://pubmed.ncbi.nlm.nih.gov/27000857/ Sutton PA, Solomon M, Sasidharan P, Lee P, Austin K. Abdominolithotomy sacrectomy for the management of locally recurrent rectal cancer: video vignette. Br J Surg. 2021 Aug 19;108(8):e257. doi: 10.1093/bjs/znab105. PMID: 34089593. https://pubmed.ncbi.nlm.nih.gov/34089593/ Drami I, Fletcher JA, Corr A, West MA, Aston W, Hellawell G, Burns EM, Jenkins JT. Total pelvic exenteration with 'high and wide' sacrectomy for recurrent rectal cancer: A video vignette. Colorectal Dis. 2022 Dec;24(12):1625-1626. doi: 10.1111/codi.16230. Epub 2022 Jul 18. PMID: 35730692. https://pubmed.ncbi.nlm.nih.gov/35730692/ References: Rajendran S, Brown KGM, Solomon MJ. Oncovascular surgery for advanced pelvic malignancy. Br J Surg. 2023 Jan 10;110(2):144-149. doi: 10.1093/bjs/znac414. PMID: 36427187. https://pubmed.ncbi.nlm.nih.gov/36427187/ Austin KK, Solomon MJ. Pelvic exenteration with en bloc iliac vessel resection for lateral pelvic wall involvement. Dis Colon Rectum. 2009 Jul;52(7):1223-33. doi: 10.1007/DCR.0b013e3181a73f48. PMID: 19571697. https://pubmed.ncbi.nlm.nih.gov/19571697/ Rogers AC, Jenkins JT, Rasheed S, Malietzis G, Burns EM, Kontovounisios C, Tekkis PP. Towards Standardisation of Technique for En Bloc Sacrectomy for Locally Advanced and Recurrent Rectal Cancer. J Clin Med. 2021 Oct 25;10(21):4921. doi: 10.3390/jcm10214921. PMID: 34768442; PMCID: PMC8584798. https://pubmed.ncbi.nlm.nih.gov/34768442/ van Kessel CS, Waller J, Steffens D, Lee PJ, Austin KKS, Stalley PD, Solomon MJ. Improving Surgical Outcomes in Pelvic Exenteration Surgery: Comparison of Prone Sacrectomy with Anterior Cortical Sacrectomy Techniques. Ann Surg. 2023 Jul 24. doi: 10.1097/SLA.0000000000006040. Epub ahead of print. PMID: 37485983. https://pubmed.ncbi.nlm.nih.gov/37485983/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Jan 16, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 15, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 12, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 11, 2024

As the cost of living continues to rise, the salary and housing stipends of resident physicians are not keeping pace. Dr. Melissa Drezdzon and Dr. Jed Calata from the Medical College of Wisconsin have explored these issues in depth and share their insights. Join hosts Dr. Ananya Anand, Dr. Joe L’Huillier, and Dr. Rebecca Moreci and their special guests as they discuss the salary of resident physicians. Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, ananya_anand@stanford.edu –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101, josephlh@buffalo.edu –Dr. Rebecca Moreci, Louisiana State University, @md_moreci, morecir@med.umich.edu –COSEF: @surgedfellows Special guests: -Dr. Melissa Drezdzon, Medical College of Wisconsin, @mdrezdzonmd, mdrezdzon@mcw.edu -Dr. Jed Calata, Medical College of Wisconsin, jcalata@mcw.edu Learning Objectives: Listeners will: – Appreciate the discrepancy between cost of living increases and stagnant resident salaries – Describe how residency salaries are funded – Recall the regional variation in resident stipends and access to affordable housing across the united states – List possible solutions for addressing this issue References: Drezdzon MK, Cowley NJ, Sweeney DP, Peterson CY, Ridolfi TJ, Ludwig KA, Evans DB, Calata JF. Going for Broke: The Impact of Cost of Living on Surgery Resident Stipend Value. Ann Surg. 2023 Dec 1;278(6):1053-1059. doi: 10.1097/SLA.0000000000005923. Epub 2023 May 25. PMID: 37226808. https://pubmed.ncbi.nlm.nih.gov/37226808/ Drezdzon, M.K., Cowley, N.J., Sweeney, D.P., Peterson CY, Ridolfi TJ, Ludwig KA, Calata JF. A costly threat to GME: the housing crisis and residency training. Global Surg Educ 2, 85 (2023). https://doi.org/10.1007/s44186-023-00157-x ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Video Link: https://www.youtube.com/watch?v=4DYJIxCrsDE Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen

Jan 10, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9 *** Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 9, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 8, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 5, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 4, 2024

The percent surface area burn for which half of patients survive, known as lethal area 50, or LA50 depends on where in the world the injury occurs. Calling all surgeons and trainees with an interest in providing more equitable delivery of global injury care - Join our Burn Surgery team as we welcome Dr. Manish Yadav, Plastic and Burn Surgeon at Kirtipur Hospital in Kathmandu, Nepal to discuss several recent challenging cases. We’ll discuss the global burden of burn injuries, how emergency burn care systems reduce preventable morbidity and mortality, innovations in resuscitation of burn shock, use of checklists for critical care and safe early excision, and application of palliative care in different cultural contexts. (Co-hosts: Dr. Barclay Stewart, Burn and Trauma Surgeon at Harborview Medical Center and Paul Herman, UWMC/HMC Surgery Resident) Hosts: (affiliation and SM handles) 1. Manish Yadav, Kirtipur Hospital, Nepal 2. Barclay Stewart, Harborview Medical Center 3. Paul Herman, UW/Harborview General Surgery Resident, @paul_herm 4. Tam Pham, Harborview Medical Center (Editor) Learning Objectives 1. Describe the global epidemiology of burn injury, disparities in burn injury and care, and highlight efforts to improve burn care in low and middle-income countries 2. Discuss two cases at a burn center in Kirtipur, Nepal, highlighting challenges in burn care in LMICs and innovations to address these challenges and provide high level care a. Highlight enteral resuscitation as an innovative strategy with advantages for treating burn shock in low resource settings b. Discuss the key burn concept of early excision and steps to ensure safe application in low resource settings 1. References a. Gosselin, R., Charles, A., Joshipura, M., Mkandawire, N., Mock, C. N. , et. al. 2015. “Surgery and Trauma Care”. In: Disease Control Priorities (third edition): Volume 1, Essential Surgery, edited by H. Debas, P. Donkor, A. Gawande, D. T. Jamison, M. Kruk, C. N. Mock. Washington, DC: World Bank. b. Stewart BT, Nsaful K, Allorto N, Man Rai S. Burn Care in Low-Resource and Austere Settings. Surg Clin North Am. 2023 Jun;103(3):551-563. doi: 10.1016/j.suc.2023.01.014. Epub 2023 Apr 4. PMID: 37149390. https://pubmed.ncbi.nlm.nih.gov/37149390/ c. Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT; SOSAS4 Research Group. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns. 2018 Aug;44(5):1228-1234. doi: 10.1016/j.burns.2018.01.015. Epub 2018 Feb 21. PMID: 29475744. https://pubmed.ncbi.nlm.nih.gov/29475744/ d. Hebron C, Mehta K, Stewart B, Price P, Potokar T. Implementation of the World Health Organization Global Burn Registry: Lessons Learned. Annals of Global Health. 2022; 88(1): 34, 1–10. DOI: https://doi. Org/10.5334/aogh.3669 https://pubmed.ncbi.nlm.nih.gov/35646613/ e. Jordan KC, Di Gennaro JL, von Saint André-von Arnim A and Stewart BT (2022) Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry. Front. Pediatr. 10:954995. doi: 10.3389/fped.2022.954995 https://pubmed.ncbi.nlm.nih.gov/35928690/ f. Mehta K, Thrikutam N, Hoyte-Williams PE, Falk H, Nakarmi K, Stewart B. Epidemiology and Outcomes of Cooking- and Cookstove-Related Burn Injuries: A World Health Organization Global Burn Registry Report. J Burn Care Res. 2023 May 2;44(3):508-516. doi: 10.1093/jbcr/irab166. PMID: 34850021; PMCID: PMC10413420. https://pubmed.ncbi.nlm.nih.gov/34850021/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://behindtheknife.org/listen/

Jan 3, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 2, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 1, 2024

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 29, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 28, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 27, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 26, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 25, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 22, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 21, 2023

There is more than one way to plug a hole… Perineal wounds after pelvic surgery can be challenging to manage. It is important for surgeons to have a general understanding of upfront reconstruction options and strategies to deal with the sequence of wound failure. Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss the management of perineal wounds following pelvic surgery. Hosts: - Susan Galandiuk MD, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky MD, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas MD, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon DO, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review perineal reconstruction options after pelvic surgery for anorectal pathology. - Understand management strategies for perineal wound breakdown. - Discuss the importance of critical appraisal of studies surrounding perineal wound reconstruction and management. References: - Asaad M, et al. Robotic Rectus Abdominis Muscle Flap following Robotic Extirpative Surgery. Plastic and Reconstructive Surgery 148(6):p 1377-1381, December 2021. doi: 10.1097/PRS.0000000000008592 https://pubmed.ncbi.nlm.nih.gov/34847128/ - Figg RE, Church JM. Perineal Crohn's disease: an indicator of poor prognosis and potential proctectomy. Dis Colon Rectum. 2009 Apr;52(4):646-50. doi: 10.1007/DCR.0b013e3181a0a5bf. https://pubmed.ncbi.nlm.nih.gov/19404069/ - Fuschillo G, Pellino G. Chronic Perineal Sinus After Proctectomy for Crohn’s Disease: Risk Reduction Strategies and Management. Diseases of the Colon & Rectum 65(4):p 468-471, April 2022. doi: 10.1097/DCR.0000000000002413 https://pubmed.ncbi.nlm.nih.gov/35067504/ - Mori GA, Tiernan JP. Management of Perineal Wounds Following Pelvic Surgery. Clin Colon Rectal Surg. 2022 Mar 7;35(3):212-220. doi: 10.1055/s-0042-1742414. https://pubmed.ncbi.nlm.nih.gov/35966381/ - Rather AA, Fisher AL, Chun D, Mannion JD, Alexander EL. Closed Incisional Negative Pressure Therapy Reduces Perineal Wound Complications After Abdominoperineal Resection. Dis Colon Rectum. 2023 Feb 1;66(2):314-321. doi: 10.1097/DCR.0000000000002289. https://pubmed.ncbi.nlm.nih.gov/35001048/ - Tiernan JP, Leavitt T, Sapci I, Valente MA, Delaney CP, Steele SR, Gorgun E. A Comparison of Perineal Myocutaneous Flaps Following Abdominoperineal Excision of the Rectum for Anorectal Pathology. Dis Colon Rectum. 2022 Nov 1;65(11):1316-1324. doi: 10.1097/DCR.0000000000002271. Epub 2021 Dec 13. PMID: 35156364. https://pubmed.ncbi.nlm.nih.gov/35156364/ - Wright J, et al. V-Y Gluteal Fasciocutaneous Advancement Flap After Robotic Abdominoperineal Resection. Diseases of the Colon & Rectum 64(9):p e526-e527, September 2021. doi: 10.1097/DCR.0000000000002126 ; https://www.youtube.com/watch?v=urs_yeLLKlQ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out out other colorectal surgery episodes : https://app.behindtheknife.org/podcast-category/colorectal

Dec 20, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 19, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 18, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 15, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ Download our iOS and Android apps from your App Store. You can easily search through our library of content, bookmark episodes for later and enjoy our premium content. You can also take notes, pin chapters and download for off-line listening. If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 14, 2023

Join our Emergency General Surgery team as we talk about a popular and controversial issue in surgery: dealing with complicated cases in pancreatitis. We discuss two hard-hitting cases and cover principles of diagnosis, early management and disposition, and things to look out for every step of the way. We cover some common and some rare but particularly problematic complications. Although there is no right answer to every case of pancreatitis, we try to help learners to develop an approach to pancreatitis that considers the morbidity and benefits of every option. Hosts: Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross Learning Objectives: - Review the diagnostic criteria for acute pancreatitis - Learn to anticipate common and major complications of acute pancreatitis - Develop an approach to complications of pancreatitis accounting for patient, family, practitioner, and institutional factors - Understand the risks and benefits of various methods for dealing with pancreatic necrosis and infection TENSION trial https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32404-2/fulltext MISER trial https://pubmed.ncbi.nlm.nih.gov/30452918/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other emergency general surgery episodes here: https://behindtheknife.org/podcast-category/emergency-general-surgery/

Dec 13, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 12, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 11, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 8, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 7, 2023

In this episode our team reviews the two groundbreaking RCTs which challenged the long-held dogma that a lobectomy is the only acceptable oncologic procedure for NSCLC. Listen as we compare and contrast the North American CALGB trial and Japanese JCOG trial which were both designed to investigate survival and recurrence outcomes by randomizing stage 1A patients to lobectomy versus a sublobar resection. Learning Objectives: -Compare and contrast the patient characteristics of the CALGB and JCOG trials -Understand the methodology each trial and be able to explain their nuanced differences -Analyze the results of the CALGB and JCOG trials and how they apply to patients today Hosts: Kelly Daus MD, Peter White MD, Eric Vallieres, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/36780674/ Altorki N, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083. PMID: 36780674; PMCID: PMC10036605. https://pubmed.ncbi.nlm.nih.gov/35461558/’ Saji H, et al. West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3. PMID: 35461558. https://pubmed.ncbi.nlm.nih.gov/37473998/ Altorki N, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2023 Jul 18:S0022-5223(23)00612-8. doi: 10.1016/j.jtcvs.2023.07.008. Epub ahead of print. PMID: 37473998. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other Cardiothoracic episodes : https://behindtheknife.org/podcast-category/cardiothoracic/

Dec 6, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 5, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 4, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 1, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 30, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 29, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 28, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 27, 2023

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts. Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Nov 23, 2023

Making a discovery that changes how we practice is one of the most exciting things about the fields of medicine and surgery. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Samantha Ruff from The Ohio State University. Hear Dr. Phay tell the story of how parathyroid autofluorescence was discovered and the work that has gone on since that day. The group discusses several articles focusing on intraoperative adjuncts used to identify parathyroid tissue during thyroid and parathyroid surgery. Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Samantha Ruff, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Twitter handles: Barbra Miller - @OSUEndosurgBSM John Phay – @JohnPhayMD Priya Dedhia – @priyaknows Samantha Ruff - @SamRuff_MD Learning objectives: 1) Understand the background of the discovery of parathyroid autofluorescence 2) Describe various intraoperative adjuncts utilized to identify parathyroid tissue 3) Compare and contrast the advantages and disadvantages of using autofluorescence versus indocyanine green for identification of parathyroid tissue 4) Recognize the impact of use of intraoperative imaging adjuncts on postoperative hypocalcemia (short and long-term) 5) Understand the general safety issues for the parathyroid imaging techniques discussed References: 1. Benmiloud, F., G. Godiris-Petit, R. Gras, et al., Association of Autofluorescence-Based Detection of the Parathyroid Glands During Total Thyroidectomy With Postoperative Hypocalcemia Risk: Results of the PARAFLUO Multicenter Randomized Clinical Trial. JAMA Surg, 2020. 155(2): p. 106-12 DOI: 10.1001/jamasurg.2019.4613. https://pubmed.ncbi.nlm.nih.gov/31693081/ 2. Kahramangil, B. and E. Berber, Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy. Gland Surg, 2017. 6(6): p. 644-8 DOI: 10.21037/gs.2017.09.04. https://pubmed.ncbi.nlm.nih.gov/29302480/ 3. Paras, C., M. Keller, L. White, et al., Near-infrared autofluorescence for the detection of parathyroid glands. J Biomed Opt, 2011. 16(6): p. 067012 DOI: 10.1117/1.3583571. https://pubmed.ncbi.nlm.nih.gov/21721833/ 4. Vidal Fortuny, J., V. Belfontali, S.M. Sadowski, et al., Parathyroid gland angiography with indocyanine green fluorescence to predict parathyroid function after thyroid surgery. Br J Surg, 2016. 103(5): p. 537-43 DOI: 10.1002/bjs.10101. https://pubmed.ncbi.nlm.nih.gov/26864909/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Behind the Knife endocrine episodes : https://behindtheknife.org/podcast-category/endocrine/

Nov 20, 2023

What is the best surgical treatment for a vasculopathy with critical limb threatening ischemia? In this episode of Behind the Knife the vascular surgery subspecialty team discusses two pivotal trials (BEST-CLI and BASIL-2) and how the findings of these trials can help answer this question. In this episode, we will discuss the age old question: open bypass versus best endovascular treatment. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives Review the definition, prevalence, and prognosis of critical limb threatening ischemia Review basic treatment options for patients with critical limb threatening ischemia Understand the methodology, findings, limitations, and clinical applications of the BEST-CLI trial Understand the methodology, findings, limitations, and clinical applications of the BASIL-2 trial Compare open bypass and best endovascular therapy for patients with critical limb threatening ischemia References Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. N Engl J Med. 2022 Dec 22;387(25):2305-2316. doi: 10.1056/NEJMoa2207899. Epub 2022 Nov 7. PMID: 36342173. https://pubmed.ncbi.nlm.nih.gov/36342173/ Bradbury AW, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L, et al. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial. The Lancet. 2023. 401(10390), 1798-1809. https://doi.org/10.1016/S0140-6736(23)00462-2 Conte MS Bradbury AW Kolh P et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg. 2019; 58 (109.e33.): S1-109 https://pubmed.ncbi.nlm.nih.gov/31182334/ Bradbury AW Adam DJ Bell J et al. Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb ischaemia due to infrainguinal disease. The bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial. Health Technol Assess. 2010; 14: 1-210 https://pubmed.ncbi.nlm.nih.gov/20307380/ Adam DJ Beard JD Cleveland T et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366: 1925-1934 https://pubmed.ncbi.nlm.nih.gov/16325694/ Bradbury AW Adam DJ Bell J et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010; 51: 5S-17 https://pubmed.ncbi.nlm.nih.gov/20435258/ Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019 Jun;69(6S):3S-125S.e40. doi: 10.1016/j.jvs.2019.02.016. Epub 2019 May 28. Erratum in: J Vasc Surg. 2019 Aug;70(2):662. PMID: 31159978; PMCID: PMC8365864. https://pubmed.ncbi.nlm.nih.gov/31159978/ Menard MT, Rosenfield K, Farber A. The BEST-CLI Trial: Implications of the Primary Results. Eur J Vasc Endovasc Surg. 2023 Mar;65(3):317-319. doi: 10.1016/j.ejvs.2022.12.032. Epub 2023 Jan 6. PMID: 36621707. https://pubmed.ncbi.nlm.nih.gov/36621707/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other vascular surgery episodes : https://behindtheknife.org/podcast-category/vascular/

Nov 16, 2023

If you operate for long enough, chances are you will come across the unique, and potentially daunting scenario of operating on a pregnant patient. If, and when, you do, would you know what to do? Join University of Washington and MIS faculty Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and residents Drs. Ben Vierra and Paul Herman as they discuss non-obstetric surgery in the pregnant patient so that you will be better informed when the challenge arises. Hosts: 1. Andrew Wright, UW Medical Center—Montlake and Northwest, @andrewswright 2. Nick Cetrulo, UW Medical Center—Northwest, @Trules25 3. Nicole White, UW Medical Center—Northwest, @NicoleWhiteTho1 4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm 5. Ben Vierra, UW General Surgery Resident PGY-2 Learning Objectives 1. Describe important physiologic changes in pregnancy that are relevant for the surgeon to know. 2. Review the epidemiology of non-obstetric general surgery in the pregnant patient. 3. Discuss specific imaging considerations in the pregnant patient. 4. Become more familiar with the technical aspects of approaching a typical surgical case in a pregnant patient. References 1. Pearl, J.P., Price, R.R., Tonkin, A.E. et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc 31, 3767–3782 (2017). https://doi.org/10.1007/s00464-017-5637-3 2. Vasileiou G, Eid AI, Qian S, Pust GD, Rattan R, Namias N, Larentzakis A, Kaafarani HMA, Yeh DD; EAST Appendicitis Study Group. Appendicitis in Pregnancy: A Post-Hoc Analysis of an EAST Multicenter Study. Surg Infect (Larchmt). 2020 Apr;21(3):205-211. https://pubmed.ncbi.nlm.nih.gov/31687887/ 3. Dongarwar D, Taylor J, Ajewole V, Anene N, Omoyele O, Ogba C, Oluwatoba A, Giger D, Thuy A, Argueta E, Naik E, Salemi JL, Spooner K, Olaleye O, Salihu HM. Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal-Fetal Mortality. World J Surg. 2020 Dec;44(12):3999-4005. https://pubmed.ncbi.nlm.nih.gov/32737556/ 4. Fong ZV, Pitt HA, Strasberg SM, Molina RL, Perez NP, Kelleher CM, Loehrer AP, Sicklick JK, Talamini MA, Lillemoe KD, Chang DC; California Cholecystectomy Group. Cholecystectomy During the Third Trimester of Pregnancy: Proceed or Delay? J Am Coll Surg. 2019 Apr;228(4):494-502.e1. https://pubmed.ncbi.nlm.nih.gov/30769111/ 5. Hong J, Yang J, Zhang X, Su J, Tumati A, Garry D, Docimo S, Bates AT, Spaniolas K, Talamini MA, Pryor AD. Considering delay of cholecystectomy in the third trimester of pregnancy. Surg Endosc. 2021 Aug;35(8):4673-4680. https://pubmed.ncbi.nlm.nih.gov/32875420/ 6. ACOG Committee Opinion No. 775: Nonobstetric Surgery During Pregnancy. Obstet Gynecol. 2019 Apr;133(4):e285-e286. https://pubmed.ncbi.nlm.nih.gov/30913200/ 7. Ashbrook M, Cheng V, Sandhu K, Matsuo K, Schellenberg M, Inaba K, Matsushima K. Management of Complicated Appendicitis During Pregnancy in the US. JAMA Netw Open. 2022 Apr 1;5(4):e227555. https://pubmed.ncbi.nlm.nih.gov/35426921/ 8. Capella CE, Godovchik J, Chandrasekar T, Al-Kouatly HB. Nonobstetrical Robotic-Assisted Laparoscopic Surgery in Pregnancy: A Systematic Literature Review. Urology. 2021 May;151:58-66. https://pubmed.ncbi.nlm.nih.gov/32445766/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Behind the Knife minimally invasive surgery episodes : https://behindtheknife.org/podcast-category/minimally-invasive/

Nov 13, 2023

Join the Hernia Team from Carolinas Medical Center as they discuss applications of artificial intelligence in predicting outcomes for patients undergoing abdominal wall reconstruction. Emerging technologies are allowing us to understand hernia patients who are at risk for increased surgical complexity and postoperative complications – find out more in this Journal Review episode. Hosts: Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein Dr. Monica Polcz, Attending Surgeon, Baptist Health (FL) Learning Objectives: Provide and introduction to artificial intelligence Develop an understanding of the applications of artificial intelligence in surgical outcome prediction for patients undergoing hernia repair Learn how risk stratification of hernia patients can affect their care References: Elhage et al, Development and Validation of Image-Based Deep Learning Models to Predict Surgical Complexity and Complications in Abdominal Wall Reconstruction, JAMA Surgery, 2021 https://pubmed.ncbi.nlm.nih.gov/34232255/ Ayuso et al, Predicting Rare Outcomes in Abdominal Wall Reconstruction Using Image-Based Deep Learning Models, Surgery, 2023 https://pubmed.ncbi.nlm.nih.gov/36229252/ Hassan et al, Novel Machine Learning Approach for Prediction of Hernia Recurrence, Surgical Complication, and 30-Day Readmission after Abdominal Wall Reconstruction, JACS, 2022 https://pubmed.ncbi.nlm.nih.gov/35426406/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more Behind the Knife hernia episodes : https://behindtheknife.org/podcast-category/hernia/

Nov 9, 2023

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? And how do you leverage those relationships into getting research experience and lines on your CV? Hosts: Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests: Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Get involved Even if you’re not destined for an academic career, getting involved in research early on can help you to participate with the scientific literature, understand data, and incorporate new research into your practice. Realistically, research is an important component of your ERAS application and your CV. It’s also a great opportunity to learn new skills and develop strong relationships with mentors. Remember why you’re in medical school You came to medical school to become a doctor first – don’t forget that or let research take away from it. Your mentors have been through it and understand that things get busy. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Medical Student Intern Survival Guide Series : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Nov 6, 2023

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? In this episode, our surgical education fellows and two expert mentors talk through the ins and outs of mentors – who are they, what can they do for you, how do you find one, and what do you do once you have one. Hosts: Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests: Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Mentorship teams: think about 4-5 people who can help you in different ways. Research mentor who can help you find opportunities and be productive 1-2 people who support you in all things (these might be residents!) 1-2 higher level sponsors who facilitate opportunities and pay for things Discipline and accountability RESPOND TO EMAILS. If you get an indication that a potential mentor would like to meet with you, take them up on the offer and be prompt with your replies! Nobody likes to be ghosted. Meet with your mentors at some regular cadence (every 2 weeks is a good place to start) Think of mentorship as a game of tennis – if your mentor gives you something to work on, the next meeting you should bring it back completed. This is a relationship, and back and forth accountability can establish trust. Change over time As you grow, you’ll change, and so will your relationships with mentors. This is one of the most rewarding aspects of these relationships and something you should aim to maintain over time. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Medical Student Intern Survival Guide Series : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Nov 2, 2023

Challenges continue to plague the residency application process, with programs receiving increased application volume that makes holistic review difficult, and medical student applicants burdened with application costs and uncertainty about what programs best align with their values. As a specialty, Ob/Gyn is facing these problems head on, and have united within their field to create a new independent residency application system, ResidencyCAS. While substantial changes to an already stressful process can be intimidating, the new platform offers many advantages that hope to improve the residency application experience for applicants, programs, and the Ob/Gyn community as a whole. We’re joined by Dr. Maya Hammoud and Dr. AnnaMarie Connolly, two of the leaders in this effort, to break down the creation of ResidencyCAS, plans for its implementation starting in the 2024-2025 application cycle, and the reaction of the Ob/Gyn and medical education communities to this change. Learning Objectives 1. Listeners will describe current challenges to applicants and programs in the residency application process. 2. Listeners will identify the coming changes to the Ob/Gyn residency application process, with awareness of the planned design and use of the ResidencyCAS system. 3. Listeners will describe the value of potential changes to the residency application process. 4. Listeners will explain the barriers and efforts required to coordinate large-scale changes within medical education like the creation and implementation of ResidencyCAS. 5. Listeners will consider how changes to the residency application process could affect and improve their own field, program, or application. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other Surgical Education Episodes : https://behindtheknife.org/podcast-category/surgical-education/

Oct 30, 2023

Direct Peritoneal Resuscitation! We’re not just dumping fluids into the open abdomen. What is DPR? Why do it? Who should get it? Does it work? Come try and stay awake for some basic science talk before then learning all about why you should consider adopting DPR into your Trauma/EGS practice? Join Drs. Cobler-Lichter, Kwon, Meizoso, Urréchaga, and Rattan as they guide you through all this and more! Hosts: Michael Cobler-Lichter, MD, PGY2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (twitter) Eva Urrechaga, MD, PGY6/R4: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @urrechisme (twitter) Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 3 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Rishi Rattan, MD, Attending Surgeon in Trauma/Critical Care, 7 years in practice Legacy Emanuel Medical Center @DrRishiRattan (twitter) Learning Objectives: - State the proposed benefits of DPR - Identify who can benefit from DPR - Demonstrate the proper way to set up a DPR circuit - Discuss the proposed basic science mechanism for DPR’s efficacy Quick Hits: 1. Consider DPR in all your open abdomens in EGS/Trauma. You never know when you’re going to be able to close some of these patients. 2. The principal of DPR is to allow the fluid to dwell in the abdomen as long as possible. Keep the catheter deep and don’t put holes in your dressing. 3. DPR is ideal for patients with packing, who are in discontinuity, and for fresh anastomoses. These will only benefit from DPR, not be harmed by it. 4. Make sure these patients are receiving hourly I/Os. Nursing by-in is huge for this procedure. 5. DPR is associated with higher rates of fascial closure, reduces inflammation, and improves blood flow to the abdomen. References Ribeiro-Junior MAF, Cássia Tiemi Kawase Costa, de Souza Augusto S, et al. The role of direct peritoneal resuscitation in the treatment of hemorrhagic shock after trauma and in emergency acute care surgery: a systematic review. Eur J Trauma Emerg Surg . Published online November 13, 2021. doi:10.1007/s00068-021-01821-x Smith JW, Garrison RN, Matheson PJ, Franklin GA, Harbrecht BG, Richardson JD. Direct Peritoneal Resuscitation Accelerates Primary Abdominal Wall Closure after Damage Control Surgery. J Am Coll Surg . 2010;210(5):658-667. doi:10.1016/j.jamcollsurg.2010.01.014 Smith JW, Neal Garrison R, Matheson PJ, et al. Adjunctive treatment of abdominal catastrophes and sepsis with direct peritoneal resuscitation: indications for use in acute care surgery. J Trauma Acute Care Surg . 2014;77(3):393-398; discussion 398-399. doi:10.1097/TA.0000000000000393 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episode here: https://behindtheknife.org/listen/

Oct 26, 2023

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 2 outlines the radical technical approaches to anteriorly invasive tumours, including en bloc cystectomy, perineal urethrectomy, inter-labial vaginectomy and radical pubic bone resections. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Paul Sutton from The Christie Hospital, Manchester, UK. Technical videos: Solomon MJ, Däster S, Loizides S, Sutton P, Brown KGM, Austin KKS, Lee PJ. Access to the anterior pelvic compartment in pelvic exenteration in women-the interlabial approach: video vignette. Br J Surg. 2021 Aug 19;108(8):e268-e269. doi: 10.1093/bjs/znab127. Solomon MJ, Alahmadi R, Lee PJ, Austin KKS. En bloc partial pubic bone excision with complete soft tissue pelvic exenteration. Br J Surg. 2022 Jun 14;109(7):640-641. doi: 10.1093/bjs/znac122. PMID: 35485605. References: Solomon MJ, Austin KK, Masya L, Lee P. Pubic Bone Excision and Perineal Urethrectomy for Radical Anterior Compartment Excision During Pelvic Exenteration. Dis Colon Rectum. 2015 Nov;58(11):1114-9. doi: 10.1097/DCR.0000000000000479. Check our more high-yield colorectal surgery content from Behind the Knife .

Oct 23, 2023

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes, that we learn during surgical training, and into all compartments of the pelvis. Episode 1 provides listeners with an overview of the principles of exenteration surgery and preoperative patient assessment and selection. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Elaine Burns from St Mark's Hospital, London, UK. References and further reading: -Burns EM, Quyn A; Lexicon Collaboration of UKPEN and the ACPGBI Advanced Cancer subcommittee. The 'Pelvic exenteration lexicon': Creating a common language for complex pelvic cancer surgery. Colorectal Dis. 2023 May;25(5):888-896. doi: 10.1111/codi.16476. -Brown KGM, Solomon MJ. Decision making, treatment planning and technical considerations in patients undergoing surgery for locally recurrent rectal cancer. Seminars in Colon and Rectal Surgery. 2020;31(3):100764 -van Kessel CS, Solomon MJ. Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking. Cancers. 2022 Oct 15;14(20):5058. doi: 10.3390/cancers14205058 -PelvEx Collaborative. Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative. Cancers (Basel). 2022 Feb 24;14(5):1161. doi: 10.3390/cancers14051161 Check out more high-yield colorectal surgery content from Behind the Knife : https://behindtheknife.org/podcast-category/colorectal/

Oct 19, 2023

This week, we discuss the experiences of residents and medical students in surgery who identify as LGBTQIA+. We discuss the question of disclosure during interviews, how to identify programs that are welcoming to diverse identities, and how AOSA has grown the community of trainees and faculty mentors and hopes to continue to support them in the future. Hosts: Jason Bingham, MD Nina Clark, MD Guests: Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center Christina Georgeades, MD, R4 General Surgery at Medical College of Wisconsin cgeorgeades@mcw.edu, Twitter/X: @CGeorgeades Cameron Smith, MS3 at Kansas City University Cameron.smith@kansascity.edu, Instagram: @cameron_smith_1996, Twitter/X: @cafe_aficionad0 Jillian Wothe, MD, R1 General Surgery at Brigham &amp; Women’s Hospital jillian.wothe@gmail.com, Twitter/X: @JillianWothe Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out episode one in this series: https://behindtheknife.org/podcast/association-of-out-surgeons-allies-aosa-episode-1/

Oct 16, 2023

Has the pendulum swung too far? Is it time to put the drill down?? Or, drill, baby, drill! While the number of rib plating cases has exploded the data supporting the practice is less-than-stellar. On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill bring you up to speed on rib plating. If you haven’t already, we recommend you listen to Behind the Knife episode 298, published in May 2020. ( https://behindtheknife.org/podcast/big-t-trauma-series-ep-10-rib-fractures/ ) This episode covers comprehensive management of rib fractures, including multimodal pain control, regional blocks, pulmonary toilet, BiPAP, etc. REFERENCES: GUIDELINES EAST PMG Rib Plating (2017): https://www.east.org/education-resources/practice-management-guidelines/details/rib-fractures-open-reduction-and-internal-fixation-of-update-in-process EAST PMG Rib Fracture Non-Surgical Management (2022): https://www.east.org/education-resources/practice-management-guidelines/details/nonsurgical-management-and-analgesia-strategies-for-older-adults-with-multiple-rib-fractures-a-systematic-review-metaanalysis Chest Wall Injury Society Guidelines (2020): https://cwisociety.org/wp-content/uploads/2020/05/CWIS-SSRF-Guideline-01102020.pdf FLAIL/UNSTABLE CHEST Operative vs Nonoperative Treatment of Acute Unstable Chest Wall Injuries: A Randomized Clinical Trial, JAMA 2022: https://jamanetwork.com/journals/jamasurgery/fullarticle/2796556 Prospective randomized controlled trial of operative rib fixation in traumatic flail chest, JACS 2013: https://pubmed.ncbi.nlm.nih.gov/23415550/ Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status, Interact Cardiovasc Thoracic Surg 2005: https://pubmed.ncbi.nlm.nih.gov/17670487/ Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients, J Trauma 2002: https://pubmed.ncbi.nlm.nih.gov/11956391/ Surgical Rib Fixation of Multiple Rib Fractures and Flail Chest: A Systematic Review and Meta-analysis, J Surg Research 2022: https://pubmed.ncbi.nlm.nih.gov/35390577/ Surgical versus nonsurgical interventions for flail chest, Cochrane Review 2015: https://pubmed.ncbi.nlm.nih.gov/26222250/ NON-FLAIL CHEST Randomized Controlled Trial of Surgical Rib Fixation to Nonoperative Management in Severe Chest Wall Injury, Ann Surgery 2023: https://pubmed.ncbi.nlm.nih.gov/37317861/ Rib fixation in non-ventilator-dependent chest wall injuries: A prospective randomized trial, J Trauma 2022: https://pubmed.ncbi.nlm.nih.gov/35081599/ A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (NONFLAIL), J Trauma 2020: https://pubmed.ncbi.nlm.nih.gov/31804414/ Operative versus nonoperative treatment of multiple simple rib fractures: A systematic review and meta-analysis, Injury 2020: https://pubmed.ncbi.nlm.nih.gov/32650981/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out the rest of the BIG T Trauma episodes here: https://behindtheknife.org/podcast-series/big-t-trauma/

Oct 12, 2023

You have a young patient with a horseshoe abscess. How should you address the abscess initially? What is the best approach to drain it? Now that it is drained, what do I do with all the drains? Tune in to figure out how to best approach the most challenging of perianal abscesses. Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Julia Saraidaridis as they discuss the management of horseshoe abscess and complicated perianal fistula. Learning Objectives 1. Describe the evaluation for perianal abscesses and fistula. 2. Discuss the different surgical options in managing horseshoe abscesses and post operative care to definitive management 3. Explain the rationale behind use of different fistula surgeries in complex perianal fistulas Link to episode video: https://behindtheknife.org/video/clinical-challenges-in-colorectal-surgery-management-of-horseshoe-abscess/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal Surgeons. Learn more here: https://behindtheknife.org/premium

Oct 9, 2023

To close or not to close - that is the question! Internal hernias following bariatric surgery can be a vexing source of delayed postoperative morbidity. Join Drs. Matthew Martin, Kunoor Jain-Spangler, Adrian Dan, and Vincent Cheng for this EXCELLENT Journal Review in Bariatric Surgery. Article #1: Stenberg 2023 - Long-term Safety and Efficacy of Closure of Mesenteric Defects in Laparoscopic Gastric Bypass Surgery Two mesenteric defects are created during Roux-en-Y gastric bypass (RNYGB) Petersen’s Defect Jejuno-jejunostomy mesenteric defect Consensus does not exist regarding the standard of care for mesenteric defect closure (e.g., closure of one or both defects, material used for closure). Risks of leaving defects open: internal herniation with or without bowel ischemia Risks of closing defects Kinking the bowel (especially near the jejunojejunostomy) leading to obstruction Chronic abdominal pain This article discusses a randomized controlled trial of obese patients undergoing bariatric RNYGB Randomized into two groups: a closure group and a non-closure group Followed patients for 10 years with 95-96% follow up rate Results analyzed using a Cox proportional hazards regression that included risk factors like BMI, total weight loss at 1 year after surgery, and the other Highlighted outcomes Within the first 30 postop days, there was a higher rate of SBO in the closure group (1.3%) compared to the non-closure group (0.2%). This was attributed to kinking of the jejunojejunostomy After 30 postop days and up to 10 years, reoperation rates for SBO were higher in the non-closure group (14.9%) compared to the closure group (7.8%). This trend was consistent regarding each site of mesenteric defect. No significant differences between the two groups regarding chronic opioid use as a metric of chronic abdominal pain. Article #2: Nawas 2022 - The Diagnostic Accuracy of Abdominal Computed Tomography in Diagnosing Internal Herniation Following Roux-en-Y Gastric Bypass Surgery Unless there is an indication to immediately operate on a RNYGB patient in whom internal herniation is suspected, computed tomography (CT) is the recommended diagnostic test This article is a meta-analysis of 20 studies published between 2007 and 2020 that analyzed the accuracy of CT or detecting internal hernias in adult patients who underwent RNYGB for morbid obesity. A collective total of 1,637 patients were included. Accuracy was determined by comparing diagnostic CT with exploratory surgery or the combination of negative CT and a negative 90 days follow-up Internal herniation was defined as presence of herniated small bowel with or without obstruction or ischemia through a visible opening at the mesenteric defect Results Pooled sensitivity of CT was 82% and specificity was 85% Positive predictive value of CT was 83% and negative predictive value was 86% CT signs with the highest sensitivity (sensitivity of finding) Venous congestion (79%) Swirl sign (78%) Mesenteric edema (67%) 15% risk of an internal hernia even with a negative CT scan In conclusion, CT can provide useful information, but these are just additional data points to consider in the overall evaluation of a patient. Surgeons should still have a low threshold for diagnostic laparoscopy even with negative CT findings If you liked this episode, check out other bariatric episodes here: https://behindtheknife.org/podcast-category/bariatric/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Oct 5, 2023

This week we sat down with the Association of Out Surgeons & Allies (AOSA) leadership in the first installment of a BTK/AOSA collaboration addressing issues important to LGBTQ+ surgeons, patients, and allies. We are joined by Guest Host Dr. Andrew Schlussel, BTK Members Drs. Nina Clark and Jason Bingham, and AOSA Leaders Drs. Nicole Goulet, Alexis Moren, and Courtney Collins. More information about AOSA and how to get involved can be found at https://www.outsurgeons.org . Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Oct 2, 2023

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management. We discuss key concepts including the genetic background of these tumors and high-yield targeted therapies that are relevant both in direct patient care and board exams. Reference: Gold JS, Gönen M, Gutiérrez A, Broto JM, García-del-Muro X, Smyrk TC, Maki RG, Singer S, Brennan MF, Antonescu CR, Donohue JH, DeMatteo RP. Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol. 2009 Nov;10(11):1045-52. doi: 10.1016/S1470-2045(09)70242-6. Epub 2009 Sep 28. PMID: 19793678; PMCID: PMC3175638. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our surgical oncology oral board exam review here: https://behindtheknife.org/premium/

Sep 28, 2023

How do you counsel the patient with a large painful hernia who still smokes a pack of cigarettes every day? Join Drs. Michael Rosen, Clayton Petro, Sara Maskal, and Ryan Ellis as they discuss some of the highlights in the literature on smoking and its impact on postoperative outcomes in elective, clean open ventral hernia repairs. Hosts: - Michael Rosen, Cleveland Clinic - Clayton Petro, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan Ellis, Cleveland Clinic, @ryanellismd Learning objectives: - Evaluate historical data on smoking in surgery - Compare with newer literature specific to contemporary ventral hernia repairs - Understand how the historical and new data can be applied in clinical practice References: Møller AM, Villebro N, Pedersen T, Tønnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002 Jan 12;359(9301):114-7. doi: 10.1016/S0140-6736(02)07369-5. PMID: 11809253. Kubasiak JC, Landin M, Schimpke S, Poirier J, Myers JA, Millikan KW, Luu MB. The effect of tobacco use on outcomes of laparoscopic and open ventral hernia repairs: a review of the NSQIP dataset. Surgical Endoscopy. 2017 Jun;31:2661-6. DeLancey JO, Blay Jr E, Hewitt DB, Engelhardt K, Bilimoria KY, Holl JL, Odell DD, Yang AD, Stulberg JJ. The effect of smoking on 30-day outcomes in elective hernia repair. The American Journal of Surgery. 2018 Sep 1;216(3):471-4. Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Archives of surgery. 2012 Apr 1;147(4):373-83. Petro CC, Haskins IN, Tastaldi L, Tu C, Krpata DM, Rosen MJ, Prabhu AS. Does active smoking really matter before ventral hernia repair? An AHSQC analysis. Surgery. 2019 Feb;165(2):406-411. doi: 10.1016/j.surg.2018.07.039. Epub 2018 Sep 13. PMID: 30220485. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more hernia episodes here: https://behindtheknife.org/podcast-category/hernia/

Sep 25, 2023

Surgeons are trained to, well…do surgery, but is that always the right treatment for the patient? Not offering surgery can be a challenge, especially when you’re consulted about a sick patient in the middle of the night and the clinical momentum is moving toward the OR. Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington as we discuss how to recognize when a surgery is potentially not beneficial and communicate serious news with the patient and consulting team. Hosts : Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow. Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 general surgery resident and current surgical oncology fellow at the University of Washington. Dr. Virginia Wang is a PGY2 general surgery resident at the University of Washington. Learning Objectives : Identify when a patient’s disease course is unlikely reversible by surgery Learn to avoid defaulting to offering potentially non-beneficial surgical treatment for patients at the end-of-life Learn to recommend comfort-focused treatments for patients at the end-of-life Develop the communication skill of delivering serious news References : 1. Cooper Z, Courtwright A, Karlage A, Gawande A, Block S. Pitfalls in communication that lead to nonbeneficial emergency surgery in elderly patients with serious illness: description of the problem and elements of a solution. Ann Surg . Dec 2014;260(6):949-57. doi:10.1097/SLA.0000000000000721 2. VitalTalk. One page Guides. https://www.vitaltalk.org/guides/ 3. VitalTalk. Using Ask-Tell-Ask to Make a Recommendation. https://www.vitaltalk.org/using-ask-tell-ask-to-make-a-recommendation/ 4. VitalTalk. What's a Headline? https://www.vitaltalk.org/whats-a-headline/ 5. Zaza SI, Zimmermann CJ, Taylor LJ, Kalbfell EL, Stalter L, Brasel K, Arnold RM, Cooper Z, Schwarze ML. Factors Associated With Provision of Nonbeneficial Surgery: A National Survey of Surgeons. Ann Surg. 2023 Mar 1;277(3):405-411. doi: 10.1097/SLA.0000000000005765. Epub 2022 Nov 24. PMID: 36538626; PMCID: PMC9905263. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical palliative care episodes here: https://behindtheknife.org/podcast-category/palliative-care/

Sep 21, 2023

While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries. Hosts: - Dr. Tam Pham: UW Medicine Regional Burn Center - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center - Dr. Alex Morzycki: UW Medicine Regional Burn Center - Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: - Review the epidemiology and common mechanisms for electrical injuries - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release - Recognize possible long-term complications of electrical injuries and their subsequent management References: 1. Daskal Y, Beicker A, Dudkiewicz M, Kessel B. [HIGH VOLTAGE ELECTRIC INJURY: MECHANISM OF INJURY, CLINICAL FEATURES AND INITIAL EVALUATION.]. Harefuah. 2019 Jan;158(1):65-69. Hebrew. PMID: 30663297. 2. Pawlik AM, Lampart A, Stephan FP, Bingisser R, Ummenhofer W, Nickel CH. Outcomes of electrical injuries in the emergency department: a 10-year retrospective study. Eur J Emerg Med. 2016 Dec;23(6):448-454. doi: 10.1097/MEJ.0000000000000283. PMID: 25969345. 3. Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T; Wilderness Medical Society. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med. 2014 Dec;25(4 Suppl):S86-95. doi: 10.1016/j.wem.2014.08.011. PMID: 25498265. 4. Zemaitis MR, Foris LA, Lopez RA, et al. Electrical Injuries. [Updated 2023 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448087/ 5. Leversedge F, Moore T, Peterson B, Seiler J; Compartment syndrome of the upper extremity. J Hand Surg. 2011; 36(4):P544-559. doi: https://doi.org/10.1016/j.jhsa.2010.12.008 6. Arnoldo B, Klein M, Gibran NS. Practice guidelines for the management of electrical injuries. J Burn Care Res 2006, 27(4): 439-47 7. Pilecky D, Vamos M, Bogyi P, et al. Risk of cardiac arrhythmias after electrical accident: a single-center study of 480 patients. Clin Res Cardiol 2019, 108(8): 901-908 8. Soar J, Perkins GD, Abbas G, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 2010, 81(10): 1400-33 9. Kaergaard A, Nielsen KJ, Casrtensen O, Biering K. Electrical injury and the long-term risk of cataract: A prospective matched cohort study. Acta Ophthalmologica 2023, e88-e94 10. Richard F. Edlich, MD, PhD and others, TECHNICAL CONSIDERATIONS FOR FASCIOTOMIES IN HIGH VOLTAGE ELECTRICAL INJURIES, The Journal of Burn Care & Rehabilitation, Volume 1, Issue 2, November-December 1980, Pages 22–26. 11. Lee DH, Desai MJ, Gauger EM. Electrical injuries of the hand and upper extremity. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2019 Jan 1;27(1):e1-8. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Sep 18, 2023

While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries. Hosts: - Dr. Tam Pham: UW Medicine Regional Burn Center - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center - Dr. Alex Morzycki: UW Medicine Regional Burn Center - Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: - Review the epidemiology and common mechanisms for electrical injuries - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release - Recognize possible long-term complications of electrical injuries and their subsequent management References: 1. Daskal Y, Beicker A, Dudkiewicz M, Kessel B. [HIGH VOLTAGE ELECTRIC INJURY: MECHANISM OF INJURY, CLINICAL FEATURES AND INITIAL EVALUATION.]. Harefuah. 2019 Jan;158(1):65-69. Hebrew. PMID: 30663297. 2. Pawlik AM, Lampart A, Stephan FP, Bingisser R, Ummenhofer W, Nickel CH. Outcomes of electrical injuries in the emergency department: a 10-year retrospective study. Eur J Emerg Med. 2016 Dec;23(6):448-454. doi: 10.1097/MEJ.0000000000000283. PMID: 25969345. 3. Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T; Wilderness Medical Society. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med. 2014 Dec;25(4 Suppl):S86-95. doi: 10.1016/j.wem.2014.08.011. PMID: 25498265. 4. Zemaitis MR, Foris LA, Lopez RA, et al. Electrical Injuries. [Updated 2023 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448087/ 5. Leversedge F, Moore T, Peterson B, Seiler J; Compartment syndrome of the upper extremity. J Hand Surg. 2011; 36(4):P544-559. doi: https://doi.org/10.1016/j.jhsa.2010.12.008 6. Arnoldo B, Klein M, Gibran NS. Practice guidelines for the management of electrical injuries. J Burn Care Res 2006, 27(4): 439-47 7. Pilecky D, Vamos M, Bogyi P, et al. Risk of cardiac arrhythmias after electrical accident: a single-center study of 480 patients. Clin Res Cardiol 2019, 108(8): 901-908 8. Soar J, Perkins GD, Abbas G, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 2010, 81(10): 1400-33 9. Kaergaard A, Nielsen KJ, Casrtensen O, Biering K. Electrical injury and the long-term risk of cataract: A prospective matched cohort study. Acta Ophthalmologica 2023, e88-e94 10. Richard F. Edlich, MD, PhD and others, TECHNICAL CONSIDERATIONS FOR FASCIOTOMIES IN HIGH VOLTAGE ELECTRICAL INJURIES, The Journal of Burn Care & Rehabilitation, Volume 1, Issue 2, November-December 1980, Pages 22–26. 11. Lee DH, Desai MJ, Gauger EM. Electrical injuries of the hand and upper extremity. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2019 Jan 1;27(1):e1-8. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Sep 14, 2023

Surgical residency is hard. In some ways, intern year may be the hardest. We’ve been there. We’re a group of surgical residents formally known as the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional organization of surgical education research fellows working together to foster peer mentorship, networking, and scholarly collaboration. We’ve collectively reflected on our experiences as surgical interns across the country. Join Drs. Ananya Anand, Joe L’Huillier, and Rebecca Moreci as they discuss three tips for thriving as a surgical intern. Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101 –Dr. Rebecca Moreci, Louisiana State University, @md_moreci –COSEF: @surgedfellows Learning Objectives: Listeners will: – List CoSEF’s three tips for thriving as a surgical intern – Challenge their definition of patient ownership – Recall the “Golden Rule” of treating others how you want to be treated – Appreciate the importance of self-care in surgical residency References: L’Huillier, Joseph C. MD; Lund, Sarah MD; Anand, Ananya MD; Jensen, Rachel M. MD; Williamson, Andrea J.H. MD; Clanahan, Julie M. MD, MHPE; Moreci, Rebecca MD; Gates, Rebecca S. MD, MMHPE. Thriving as a Surgical Intern: Three Tips From the Collaboration of Surgical Education Fellows (CoSEF). Annals of Surgery Open 4(3):p e306, September 2023. | DOI: 10.1097/AS9.0000000000000306 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/ Ad referenced in episode: https://jomi.com/

Sep 11, 2023

For patients with insufficient future liver remnant (FLR) volume, adequate hypertrophy after Portal Venous Embolization (PVE) is associated with reduced likelihood of post-operative hepatic insufficiency. But what happens when PVE isn’t enough to obtain adequate volume prior to surgery? In this episode from the HPB team at Behind the Knife, listen in on the discussion about advances in venous deprivation techniques that can potentially increase resection rates and hypertrophy Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center. Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center Learning Objectives: - Develop an understanding of Portal Venous Embolization (PVE) - Develop an understanding of Sequential Hepatic Venous Embolization (HVE) - Develop an understanding of Radiological Simultaneous Porto-hepatic Venous Embolization (RASPE) - Develop an understanding of the traditional two-stage hepatectomy with PVE - Develop an understanding of the Fast Track Two-Stage Hepatectomy Papers Referenced (in the order they were mentioned in the episode): 1) Niekamp AS, Huang SY, Mahvash A, Odisio BC, Ahrar K, Tzeng CD, Vauthey JN. Hepatic vein embolization after portal vein embolization to induce additional liver hypertrophy in patients with metastatic colorectal carcinoma . Eur Radiol. 2020 Jul;30(7):3862-3868. doi: 10.1007/s00330-020-06746-4. Epub 2020 Mar 7. PMID: 32144462. 2) Laurent C, Fernandez B, Marichez A, Adam JP, Papadopoulos P, Lapuyade B, Chiche L. Radiological Simultaneous Portohepatic Vein Embolization (RASPE) Before Major Hepatectomy: A Better Way to Optimize Liver Hypertrophy Compared to Portal Vein Embolization . Ann Surg. 2020 Aug;272(2):199-205. doi: 10.1097/SLA.0000000000003905. PMID: 32675481. 3) Nishioka Y, Odisio BC, Velasco JD, Ninan E, Huang SY, Mahvash A, Tzeng CD, Tran Cao HS, Gupta S, Vauthey JN. Fast-track two-stage hepatectomy by concurrent portal vein embolization at first-stage hepatectomy in hybrid interventional radiology / operating suite. Surg Oncol. 2021 Dec;39:101648. doi: 10.1016/j.suronc.2021.101648. Epub 2021 Aug 16. PMID: 34438236. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Sep 7, 2023

Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Sep 4, 2023

Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 31, 2023

We know cardiac surgery can seem a bit daunting on the surface. However, most surgeons will come across cardiac surgery patients at some point whether in the OR, ICU, ED, etc. As the FIRST cardiac surgery specialty team for Behind the Knife, we are excited to bring you episodes focused on high-yield topics to help you navigate common cardiac surgery challenges, discuss relevant literature to help you in practice, and help our listeners feel more comfortable around cardiac surgery patients. In this episode we’ll discuss common cardiac surgery post-op problems. Whether you're on a cardiac surgery rotation or just covering an ICU with cardiac surgery patients for the night, these common post-op problems are bound to occur. Hosts: - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 - Aaron William, MD- Cardiothoracic Surgery Fellow, Duke University, @AMWilliamsMD - Nick Teman, MD- Assistant Profressor of Thorasis and Cardiovascular Surgery, University of Virginia, @nickteman Learning objectives: - Understand the workup and management strategies for post-operative bleeding in the post-cardiac surgery patient. - Understand how to recognize and manage post-cardiotomy cardiogenic shock in the post-cardiac surgery patient. - Understand the workup, short-term, and long-term management for post-cardiac surgery atrial fibrillation. Helpful Resources: - 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665 - 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures, Executive summary: https://www.jtcvs.org/article/S0022-5223(14)00835-6/fulltext For episode ideas/suggestions/feedback feel free to email Jessica Millar at: millarje@med.umich.edu Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our 4 Part Cardiac Surgery Crash Course Series here: https://behindtheknife.org/podcast/cardiac-surgery-crash-course-series-episode-1-intro-to-the-cardiac-or/

Aug 28, 2023

CME - What is it? Why do I need it? How do I get it? How much do I need? How do I keep track of credits? Listen to BTK's Dr. Kevin Kniery's interview with the CEO of ACCME, Dr. Graham McMahon, to learn about the nuts and bolts of CME as well as recent changes to the program. Helpful Links: Behind the Knife's FREE CME: https://behindtheknife.org/cme/ CME Passport: CMEpassport.org CME Passport/Behind the Knife: https://www.cmepassport.org/activity/search?specialty=behind%20the%20knife Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Aug 24, 2023

In the fifth episode of the “Innovation in Surgery” series, Dan Scheese sits down with Dr. Jeffrey Ponsky to discuss his innovation, the PEG tube. Dr. Ponsky shares many stories about his work with endoscopy in the late 1970s and how the idea for the PEG tube originated. “The Development of PEG: How it was” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/ “Following the light: A history of the percutaneous endoscopic gastrostomy tube” https://www.facs.org/media/cyrndd5u/07_gastrostomy_tube.pdf Dr. Ponsky completed his surgical training at University Hospitals of Cleveland in 1976. In 1979, he became the Director of the Department of Surgery at The Mount Sinai Medical Center in Cleveland, where he remained through 1997. In 1997, Dr Ponsky joined The Cleveland Clinic as the Director of Endoscopic Surgery and Executive Director of the Minimally Invasive Surgery Center. In 2005, he assumed the Oliver H. Payne Professorship and Chair of the Department of Surgery at Case Western University School of Medicine. He returned to The Cleveland Clinic as Director of Developmental Endoscopy in 2014. Dr Ponsky has served as president of many organizations including the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American Society for Gastrointestinal Endoscopy (ASGE). Additionally, Dr. Ponsky has received numerous awards and has published over 300 original articles and book chapters. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other innovation episodes here : https://behindtheknife.org/podcast-series/innovations-in-surgery/

Aug 21, 2023

Have you ever struggled choosing which type of stoma to mature in an anatomically or medically challenging patient? What about wrestled with the associated postoperative complications? Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss ostomy creation and management of stoma complications. Hosts: - Susan Galandiuk MD, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky MD, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas MD, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon DO, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives: - Review pre-operative stoma marking and ostomy education. - Understand “bail-out” ostomy creation options in medically and anatomically challenging patients. - Discuss common postoperative ostomy complications and management. - Review common peristomal skin pathology and treatment options. Video References : - Colwell, Janice C. A.P.R.N., C.W.O.C.N.1; Williams, Toyia M.S.N., R.N.2. Management of the Patient With a Prolapsed Ileostomy. Diseases of the Colon & Rectum 65(12):p e1073, December 2022. | DOI: 10.1097/DCR.0000000000002605 https://www.youtube.com/watch?v=Wx83CpRLkqk Non-operative management of stoma prolapse/reduction - Colwell, Janice C. A.P.R.N.. Management of the Patient With a Retracted Loop Ileostomy Located in a Crease. Diseases of the Colon & Rectum 65(3):p e182-e183, March 2022. | DOI: 10.1097/DCR.0000000000002367 https://www.youtube.com/watch?v=mc6o7nG1fsQ Management of a retracted stoma, in a crease, with peristomal skin breakdown - Watanabe, Kazuhiro M.D., Ph.D.; Kohyama, Atsushi M.D., Ph.D.; Suzuki, Hideyuki M.D., Ph.D.; Kajiwara, Taiki M.D., Ph.D.; Karasawa, Hideaki M.D., Ph.D.; Ohnuma, Shinobu M.D., Ph.D.; Kamei, Takashi M.D., Ph.D.; Unno, Michiaki M.D., Ph.D.. Slug Method: A Technique for Stoma Prolapse Reduction Using High Osmolality of the 50% Glucose Solution. Diseases of the Colon & Rectum 63(12):p e565, December 2020. | DOI: 10.1097/DCR.0000000000001798 https://cdn-links.lww.com/permalink/dcr/b/dcr_1_1_2020_09_01_watanabe_20-00282_sdc1.mp4 Osmotic reduction Other References : - Baker ML, Williams RN, Nightingale J.. Causes and management of a high-output stoma. Colorectal Dis. 2011;13(2):191–197. doi: 10.1111/j.1463-1318.2009.02107.x. - Behrenbruch, C., Carr, G., Johnston, M. and Woods, R. (2019), Three-point stapled fixation technique to manage ileostomy spout retraction. ANZ Journal of Surgery, 89: 423-424. doi: 10.1111/ans.15006 - O’Brien, Stephen J. M.B. B.Ch ., B.A.O.; Ellis, C. Tyler M.D., M.S.C.R.. The Management of Peristomal Pyoderma Gangrenosum in IBD. Diseases of the Colon & Rectum 63(7):p 881-884, July 2020. | DOI: 10.1097/DCR.0000000000001701 - Paquette IM, Solan P, Rafferty JF, Ferguson MA, Davis BR.. Readmission for dehydration or renal failure after ileostomy creation. Dis Colon Rectum. 2013;56(8):974–979. doi: 10.1097/DCR.0b013e31828d02ba - Steele S, Hull Tracy, Hyman N, Maykel J, Read T, and Whitlow C. The ASCRS Textbook of Colon and Rectal Surgery. 4th Edition. Volume II. Springer, Switzerland AG, 2022. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other recent Colorectal Surgery Episodes here: https://behindtheknife.org/podcast-category/colorectal/

Aug 17, 2023

In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Part 1: https://behindtheknife.org/podcast/clinical-challenges-in-thoracic-surgery-complex-pleural-effusions-empyema-part-1-of-2/ Learning Objectives: -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions -Review the evidence for fibrinolytic therapy for management of complex pleural effusions -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion Hosts: Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/15745977/ Maskell NA, et al. First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med. 2005 Mar 3;352(9):865-74. doi: 10.1056/NEJMoa042473. Erratum in: N Engl J Med. 2005 May 19;352(20):2146. PMID: 15745977. https://pubmed.ncbi.nlm.nih.gov/21830966/ Rahman NM, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011 Aug 11;365(6):518-26. doi: 10.1056/NEJMoa1012740. PMID: 21830966. https://pubmed.ncbi.nlm.nih.gov/35830586/ Wilshire CL, et al. Comparing Initial Surgery versus Fibrinolytics for Pleural Space Infections: A Retrospective Multicenter Cohort Study. Ann Am Thorac Soc. 2022 Nov;19(11):1827-1833. doi: 10.1513/AnnalsATS.202108-964OC. PMID: 35830586. https://pubmed.ncbi.nlm.nih.gov/37043201/ Wilshire CL, et al. Effect of Intrapleural Fibrinolytic Therapy vs Surgery for Complicated Pleural Infections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Apr 3;6(4):e237799. doi: 10.1001/jamanetworkopen.2023.7799. PMID: 37043201; PMCID: PMC10098968. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more thoracic surgery episodes here : https://behindtheknife.org/podcast-category/cardiothoracic/

Aug 14, 2023

In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Learning Objectives: -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions -Review the evidence for fibrinolytic therapy for management of complex pleural effusions -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion Hosts: Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/15745977/ Maskell NA, et al. First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med. 2005 Mar 3;352(9):865-74. doi: 10.1056/NEJMoa042473. Erratum in: N Engl J Med. 2005 May 19;352(20):2146. PMID: 15745977. https://pubmed.ncbi.nlm.nih.gov/21830966/ Rahman NM, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011 Aug 11;365(6):518-26. doi: 10.1056/NEJMoa1012740. PMID: 21830966. https://pubmed.ncbi.nlm.nih.gov/35830586/ Wilshire CL, et al. Comparing Initial Surgery versus Fibrinolytics for Pleural Space Infections: A Retrospective Multicenter Cohort Study. Ann Am Thorac Soc. 2022 Nov;19(11):1827-1833. doi: 10.1513/AnnalsATS.202108-964OC. PMID: 35830586. https://pubmed.ncbi.nlm.nih.gov/37043201/ Wilshire CL, et al. Effect of Intrapleural Fibrinolytic Therapy vs Surgery for Complicated Pleural Infections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Apr 3;6(4):e237799. doi: 10.1001/jamanetworkopen.2023.7799. PMID: 37043201; PMCID: PMC10098968. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more thoracic surgery episodes here : https://behindtheknife.org/podcast-category/cardiothoracic/

Aug 10, 2023

Entrustable Professional Activities, or EPAs, is a term you may have heard…or maybe not. EPAs represent a tectonic shift in surgical training and how residents will be evaluated. So, what are EPAs? How will they affect you? And what do you need to know? We sat down with Dr. George Sarosi, previous member of the ABS EPA Advisory Council and current General Surgery Residency Program Director at the University of Florida, to answer all of our questions now that EPAs are here. Guests: George Sarosi, MD- Professor of Surgery and General Surgery Residency Program Director- University of Florida Patrick Georgoff, MD- Trauma Surgery and Surgical Critical Care- WakeMed Hospital; Co-director and Host of Behind the Knife Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Daniel Scheese, MD- General Surgery Resident- Virginia Commonwealth University; Education Fellow- Behind the Knife Helpful Websites: Resources Page - ABS EPA resources page for Programs and Trainees: https://www.absurgery.org/default.jsp?eparesources - FAQs about EPAs and the ABS EPA Project (continuously updated so be sure to check back periodically): https://www.absurgery.org/xfer/epaprogfaqs.pdf - ABS EPA Program Timeline for program engagement (includes webinars, suggestions for activities for programs to consider, and an expected timeframe for the distribution of additional implementation resources): https://www.absurgery.org/xfer/absepaprogtimeline.pdf - Checklists for Program directors/Residency administrators/Faculty ( https://www.absurgery.org/xfer/epaimplementationchecklist_programs.pdf ) and for Residents ( https://www.absurgery.org/xfer/epaimplementationchecklist_residents.pdf ) to guide and sequence implementation priorities and timing If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Aug 7, 2023

An ever-present spectre looming over the hearts of general surgeons everywhere! Please join our Emergency General Surgery team for a journal review about Clostridium difficile (C. diff) infection. Dr. Ashlie Nadler and Dr. Jordan Nantais are joined by guest Dr. Marika Sevigny, recent graduate of trauma and acute care surgery at the University of Toronto, as Dr. Graham Skelhorne-Gross prepares for his upcoming fellowship at Harborview. Paper 1: Ahmed et al. Risk factors of surgical mortality in patients with Clostridium difficile colitis. A novel scoring system. Eur J Trauma Emerg Surg. 2022 Jun. - Risk score development study using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) - 525 adult (18-89) patients undergoing colectomy between 2012 and 2016 - Split data into training (80%) and testing (20%) datasets - Identified mortality risk factors to create and validate a scoring system - Scores ranged from 0 to 37 with the highest score predicting an 83.9% risk of mortality - This scoring system appears relatively straight-forward and methodically sound but the lack of a currently available calculator limits use to some degree Paper 2: McKechnie et al. Total Abdominal Colectomy Versus Diverting Loop Ileostomy and Antegrade Colonic Lavage for Fulminant Clostridioides Colitis: Analysis of the National Inpatient Sample 2016-2019. J Gastrointest Surg. 2023 Apr 20. - Retrospective cohort study of adults (18+) in the National Inpatient Sample (NIS) admitted between Jan 2016 and Dec 2019 for C. difficile colitis, undergoing either a total abdominal colectomy (TAC) or diverting loop ileostomy (DLI) with antegrade vancomycin enemas - Focus on not only mortality and complications but also admission cost and length of stay - 886 TAC and 409 DLI patients were identified - Multivariable logistic regression analysis showed no difference in mortality or overall complications - TAC patients had shorter admissions (mean difference 4.06 days) and lower cost (mean difference $79,715.34) - Study was limited as it considered only the initial admission and is unable to provide data on outcomes and costs beyond this time - Furthermore, there is consideration for disease severity in the analysis, which may impede the ability to compare the two operative approaches Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other Emergency General Surgery episodes here : https://behindtheknife.org/podcast-category/emergency-general-surgery/

Aug 3, 2023

It’s that time of year (again!)- when medical students across the country are preparing their residency applications. The process can be a bit daunting, and there have been a number of changes to process for the 2024 application cycle. Join our education fellow, Dr. Jessica Millar, and Dr. David Hughes as they review the “nuts and bolts” of this year’s residency application cycle. Guests: David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan Important Dates: - June 7, 2023: ERAS application opens at 9 a.m. ET. - September 6, 2023: Residency applicants may begin submitting MyERAS applications to programs at 9 a.m. ET. - September 15, 2023: Registration for the NRMP Match Opens - September 27, 2023: Residency programs may begin reviewing MyERAS applications, MSPEs, and supplemental ERAS application data (if applicable) at 9 a.m. ET. - October 26-31, 2023: Common Interview Release Window - January 31, 2024: Registration for the NRMP Match Closes Previous DOMINATE the Match Episodes: Episode 2- “Choose Me” (Personal Statements and Letters of Recommendations) https://behindtheknife.org/podcast/dominate-the-match-episode-2-choose-me/ Episode 3- “The Interview” https://behindtheknife.org/podcast/dominate-the-match-episode-3-the-interview/ Episode 4- “Rank and Match” https://behindtheknife.org/podcast/dominate-the-match-episode-4-rank-and-match/ Residency Program Lists: - FREIDA Residency and Fellowship Database: https://freida.ama-assn.org/ - Doximity: https://www.doximity.com/residency/?utm_campaign=marketing_resnav_competitor_broad_20210520&utm_source=google&utm_medium=cpc&gclid=CjwKCAjwt52mBhB5EiwA05YKo1J47BLAtTPtsJBmVvXGP2pDXLLqgDIwM0pgkSYjoBhFUOO1ktXDYRoC2bkQAvD_BwE Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our intern bootcamp series here: https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Jul 31, 2023

The first BTK THROW DOWN! A spicy debate…a war of words…a battle of ideas! This fiery episode features leaders in the field of trauma surgery discussing the optimal approach to vascular access in trauma patients. A recent study titled “Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video review” concluded that intraosseous access should be considered a first line therapy in hypotensive trauma patients. Is this appropriate? Crazy? Just so crazy it might work? Let’s get ready to ruuuummmmbbbbbbllllllleeeee! Hosts: Patrick Georgoff, MD (@georgoff) Nina Clark, MD (@clarkninam) Guests : Ryan Dumas, MD – UT Southwestern (@RPDumasMD) Michael Vella, MD, MBA – University of Rochester (@MichaelVella32) Bellal Joseph, MD – University of Arizona (@TopKnife_B) Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video review. - Dumas RP, Vella MA, Maiga AW, Erickson CR, Dennis BM, da Luz LT, Pannell D, Quigley E, Velopulos CG, Hendzlik P, Marinica A, Bruce N, Margolick J, Butler DF, Estroff J, Zebley JA, Alexander A, Mitchell S, Grossman Verner HM, Truitt M, Berry S, Middlekauff J, Luce S, Leshikar D, Krowsoski L, Bukur M, Polite NM, McMann AH, Staszak R, Armen SB, Horrigan T, Moore FO, Bjordahl P, Guido J, Mathew S, Diaz BF, Mooney J, Hebeler K, Holena DN. Moving the needle on time to resuscitation: An EAST prospective multicenter study of vascular access in hypotensive injured patients using trauma video review. J Trauma Acute Care Surg. 2023 Jul 1;95(1):87-93. doi: 10.1097/TA.0000000000003958. Epub 2023 Apr 4. PMID: 37012624. Time to early resuscitative intervention association with mortality in trauma patients at risk for hemorrhage. - Deeb AP, Guyette FX, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Eastridge BJ, Joseph B, Nirula R, Vercruysse GA, Sperry JL, Brown JB. Time to early resuscitative intervention association with mortality in trauma patients at risk for hemorrhage. J Trauma Acute Care Surg. 2023 Apr 1;94(4):504-512. doi: 10.1097/TA.0000000000003820. Epub 2023 Jan 11. PMID: 36728324; PMCID: PMC10038862. Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: a systematic review and meta-analysis - van Loon FHJ, Buise MP, Claassen JJF, Dierick-van Daele ATM, Bouwman ARA. Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaesth. 2018 Aug;121(2):358-366. doi: 10.1016/j.bja.2018.04.047. Epub 2018 Jul 2. PMID: 30032874. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Jul 27, 2023

In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Hosts: - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD, - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen Learning objectives: - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations - Define the indications for surgical intervention - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation - Detail methods for safe and effective perioperative management References: - Dream S, Kuo LE, Kuo JH, Sprague SM, Nwariaku FE, Wolf M, Olson JA Jr, Moe SM, Lindeman B, Chen H. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism. Ann Surg. 2022 Sep 1;276(3):e141-e176. doi: 10.1097/SLA.0000000000005522. Epub 2022 Jul 18. PMID: 35848728. - Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959–968. - Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what’s changed and why it matters. Kidney Int. 2017;92:26–36. - Andress DL, Coyne DW, Kalantar-Zadeh K, et al. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008;14:18–27. - Cozzolino M, Brancaccio D, Gallieni M, et al. Pathogenesis of parathyroid hyperplasia in renal failure. J Nephrol. 2005;18:5–8. - Lau WL, Cobi Y, Kalantar-Zadeh K. Parathyroidectomy in the management of secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2018;13:952–961. - Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98:4834–4844. - Costa-Hong V, Jorgetti V, Gowdak LH, et al. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery. 2007;142:699–703. - McManus C, Oh A, Lee JA, et al. Timing of parathyroidectomy for tertiary hyperparathyroidism with end-stage renal disease: a cost-effectiveness analysis. Surgery. 2021;169:94–101. - Finnerty BM, Chan TW, Jones G, et al. Parathyroidectomy versus cinacalcet in the management of tertiary hyperparathyroidism: surgery improves renal transplant allograft survival. Surgery. 2019;165:129–134. Suture Kit: Purchase on suturekit.com Purchase on Amazon How-to Video Series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other endocrine episodes here : https://behindtheknife.org/podcast-category/endocrine/

Jul 24, 2023

In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Hosts: - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD, - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen Learning objectives: - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations - Define the indications for surgical intervention - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation - Detail methods for safe and effective perioperative management References: - Dream S, Kuo LE, Kuo JH, Sprague SM, Nwariaku FE, Wolf M, Olson JA Jr, Moe SM, Lindeman B, Chen H. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism. Ann Surg. 2022 Sep 1;276(3):e141-e176. doi: 10.1097/SLA.0000000000005522. Epub 2022 Jul 18. PMID: 35848728. - Wilhelm SM, Wang TS, Ruan DT, et al. The American Association of Endocrine Surgeons Guidelines for definitive management of primary hyperparathyroidism. JAMA Surg. 2016;151:959–968. - Ketteler M, Block GA, Evenepoel P, et al. Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what’s changed and why it matters. Kidney Int. 2017;92:26–36. - Andress DL, Coyne DW, Kalantar-Zadeh K, et al. Management of secondary hyperparathyroidism in stages 3 and 4 chronic kidney disease. Endocr Pract. 2008;14:18–27. - Cozzolino M, Brancaccio D, Gallieni M, et al. Pathogenesis of parathyroid hyperplasia in renal failure. J Nephrol. 2005;18:5–8. - Lau WL, Cobi Y, Kalantar-Zadeh K. Parathyroidectomy in the management of secondary hyperparathyroidism. Clin J Am Soc Nephrol. 2018;13:952–961. - Parfrey PS, Chertow GM, Block GA, et al. The clinical course of treated hyperparathyroidism among patients receiving hemodialysis and the effect of cinacalcet: the EVOLVE trial. J Clin Endocrinol Metab. 2013;98:4834–4844. - Costa-Hong V, Jorgetti V, Gowdak LH, et al. Parathyroidectomy reduces cardiovascular events and mortality in renal hyperparathyroidism. Surgery. 2007;142:699–703. - McManus C, Oh A, Lee JA, et al. Timing of parathyroidectomy for tertiary hyperparathyroidism with end-stage renal disease: a cost-effectiveness analysis. Surgery. 2021;169:94–101. - Finnerty BM, Chan TW, Jones G, et al. Parathyroidectomy versus cinacalcet in the management of tertiary hyperparathyroidism: surgery improves renal transplant allograft survival. Surgery. 2019;165:129–134. Suture Kit: Purchase on suturekit.com Purchase on Amazon How-to Video Series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other endocrine episodes here : https://behindtheknife.org/podcast-category/endocrine/

Jul 20, 2023

The anterior abdominal stab wound! Who gets explored? When do you get imaging? Who gets serial abdominal exams? How does this change depending on the location of injury? Join Drs. Cobler-Lichter, Kwon, Meizoso, and Urréchaga in their first episode as the new Miami Trauma team - as they discuss how to navigate the nuances of stab wounds to the torso! Hosts: - Michael Cobler-Lichter, MD, PGY2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (twitter) - Eva Urrechaga, MD, PGY6/R4: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @urrechisme (twitter) - Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Learning Objectives: - Identify the differences in management of abdominal/thoracoabdominal stab wounds depending on location of injury - Identify who needs immediate operative intervention and who can undergo further evaluation - Define the management pathways for patients with abdominal stab wounds without an immediate indication for the OR - Define thoracoabdominal stab wound and when to evaluate for thoracic injuries - Discuss the role of diagnostic imaging when evaluating a patient with a stab to the torso Quick Hits: 1. Don’t forget about the blunt trauma that may be associated with an assault! 2. Don't miss injuries- always start with the ABCs and do a thorough head to toe exam 3. For stab wounds to the torso- hemodynamic instability, evisceration, peritonitis, impalement, or gross blood should go to the OR. 4. The three general clinical pathways for patients without a clear indication for the OR, include serial abdominal exams, local wound exploration, or diagnostic imaging. 5. Serial abdominal exams require frequent monitoring ideally by the same team member every time to detect changes early. 6. Local wound exploration requires adequate lighting and retraction to visualize the anterior rectus fascia. A negative LWE rules out an intra-abdominal injury, but a positive LWE does not necessarily rule it in. 7. Left thoracoabdominal stab wounds require evaluation of the diaphragm to rule out a traumatic diaphragm injury. 8. If there are no clear indications for the OR, diaphragm evaluation should be performed via laparoscopy after a period of 8 - 12 hours from injury. 9. A negative pericardial ultrasound does not rule out a cardiac injury in patients with a left-sided hemothorax. 10. Patients with flank and back stab wounds should be evaluated with CT scan to rule-out retroperitoneal injuries References 1. Martin MJ, Brown CVR, Shatz DV, Alam HB, Brasel KJ, Hauser CJ, de Moya M, Moore EE, Rowell SE, Vercruysse GA, Baron BJ, Inaba K. Evaluation and management of abdominal stab wounds: A Western Trauma Association critical decisions algorithm. J Trauma Acute Care Surg. 2018 Nov;85(5):1007-1015. doi: 10.1097/TA.0000000000001930. PMID: 29659472. 2. Como JJ, Bokhari F, Chiu WC, Duane TM, Holevar MR, Tandoh MA, Ivatury RR, Scalea TM. Practice management guidelines for selective nonoperative management of penetrating abdominal trauma. J Trauma. 2010 Mar;68(3):721-33. doi: 10.1097/TA.0b013e3181cf7d07. PMID: 20220426. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this trauma episode, check out our BIG T Trauma Series here : https://behindtheknife.org/podcast-series/big-t-trauma/

Jul 17, 2023

In the fourth episode of the “Innovation in Surgery” series, Drs. Patrick Georgoff and Dan Scheese sit down with Dr. Mark Piehl to discuss his innovation, LifeFlow. Additionally, Dr. Piehl covers multiple other topics in this episode, including circulation-first resuscitation and the process of innovation from the physician’s perspective. 410 Medical Website: https://410medical.com Reel Emergency trauma podcast: https://www.youtube.com/watch?v=unog3YkFSOE Prehospital emergency care case report from the episode: https://pubmed.ncbi.nlm.nih.gov/36703273/ Dr. Piehl’s Resuscitation review article: https://link.springer.com/content/pdf/10.1007/s40138-021-00237-6.pdf Dr. Piehl’s Shock article on circulation-first resuscitation in trauma: https://pubmed.ncbi.nlm.nih.gov/36703273/ Preliminary data on prehospital trauma resuscitation with LifeFlow (Larger version of this with historical controls to be presented at AAST): https://410medical.com/app/uploads/2023/04/ESO-Poster-Presentation-April-2023.pdf “Unraveling the Fluid Confusion in Sepsis” webinar: https://www.youtube.com/watch?v=yip3AhEezA0 Dr. Mark Piehl is a pediatric critical care physician at WakeMed in Raleigh, NC, and a Medical Director with the WakeMed Mobile Critical Care transport team. Mark is also Founder and Chief Medical Officer of 410 Medical, a company focused on improving resuscitation in shock, sepsis, and trauma. He previously served as Medical Director of the WakeMed Children's Hospital and Director of Pediatrics at WakeMed. He has numerous Department of Defense grants funding the development of technology to improve trauma care. Mark is also Founder of the Samaritan Health Center, a clinic for the homeless and uninsured in Durham, NC. Suture Kit: Purchase on suturekit.com Purchase on Amazon How-to Video Series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other innovation episodes here : https://behindtheknife.org/podcast-series/innovations-in-surgery/

Jul 13, 2023

In this episode of Behind the Knife the vascular surgery subspecialty team discusses a case of an infected endovascular aortic graft. Although rare, aortic graft infections remain a devastating complication. What options do you have to fix this problem? In this episode, we will cover the who is at risk of this, how they present, and what options you have to fix it. Hosts: Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-3 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives · Understand the incidence of and the relevant risk factors for aortic graft infections · Review the spectrum of presenting symptoms and relevant workup for aortic graft infections · Understand surgical treatment options including options for in-situ bypass and extra-anatomic bypass · Review the different conduits that can be used for in-situ and extra-anatomic reconstruction · Discuss relevant post-operative considerations for patients undergoing operative intervention for aortic graft infection References · Chiesa R, Astore D, Frigerio S, Garriboli L, Piccolo G, Castellano R, Scalamogna M, Odero A, Pirrelli S, Biasi G, Mingazzini P, Biglioli P, Polvani G, Guarino A, Agrifoglio G, Tori A, Spina G. Vascular prosthetic graft infection: epidemiology, bacteriology, pathogenesis and treatment. Acta Chir Belg. 2002 Aug;102(4):238-47. doi: 10.1080/00015458.2002.11679305. PMID: 12244902. · Bisdas T, Bredt M, Pichlmaier M, Aper T, Wilhelmi M, Bisdas S, Haverich A, Teebken OE. Eight-year experience with cryopreserved arterial homografts for the in situ reconstruction of abdominal aortic infections. J Vasc Surg. 2010 Aug;52(2):323-30. doi: 10.1016/j.jvs.2010.02.277. Epub 2010 Jun 8. PMID: 20570473. · PereraG. B.FujitaniR. M.KubaskaS. M.2006Aortic graft infection: Update on Management and Treatment Options.Vasc Endovascular Surg, 401Jan), 1101538-5744 · Hallett J., Marshall D.M., Petterson T.M., et. al.: Graft-related complications after abdominal aortic aneurysm repair: Population-based experience. J Vasc Surg 1977; 25: pp. 277-284. · Kieffer E, Sabatier J, Plissonnier D, Knosalla C. Prosthetic graft infection after descending thoracic/ thoracoabdominal aortic aneurysmectomy: management with in situ arterial allografts. J Vasc Surg. 2001 Apr;33(4):671-8. doi: 10.1067/mva.2001.112314. PMID: 11296316. · Gutowski P. Zakazenie aortalno-biodrowej protezy naczyniowej jako problem diagnostyczny i leczniczy [Aortoiliac graft infection as a diagnostic and treatment problem]. Ann Acad Med Stetin. 1998;Suppl 41:1-72. Polish. PMID: 9766086. · Capoccia L, Mestres G, Riambau V. Current technology for the treatment of infection following abdominal aortic aneurysm (AAA) fixation by endovascular repair (EVAR). J Cardiovasc Surg (Torino). 2014;55:381–389. · Setacci C, Chisci E, Setacci F, Ercolini L, de Donato G, Troisi N, Galzerano G, Michelagnoli S. How To Diagnose and Manage Infected Endografts after Endovascular Aneurysm Repair. Aorta (Stamford). 2014 Dec 1;2(6):255-64. doi: 10.12945/j.aorta.2014.14-036. PMID: 26798744; PMCID: PMC4682678. · Reinders Folmer E.I., Von Meijenfeldt G.C.I., Van der Laan M.J., Glaudemans A.W.J.M., Slart R.H.J.A., Saleem B.R., Zeebregts C.J. Diagnostic Imaging in Vascular Graft Infection: A Systematic Review and Meta-Analysis. Eur. J. Vasc. Endovasc. Surg. 2018;56:719–729. doi: 10.1016/j.ejvs.2018.07.010. · Rafailidis V., Partovi S., Dikkes A., Nakamoto D.A., Azar N., Staub D. Evolving clinical applications of contrast-enhanced ultrasound (CEUS) in the abdominal aorta. Cardiovasc. Diagn. Ther. 2018;8:S118–S130. doi: 10.21037/cdt.2017.09.09. · Hayes P.D., Nasim A., London N.J., et. al.: In situ replacement of infected aortic grafts with rifampicin-bonded prostheses: The Leicester experience (1992 to 1998). J Vasc Surg 1999; 30: pp. 92-98. · Oderich GS, Bower TC, Hofer J, Kalra M, Duncan AA, Wilson JW, Cha S, Gloviczki P. In situ rifampin-soaked grafts with omental coverage and antibiotic suppression are durable with low reinfection rates in patients with aortic graft enteric erosion or fistula. J Vasc Surg. 2011 Jan;53(1):99-106, 107.e1-7; discussion 106-7. doi: 10.1016/j.jvs.2010.08.018. PMID: 21184932. · Bisdas T., Bredt M., Pichlmaier M., et. al.: Eight-year experience with cryopreserved arterial homografts for the in situ reconstruction of abdominal aortic infections. J Vasc Surg 2010; 52: pp. 323-330. · O'Hara P.J., Hertzer N.R., Beven E.G., et. al.: Surgical management of infected abdominal aortic grafts: Review of a 25-year experience. J Vasc Surg 1986; 3: pp. 725-731. · Quiñones-Baldrich WJ, Hernandez JJ, Moore WS. Long-term Results Following Surgical Management of Aortic Graft Infection. Arch Surg. 1991;126(4):507–511. doi:10.1001/archsurg.1991.01410280111018 · Kieffer E., Gomes D., Chieche L., et. al.: Allograft replacement for infrarenal aortic graft infection: Early and late results in 179 patients. J Vasc Surg 2004; 39: pp. 1009-1017. · Zhou W., Lin P.H., Bush R.L., et. al.: In situ reconstruction with cryopreserved arterial allografts for management of mycotic aneurysms or aortic prosthetic graft infections: A multi-institutional experience. Texas Heart Institute J 2006; 33: pp. 14-18. 2006 · Ali AT, Modrall JG, Hocking J, Valentine RJ, Spencer H, Eidt JF, Clagett GP. Long-term results of the treatment of aortic graft infection by in situ replacement with femoral popliteal vein grafts. J Vasc Surg. 2009 Jul;50(1):30-9. doi: 10.1016/j.jvs.2009.01.008. PMID: 19563952. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other vascular episodes here : https://behindtheknife.org/podcast-category/vascular/

Jul 10, 2023

Have you transitioned a portion of your practice to the robot, but would be hesitant to book an urgent/call case on the robot? Have you wondered if the robot might be useful in your emergency or acute care surgery practice? Join University of Washington MIS Surgeons, Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and Resident Drs. Ben Vierra and Paul Herman as they discuss the growing use of the robot for acute cases and provide tips on appropriate case selection. Hosts: 1. Andrew Wright, UW Medical Center – Montlake and Northwest, @andrewswright 2. Nick Cetrulo, UW Medical Center - Northwest, @Trules25 3. Nicole White, UW Medical Center - Northwest 4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm 5. Ben Vierra, UW General Surgery Resident PGY-2 Learning objectives: - Describe the importance of the MIS approach in EGS - Review 3 articles on robotic EGS outcomes 1) Robotic surgery in emergency setting: 2021 WSES position paper 2) Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients 3) Urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable periop outcomes to laparoscopic surgery - Discuss factors influencing appropriate case selection for urgent/emergent robotic cases - Discuss value as it pertains to robotic EGS References 1. Havens JM, Peetz AB, Do WS, Cooper Z, Kelly E, Askari R, Reznor G, Salim A. The excess morbidity and mortality of emergency general surgery. J Trauma Acute Care Surg. 2015 Feb;78(2):306-11. doi: 10.1097/TA.0000000000000517. PMID: 25757115. 2. Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of National Burden to Define Operative Emergency General Surgery. JAMA Surg. 2016 Jun 15;151(6):e160480. doi: 10.1001/jamasurg.2016.0480. Epub 2016 Jun 15. PMID: 27120712. 3. Arnold M, Elhage S, Schiffern L, Lauren Paton B, Ross SW, Matthews BD, Reinke CE. Use of minimally invasive surgery in emergency general surgery procedures. Surg Endosc. 2020 May;34(5):2258-2265. doi: 10.1007/s00464-019-07016-1. Epub 2019 Aug 6. PMID: 31388806. 4. Sheetz KH, Claflin J, Dimick JB. Trends in the Adoption of Robotic Surgery for Common Surgical Procedures. JAMA Netw Open. 2020 Jan 3;3(1):e1918911. doi: 10.1001/jamanetworkopen.2019.18911. PMID: 31922557; PMCID: PMC6991252. 5. de'Angelis N, Khan J, Marchegiani F, Bianchi G, Aisoni F, Alberti D, Ansaloni L, Biffl W, Chiara O, Ceccarelli G, Coccolini F, Cicuttin E, D'Hondt M, Di Saverio S, Diana M, De Simone B, Espin-Basany E, Fichtner-Feigl S, Kashuk J, Kouwenhoven E, Leppaniemi A, Beghdadi N, Memeo R, Milone M, Moore E, Peitzmann A, Pessaux P, Pikoulis M, Pisano M, Ris F, Sartelli M, Spinoglio G, Sugrue M, Tan E, Gavriilidis P, Weber D, Kluger Y, Catena F. Robotic surgery in emergency setting: 2021 WSES position paper. World J Emerg Surg. 2022 Jan 20;17(1):4. doi: 10.1186/s13017-022-00410-6. PMID: 35057836; PMCID: PMC8781145. 6. Robinson TD, Sheehan JC, Patel PB, Marthy AG, Zaman JA, Singh TP. Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients. Surg Endosc. 2022 Feb;36(2):1573-1577. doi: 10.1007/s00464-021-08447-5. Epub 2021 Mar 24. PMID: 33760973. 7. Anderson M, Lynn P, Aydinli HH, Schwartzberg D, Bernstein M, Grucela A. Early experience with urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable perioperative outcomes to laparoscopic surgery. J Robot Surg. 2020 Apr;14(2):249-253. doi: 10.1007/s11701-019-00968-5. Epub 2019 May 10. PMID: 31076952. 8. Gangemi A, Danilkowicz R, Bianco F, Masrur M, Giulianotti PC. Risk Factors for Open Conversion in Minimally Invasive Cholecystectomy. JSLS. 2017 Oct-Dec;21(4):e2017.00062. doi: 10.4293/JSLS.2017.00062. PMID: 29238153; PMCID: PMC5714218. 9. Bhama AR, Wafa AM, Ferraro J, Collins SD, Mullard AJ, Vandewarker JF, Krapohl G, Byrn JC, Cleary RK. Comparison of Risk Factors for Unplanned Conversion from Laparoscopic and Robotic to Open Colorectal Surgery Using the Michigan Surgical Quality Collaborative (MSQC) Database. J Gastrointest Surg. 2016 Jun;20(6):1223-30. doi: 10.1007/s11605-016-3090-6. Epub 2016 Feb 3. PMID: 26847352. 10. https://www.east.org/about-east/news-and-events/news/details/320/east-robotic-surgery-for-the-acute-care-surgeon-webinar-series Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other MIS episodes here : https://behindtheknife.org/podcast-category/minimally-invasive/

Jul 7, 2023

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GENERAL TIPS FOR SUCCESS ON THE WARDS Spend time with the patient! Trust, but verify. Be kind to everyone. Stay humble. Be flexible. Seek and apply feedback. HOW TO LEARN IN THE OR Double scrub as many cases as you can. Write down/record everything after a case. MAINTAIN YOUR PERSONAL SANITY Figure out your stress outlets and what brings you joy. Decompress after work. Maintain work/life boundaries. Keep in touch with loved ones. Vacations are meant for relaxation. Repeat after me: NO WORK ON VACATION! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 6, 2023

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. Today, we’re hitting the wards and tackling some of the scary clinical scenarios you will see as an intern. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: THINGS TO REMEMBER · BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn’t help anybody. · See the patient. Getting a bunch of pages? Worried about someone? Confused as to what’s going on? Go see the patient and chat with the bedside team. · Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients. · Load the boat. You’ve heard this one from us all week! Loop senior level residents in early. HYPOTENSION · Differential: measurement error, patient’s baseline, and don’t miss – SHOCK. - Etiologies of shock: hemorrhagic, hypovolemic, · On the phone: full set of vitals, accurate I/Os, · On the way: recent notes, PMH/PSH including from this hospital stay, and vitals/I&Os/studies from earlier in the day · In the room: ABCDs – rapidly gives you a sense of how high acuity the patient is · Get more info: labs, consider imaging, work up specific types of shock based on clinical concern. · Initial management: depends on etiology of hypotension; don’t forget to consider peripheral or central access, foley catheterization for close monitoring of urine output, and level of care HYPOXEMIA · Differential: atelectasis, baseline pulmonary disease, pneumonia, PE, hemo/pneumothorax, volume overload · On the phone: full set of vitals, amount of supplemental oxygen required and delivery device, rate of escalation in oxygen requirement · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, pulmonary and cardiac exam, volume status exam · Get more info: basic labs, ABG if worried about oxygenation, CXR, consider bedside US of the lungs/heart, if high suspicion for PE consider CTA chest · Initial Management: supplemental O2, higher level of care, consider intubation or other supplemental oxygenation adjuncts, additional management dependent on suspected etiology · ABG Vs VBG (IBCC): https://emcrit.org/ibcc/vbg/ ALTERED MENTAL STATUS · Differential: stroke, medication effect, hypoxemia or hypercarbia, toxic or medication effect, endocrine/metabolic, stroke or MI, psychiatric illness, or infections, delirium · On the way: review PMH/PSH, recent notes for evidence of altered mentation or agitation, or signs hinting at above etiologies · In the room: ABCDs, focal neuro deficits?, alert/oriented? Be sure the patient’s mental status is adequate for airway protection! · Get more info: basic labs, blood gas/lactate, CT head noncontrast if concerned for stroke. · Initial management: rule out above; if concerned about delirium, optimize sleep/wake cycles, pain control, and lines/drains/tubes. OLIGURIA · Differential: prerenal due to hypovolemia or low effective circulating volume, intrinsic renal disease, post-renal obstruction · On the phone: clarify functional foley or bladder scan results, full set of vitals · On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection · In the room: ABCDs, confirm functioning foley catheter · Get more info: basic labs, urine electrolytes, consider fluid challenge to evaluate responsiveness, consider adjuncts including renal US · Initial management: typically consider IVF bolus initially, but if patient not volume responsive, don't overload them -- look for other etiologies! TACHYCARDIA · Differential: sinus tachycardia (pain, hypovolemia, agitation, infection), cardiac arrhythmia, MI, PE · On the phone: full set of vitals, acuity of change in heart rate, updated I/Os · On the way: Review PMH/PSH, known cardiac history, cardiac and PE risk factors, volume resuscitation, signs concerning for infection, updated I/Os · In the room: ABCDs, cardiac/pulmonary exam, evaluate for any localizing signs for infection · Get more info: basic labs, EKG, consider CXR, troponins · Initial management: depends heavily on etiology Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 5, 2023

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll talk about how to give and receive consults in the hospital like a pro. We’ll also provide some tips on how to make those long call days a little more manageable. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GIVING CONSULTS Clear and Concise Question! Develop a script, such as: “Hi, this is XX with the general surgery team. We’re calling to request an evaluation for a patient presenting with XX. I can give you the MRN whenever you are ready…” Follow this with a brief H&P. If you are asking another team to perform a procedure on your patient, be prepared with the following information: NPO Status Ability to Consent or Proxy Contact Blood Thinners Urgency of Procedure RECEIVING CONSULTS Make sure you are clear on what the team is asking of you as a consultant. Clarify if the patient is expecting to receive a surgery before talking to them about an operation! Quickly gather information about the patient and their hospital course from the consultant, electronic medical record, and, most importantly, the patient! Note the callback number on the primary team and call them with the plan after you have staffed the patient with your attending. If you are asked to perform a procedure as a consultant, clarify the following information: NPO Status Ability to Consent or Proxy Contact Blood Thinners Urgency of Procedure Develop a system to stay organized and keep track of your to-do list with consults! CALL SHIFTS Bring a survival bag with toothbrush/toothpaste, face wash, deodorant, change of clothes, etc to reset. Try to nap when you can, but: PM round to address non-urgent pages ahead of time Set alarms! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 4, 2023

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. You’ve been a doctor for about 3.5 seconds, and suddenly that bright eyed, bushy-tailed medical student on service is looking to you for advice? Don’t fret, in this episode we’ll give you some tips for how to handle it. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: REMEMBER HOW INTERNS DO AND DO NOT TEACH - Nobody, not even the med students, expect you to be an expert in everything or give a fully-planned formal lecture - You WILL however spend a ton of time working with students on your team – and via modeling and teachable moments, you can help them learn how it’s done! MODELING - Remember how hard everything has been in the few days since you started residency? Think about all the information you’ve picked up, tips and tricks you’re developing for efficiency, and best practices you’re learning in the care of your patients. ALL of these are things you can pass on to students. - Presentations, case prep, answering questions from senior members of the team are ALL excellent opportunities to teach (and show students how you learn yourself, so they can do it independently). TEACHABLE MOMENTS - Find small topics that you know or are getting to know well – things like looking at a CXR, CT scan, etc. - Once you’re getting more comfortable caring for specific disease processes, think about high yield lessons for students: - Acute trauma evaluation and management (ABCDE’s), appendicitis, diverticulitis, benign biliary disease all make great 5 minute chalk talks that you can have in your back pocket IN THE OR - Watch students practice skills, and try to give some feedback and tips that you use (you learned knot tying and suturing more recently than ANYONE else in the OR and probably have some tips that you’re still using to improve) - If you’re not sure where or why the student is struggling with a particular skill (like tying a knot), model doing it yourself in slow motion while watching them do it – often the side by side comparison can help you identify where they’re going astray BE THE RESIDENT YOU WISH YOU HAD - Refer to EVERYONE with respect - Model being a kind, conscientious, and curious physician - Try to find universal lessons and crossover topics that non-surgeons need to know - A great student makes their interns look even better – be explicit about how they can be successful, then advocate for them to have opportunities to show everything they’re learning! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jul 3, 2023

SHOW NOTES Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll tackle the resources that you should know about to support your own learning throughout residency. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: STRUCTURE YOUR STUDYING - 2 things you need to do: (1) develop a knowledge base and (2) answer questions - Knowledge base Pick a level-appropriate textbook, read it (ideally all of it) yearly. Ideally, lead a little bit every day - 10 pages/day is a good goal to start with and you may need to adjust. - Questions Do some questions every week – 50/week is a good goal to start Plan to do more questions closer to ABSITE! Consider storing everything you learn in one place – either a notebook you carry with you or a cloud-based note app Share this with others, use it to take notes while reading, doing cases, getting feedback, or gaining experience while taking care of patients every day. SPECIFIC RESOURCES - Textbooks Sabiston: big book, very dense, with a lot of great information. Schwartz: shorter chapters, clinically oriented, ideal for junior residents Cameron: shorter chapters, clinically oriented, ideal for senior residents - ABSITE review books Fiser: Classic, packed with facts but can be difficult to read, good for looking things up quickly BTK ABSITE Companion: from yours truly! High quality illustrations and algorithms that pairs well with the BTK ABSITE podcast episodes. Stay tuned for an updated episodes and companion book in Fall 2023! - Question banks TrueLearn: high quality, can be pricy depending on program SCORE: written/edited by ABS, free for subscribing programs LEARN HOW TO OPERATE?? - Carry suture and a needle driver with you and practice basic moves - Consider a home suture kit for practice when you don’t want to be in sim lab – BTK released one this year - Use VIDEOS to ensure learning things the correct way! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jun 30, 2023

Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. First up, the first day of intern year. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: BRING WHAT YOU NEED Name badge Scrubs, white coat, and extra clinic clothes Comfortable shoes - even on clinic days Pager Phone Pen Bonus stuff that’s good to keep in your bag: Snacks, extras of everything, toothbrusth/toothpaste/deodorant, suture STAY ORGANIZED Preround purposefully and systematically Look at the same things in the same order every day on every patient Write data in the same physical location on your sheet so you can quickly find information on the fly Keep track of to-do’s from rounds Check box system: Nina’s system: empty = not done, half full = ordered/needs follow up, full = completely done and followed up on Don’t forget to look at the results of imaging studies, labs, or consults after they are entered! Prioritize urgent/emergent things first, then consults and discharges, then routine orders, then notes As you get more efficient, start drafting your notes as you pre-round – it will save you lots of time later in the afternoon! OWN THE FLOOR During the day, be ready to shift your priorities as urgent issues arise. Develop a system for remembering what happened after rounds so you can quickly update seniors Shanaz’s system: One color for AM rounds, a different color for afternoon events Load the boat! Your team is there to help you. If you are concerned about someone or have a question, ask. There is truly no better time than as an intern. Master the art of getting your seniors’ attention in the OR - be conscientious, be clear in what you’re asking, and be prepared to report back about urgent findings! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills - https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

Jun 29, 2023

In their BTK debut, the Hernia team from Carolinas Medical Center discusses how to approach a hernia patient with loss of domain. This Clinical Challenges episode reviews strategies that optimize patients and provide them with the best chance of fascial closure. So, tune in, and enjoy a data driven conversation with our newest hernia enthusiasts! Hosts: - Sullivan "Sully" Ayuso, MD - PGY4 General Surgery Resident, sullivan.ayuso@gmail.com, Carolinas Medical Center - Monica Polcz, MD - Clinical Fellow (PGY-8) in Abdominal Wall Reconstruction, monica.polcz@atriumhealth.org, Carolinas Medical Center - Vedra Augenstein, MD FACS - Associate Professor of Surgery (11 years in practice), vedra.augenstein@gmail.com, Carolinas Medical Center B - Todd Heniford, MD FACS - Professor of Surgery (25 years in practice), todd.heniford@gmail.com, Carolinas Medical Center Links to articles: - Katzen et al, Open Preperitoneal Ventral Hernia Repair: Prospective Observational Study of Quality Improvement Outcomes over 18 Years and 1,842 patients, Surgery, 2022 https://pubmed.ncbi.nlm.nih.gov/36280505/ - Bernardi et al, Primary Fascial Closure During Laparoscopic Ventral Hernia Repair Improves Patient Quality of Life: A Multicenter, Blinded Randomized Trial, Ann Surg, 2020 https://pubmed.ncbi.nlm.nih.gov/31365365/ - Deerenberg et al, The Effects of Preoperative Botulinum Toxin A on Abdominal Wall Reconstruction, J Surg Res, 2021 https://pubmed.ncbi.nlm.nih.gov/33360691/ - Bueno-Lledó, Preoperative Progressive Pneumoperitoneum and Botulinum Toxin A in Patients with Large Incisional Hernia, Hernia, 2017 https://pubmed.ncbi.nlm.nih.gov/28124308/ - Maloney et al, Twelve Years of Component Separation Technique in Abdominal Wall Reconstruction, Surgery, 2021 https://pubmed.ncbi.nlm.nih.gov/31358348/ - Ayuso et al, Delayed Primary Closure (DPC) of the Skin and Subcutaneous Tissues Following Complex, Contaminated Abdominal Wall Reconstruction (AWR): A Propensity-Matched Study, Surg Endo, 2022 https://pubmed.ncbi.nlm.nih.gov/34018046/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more hernia episodes here : https://behindtheknife.org/podcast-category/hernia/

Jun 26, 2023

Join BTK's Dr. Kevin Kniery for a discussion on How to do a Liver Transplant with Dr. Shah and Dr. Dageforde. Additional resources: - Watch: Liver Transplant Surgical Techniques - https://www.youtube.com/watch?v=Vk1Ld7Fp5es - Listen: Surgical Technique: Kidney Transplant (Part 1) https://behindtheknife.org/podcast/surgical-technique-kidney-transplant-part-1/ Surgical Technique: Kidney Transplant (Part 2) https://behindtheknife.org/podcast/surgical-technique-kidney-transplant-part-2/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 22, 2023

Dr. Buchwald is Professor Emeritus of Surgery and Biomedical Engineering at the University of Minnesota. He is a veteran, world-renowned metabolic surgeon, author, professor and patient healthcare advocate. His book “Healthcare Upside Down: A Critical Examination of Policy and Practice” was born out of Dr. Buchwald’s observations of the healthcare industry over the last 50 years. In it, he explores how healthcare has been turned upside down to serve the administrators of the system and away from its basic function of offering the best care for patients. More importantly, he discusses solutions for turning our broken healthcare system right-side up to better serve all patients. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other recent episodes here : https://behindtheknife.org/listen/

Jun 19, 2023

Application season is almost here! Whether you are about to apply to surgery residency or are part of a program recruiting applicants, there are several recent changes to the process that you should be aware of. Residency recruitment continues to see increased numbers of applications that create challenges for both students and programs. ERAS and other organizations are trying to address these issues with alterations to the application process. Today, we’ll discuss how the ERAS supplemental application, as well as new concepts like a single interview release period and decoupled rank lists, can help. We’re joined by Dr. Jennifer LaFemina, one of the leaders in these efforts within the general surgery recruitment process. Learning Objectives - Listeners will describe current challenges in the residency recruitment process. - Listeners will describe the value that changes such as the ERAS supplemental application can add to the residency recruitment process. - Listeners will recognize the results that changes to the residency application process have had during the first 2 years of implementation in surgery. - Listeners will consider how alterations to the residency application process can be successfully applied within their own program or application. References: LaFemina J, Rosenkranz KM, Aarons CB, et al. Outcomes of the 2021-2022 APDS General Surgery Recruitment Process Recommendations. Journal of Surgical Education . 2023;80(6):767-775. doi:10.1016/j.jsurg.2023.02.019 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical education episodes here : https://behindtheknife.org/podcast-category/surgical-education/

Jun 15, 2023

You just finished a difficult case in which a complication occurred. Feelings of guilt, sadness, and anxiety are pouring over you. You can't help but think you are a terrible surgeon, maybe even a terrible person. Does this sound familiar? Complications have profound psychological impact on surgeons. Find out how one surgeon decided to do something about it by creating a peer support program. Join Jessica Millar and Patrick Georgoff as they discuss the second victim syndrome with Dr. Haytham Kaafarani (@hayfarani). References: - The Surgeon as the Second Victim? Results of the Boston Intraoperative Adverse Events Surgeons' Attitude (BISA) Study: https://pubmed.ncbi.nlm.nih.gov/28093300/ - Design and Impact of a Novel Surgery-Specific Second Victim Peer Support Program: https://pubmed.ncbi.nlm.nih.gov/31857209/ - When Things Go Wrong: The Surgeon as Second Victim: https://pubmed.ncbi. nlm.nih.gov/30480564/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here : https://behindtheknife.org/listen/

Jun 12, 2023

Join the Surgical Oncology team from UTSouthwestern and the University of Miami as they tackle a journal review covering how to choose perioperative antimicrobial prophylaxis for pancreatoduodenectomy. Listen in as they also review novel methodology and the origins of the study. Learning Objectives: What antibiotics are you giving before your Whipple? In the group’s final episode together, we review the 1st of its kind, registry linked, pragmatic surgical trial in North America. In the episode we dissect “Piperacillin-Tazobactam Compared With Cefoxitin as Antimicrobial Prophylaxis for Pancreatoduodenectomy - A Randomized Clinical Trial” and discuss the practice changing findings, and the future of surgical clinical trials. Hosts: Adam Yopp, MD, FACS (@AdamYopp) is an Associate Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a recent graduate of the MD Anderson Complex General Surgical Oncology fellowship and is now a new faculty member in the Division of Surgical Oncology within the Sylvester Cancer Center at the University of Miami where she specializes in surgery for cancers of the liver, pancreas, and other gastrointestinal sites. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-4 Research Fellow and General Surgery Resident at the UT Southwestern Medical Center. He is studying the pancreatic tumor microenvironment and targeted therapies in the lab of Rolf Brekken within the Hamon Center for Therapeutic Oncology Research. He also does work on access to care, social determinants of health, and interventions to mitigate disparities in surgical and oncologic outcomes under the mentorship of Patricio Polanco. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out surgical oncology episodes here : https://behindtheknife.org/podcast-category/surgical-oncology/

Jun 8, 2023

Join BTK’s Dr. Scott Steele for a discussion with Dr. Tom Read on leadership opportunities outside of clinical medicine. They discuss Dr. Tom Read's role as the executive chairman for the American Board of Colorectal Surgery. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other recent episode here : https://behindtheknife.org/listen/

Jun 5, 2023

Join BTK’s Dr. Scott Steele for a discussion with Dr. Conor Delaney on leadership opportunities outside of clinical medicine. They discuss Dr. Conor Delaney's role as the chief executive officer and president of Cleveland Clinic Florida. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other recent episode here : https://behindtheknife.org/listen/

Jun 1, 2023

Join BTK's Dr. Scott Steele for a discussion with Dr. Bradley Champagne on leadership opportunities outside of clinical medicine. They discuss Dr. Bradley Champagne's role as the chief medical officer of a large hospital. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other recent episode here : https://behindtheknife.org/listen/

May 29, 2023

Join BTK's Dr. Scott Steele for the first episode of a new leadership series that explores opportunities outside of clinical medicine. In this episode, Dr. Steele sits down with Dr. Amy Lightner who is the Chief Medical Officer for Direct Biologics. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other recent episode here : https://behindtheknife.org/listen/

May 25, 2023

This spectacular keynote address was given by Dr. David Knott at the “Mattox” Trauma Conference in 2023. Mattox Vegas TCCACS: https://www.trauma-criticalcare.com/ War Doctor: https://www.amazon.com/War-Doctor-Surgery-Front-Line/dp/1419744240/ref=asc_df_1419744240/?tag=hyprod-20&linkCode=df0&hvadid=508953752346&hvpos=&hvnetw=g&hvrand=15602939439351749599&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9009673&hvtargid=pla-906115140419&psc=1 The David Nott Foundation: https://davidnottfoundation.com/ Dr. Nott on BTK July 1, 2020: https://behindtheknife.org/podcast/war-doctor-david-nott-on-surgery-in-war-zones/ David gained his medical degree from Manchester University and in 1992 gained his FRCS from the Royal College of Surgeons of England to become a Consultant Surgeon. He is a Consultant Surgeon at St Mary’s Hospital where he specialises in vascular and trauma surgery and also performs cancer surgery at the Royal Marsden Hospital. David is an authority in laparoscopic surgery and was the first surgeon to combine laparoscopic and vascular surgery. For the past 30 years David has taken unpaid leave to work for the aid agencies Médecins Sans Frontières, the International Committee of the Red Cross and Syria Relief. He has provided surgical treatment to patients in conflict and catastrophe zones in Bosnia, Afghanistan, Sierra Leone, Liberia, Ivory Coast, Chad, Darfur, Yemen, the Democratic Republic of Congo, Haiti, Iraq, Pakistan, Libya, Syria, Central African Republic, Palestine, Nepal and Ukraine As well as treating patients affected by conflict and catastrophe and raising hundreds of thousands of pounds for charitable causes, David teaches advanced surgical skills to local medics and surgeons when he is abroad. In Britain, he set up and led the teaching of the Surgical Training for the Austere Environment (STAE) course at the Royal College of Surgeons. In 2015 David established the David Nott Foundation with his wife Elly. The Foundation supports surgeons in developing their operating skills for war zones and austere environments and has now trained over 900 doctors through their bespoke Hostile Environment Surgical Training (HEST) course. In 2019, Picador published David’s bestselling memoir, War Doctor . Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episode list here : https://behindtheknife.org/listen/

May 22, 2023

Join our transplant team as they discuss cases of acute and chronic liver disease requiring liver transplant. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out more transplant episodes here : https://behindtheknife.org/podcast-category/transplant/

May 18, 2023

For our last submission as the BTK Bariatric Surgery Team, we thought we would take a minute to review some recent landmark trials in bariatric surgery. Get caught up on the impact of bariatric surgery on obesogenic cancers and non-alcoholic steatohepatitis. Journal articles: Association of Bariatric Surgery with Cancer Risk and Mortality in Adults with Obesity: https://pubmed.ncbi.nlm.nih.gov/35657620/ . Bariatric-Metabolic Surgery versus Lifestyle Intervention plus Best Medical Care in Non-Alcoholic Steatophepatitis (BRAVES): A Multicentre, Open-Label, Randomised Trial: https://pubmed.ncbi.nlm.nih.gov/37088093/ . Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed robotic general surgery procedures. If you are a general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com for more information on how you could be compensated $500 per video submitted of each (up to $1000 per surgeon). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other bariatric episodes here : https://behindtheknife.org/podcast-category/bariatric/

May 15, 2023

Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as colorectal surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 51 scenarios here : https://behindtheknife.teachable.com/p/btk-colorectal-surgery-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 11, 2023

Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as colorectal surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 51 scenarios here : https://behindtheknife.teachable.com/p/btk-colorectal-surgery-oral-board-review-course Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 8, 2023

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss the nuances of 3 common pediatric general surgery scenarios. Journal Article links: Nguyen HN, Navarro OM, Bloom DA, Feinstein KA, Guillerman RP, Munden MM, et al. Ultrasound for Midgut Malrotation and Midgut Volvulus: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2022;218(6):931-9. https://pubmed.ncbi.nlm.nih.gov/35107311/ Plut D, Phillips GS, Johnston PR, Lee EY. Practical Imaging Strategies for Intussusception in Children. AJR Am J Roentgenol 2020;215(6):1449-63. https://pubmed.ncbi.nlm.nih.gov/33084362/ Markel TA, Scott MR, Stokes SM, Ladd AP. A randomized trial to assess advancement of enteral feedings following surgery for hypertrophic pyloric stenosis. J Pediatr Surg 2017;52(4):534-9. https://pubmed.ncbi.nlm.nih.gov/27829521/ St Peter SD, Holcomb GW, 3rd, Calkins CM, Murphy JP, Andrews WS, Sharp RJ, et al. Open versus laparoscopic pyloromyotomy for pyloric stenosis: a prospective, randomized trial. Ann Surg 2006;244(3):363-70. https://pubmed.ncbi.nlm.nih.gov/16926562/ Dalton BG, Gonzalez KW, Boda SR, Thomas PG, Sherman AK, St Peter SD. Optimizing fluid resuscitation in hypertrophic pyloric stenosis. J Pediatr Surg 2016;51(8):1279-82. https://pubmed.ncbi.nlm.nih.gov/26876090/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other pediatric surgery episodes here: https://behindtheknife.org/podcast-category/pediatric/

May 4, 2023

On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill discuss brain death and why you as a provider must be able to provide clarity when it is needed most. This episode is packed with useful information on a very complicated topic. So, sit back, relax, and enjoy the show. The World Brain Death Project (JAMA 2020): https://pubmed.ncbi.nlm.nih.gov/32761206/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out the rest of the BIG T trauma series here : https://behindtheknife.org/podcast-series/big-t-trauma/

May 1, 2023

Upon encountering a patient who develops an anastomotic leak after a straight-forward low anterior resection, you are taken aback, as the patient is healthy and has no apparent risk factors. This prompts you to consider whether the microbiota may have played a role in causing the leak. Join Dr. Carole Richard, Dr. François Dagbert, Dr. Maher Al Khaldi, and Dr. Roy Hajjar in their conversation about the impact of gut microbiota on anastomotic healing and leak. Learning objectives - To list the known risk factors for anastomotic leak. - To understand how preoperative gut microbiota influence anastomotic healing and could lead to leak. Reference Hajjar R, Gonzalez E, Fragoso G, et al. Gut microbiota influence anastomotic healing in colorectal cancer surgery through modulation of mucosal proinflammatory cytokines. Gut. Published Online First: 30 December 2022. doi: 10.1136/gutjnl-2022-328389 Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed robotic general surgery procedures. If you are a general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com for more information on how you could be compensated $500 per video submitted of each (up to $1000 per surgeon). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other colorectal surgery episodes here : https://behindtheknife.org/podcast-category/colorectal/

Apr 27, 2023

Dr. Cunningham is the section head of the Massachusetts General Hospital Endocrine Surgery unit, a NIH-funded researcher, and the immediate past-president of the Association for Academic Surgery. This episode is a recording of her presidential address at their annual Academic Surgical Congress. Guest Dr. Carrie Cunningham, MD, MPH Associate Professor of Surgery, Harvard Medical School Learn More Association for Academic Surgery: https://www.aasurg.org/ Dr. Lorna Breen Heroes foundation: https://drlornabreen.org/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 24, 2023

While you are likely aware of BRCA mutations as a significant risk factor for development of breast cancer (60-80% lifetime risk), there are many other pathogenic gene variants that have been identified in recent years. The surgical treatment of women with hereditary breast cancer differs from that of women with sporadic breast cancer, and women with hereditary breast cancer are also eligible for prophylactic mastectomy or intensive surveillance protocols. In this episode of BTK, we examine current national consensus guidelines for management of hereditary breast cancer, discuss a recent population-based study that establishes risk associated with various genes, and address both surgical and surveillance strategy for patients without breast cancer but with known pathogenic gene variants. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other breast surgery episodes here : https://behindtheknife.org/podcast-category/breast/

Apr 20, 2023

Calling all surgeons! It’s time to take back common bile duct stones! Join our surgical education fellow, Shanaz Hossain, as she talks about laparoscopic common bile duct exploration (LCBDE) with Drs. Maggie Bosley, Lucas Neff, and Byron Fernando Santos. Dr. Bosley is a graduating chief resident at Wake Forest and incoming MIS fellow at Washington University in St. Louis. Dr. Neff is an assistant professor of pediatric surgery with Wake Forest Baptist Health and Brenner’s Children’s Hospital. Dr. Santos is an assistant professor of surgery at Dartmouth-Hitchcock Medical Center. As a research resident at Northwestern University, he co-invented a LCBDE simulator that is used to train surgeons in these techniques. He is also a member of the SAGES Safe Cholecystectomy Task Force and has led numerous LCBDE courses. Join us for a discussion on LCBDE indications, implementation, techniques, and tips for incorporation into patient care. If you’re interested in learning more, check out the instructional video from these surgeons as well as some of their work on LCBDE: Instructional Video: https://behindtheknife.org/video-playlists/laparoscopic-common-bile-duct-tutorial-series/ Research Articles · Anterograde Balloon Sphincteroplasty as an Adjunct to Laparoscopic Common Bile Duct Exploration for the Acute Care Surgery: https://journals.lww.com/jtrauma/Citation/2022/03000/Antegrade_balloon_sphincteroplasty_as_an_adjunct.22.aspx · Choledocholithiasis – A New Clinical Pathway: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343507/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 17, 2023

Hernias are some of the most common problems treated by general surgeons. The field of abdominal wall surgery has rapidly evolved as a result of innovation and the development of new techniques. In this podcast, Drs. Charlotte Horne and Jenny Shao join Vahagn Nikolian to discuss their decision to pursue careers as abdominal wall specialists, the role that hernia surgeons play in modern day surgical programs, and the pathway to becoming a hernia surgeon. · Dr. Charlotte Horne is an Assistant Professor of Surgery at Pennsylvania State University. · Dr. Jenny Shao is an Assistant Professor of Surgery at the University of Michigan. · Dr. Vahagn Nikolian is an Assistant Professor of Surgery at Oregon Health & Science University. Recommended Reading: Shulkin JM, Mellia JA, Patel V, Naga HI, Morris MP, Christopher A, Heniford BT, Fischer JP. Characterizing hernia centers in the United States: what defines a hernia center? Hernia. 2022 Feb;26(1):251-257. doi: 10.1007/s10029-021-02411-x. Epub 2021 Apr 19. PMID: 33871743. Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012 Nov;204(5):709-16. doi: 10.1016/j.amjsurg.2012.02.008. Epub 2012 May 16. PMID: 22607741. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Hernia episodes here: https://behindtheknife.org/podcast-category/hernia/

Apr 13, 2023

To operate or not to operate, to drain the urine leak or to not drain it, those are the questions. Join our Miami Trauma team including Drs. Urréchaga, Neeman, and Rattan- in their final episode together! - as they discuss how to navigate the ins and outs of renal trauma! Learning Objectives: · Define the different renal injury grades and how to manage each, · Identify when to take the renal trauma patient to the operating room, · Discuss when to involve IR for urinary drainage or embolization. · Explain when and how to perform a nephrectomy. · Debate the treatment of penetrating zone two injuries- to explore or not explore? Quick Hits: 1. Most kidney injuries, the vast majority, can be non-operatively managed. 2. For pretty much all AAST grade of injury, the choice to go to the OR immediately lies in whether the patient is stable or unstable. 3. If there is a urinary leak seen on imaging, it can usually just be observed and followed with repeat imaging to determine the need for drainage, unless the injury is significant or if there is injury to the renal pelvis- then the patient will usually need a drainage procedure. 4. Consider IR in any stable patient found to have active extravasation, fistula, or pseudoaneurysm. 5. In the case of an unstable patient, except very rare circumstances, you should be going to the OR 6. If there is another cause of instability, address that first. If you’re opening Gerota’s fascia, be prepared to commit to a nephrectomy. 7. In penetrating injury, the formal teaching is mandatory exploration of a renal hematoma. Real world experience shows that this isn’t always necessary- such as in tangential injuries or injuries to the periphery- on a case-by-case basis. References 1. Federico C, Moore Ernest E, Yoram K, Walter B, Aari L, Yosuke M, et al. Kidney and uro-trauma: WSES-AAST guidelines. World J Emerg Surg 2019;14:54. 2. Morey AF, Brandes S, Dugi DD 3rd et al: Urotrauma: AUA guideline. J Urol 2014, 192: 327. Published 2014; Amended 2017, 2020. 3. Aziz HA, Bugaev N, Baltazar G, Brown Z, Haines K, Gupta S, Yeung L, Posluszny J, Como J, Freeman J, Kasotakis G. Management of adult renal trauma: a practice management guideline from the eastern association for the surgery of trauma. BMC Surg. 2023 Jan 27;23(1):22. doi: 10.1186/s12893-023-01914-x. PMID: 36707832; PMCID: PMC9881253. 4. Petrone P, Perez-Calvo J, Brathwaite CEM, Islam S, Joseph DK. Traumatic kidney injuries: A systematic review and meta-analysis. Int J Surg. 2020 Feb;74:13-21. doi: 10.1016/j.ijsu.2019.12.013. Epub 2019 Dec 21. PMID: 31870753. **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other trauma surgery episodes here : https://behindtheknife.org/podcast-category/trauma/

Apr 10, 2023

Have a grand idea for how to improve education and patient safety in surgery, but unsure how to make it a reality? Perhaps the OR Black Box can inspire you and set you on your path as an innovator. We are joined by Dr. Teodor Grantcharov, one of its creators. The OR Black Box is a system that collects, stores, and analyzes a large amount of data from the operating room beyond just surgical video, such as video and audio of the operating room and patient physiology data. Using the system for feedback through self-directed review, coaching, and integrated AI analysis has changed the way we can learn and teach in surgery, and may have implications for the future of evaluation and credentialing. Learning Objectives Listeners will describe the value that accessible data review and analysis adds to surgical education. Listeners will describe how review of operative data could be utilized for more objective evaluation and credentialing, and how this can be used for continuous improvement. Listers will recognize common barriers to using new technology or process changes in surgery. Listeners will recognize the importance of a well-developed research question and its application to a clinical need when designing research or innovation in surgery and education. Listeners will appreciate the long and iterative process required to go from a research idea to implementation and impact on clinical outcomes. Listeners will organize their own ideas for research utilizing the advice offered in the episode. References: 1. Goldenberg MG, Jung J, Grantcharov TP. Using Data to Enhance Performance and Improve Quality and Safety in Surgery. JAMA Surg . 2017;152(10):972. doi:10.1001/jamasurg.2017.2888 2. van Dalen ASHM, van Haperen M, Swinkels JA, Grantcharov TP, Schijven MP. Development of a Model for Video-Assisted Postoperative Team Debriefing. J Surg Res . 2021;257:625-635. doi:10.1016/j.jss.2020.07.065 **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical education episodes here : https://behindtheknife.org/podcast-category/surgical-education/

Apr 6, 2023

Please join BTK's Dr. Nina Clark and Dr. Shreya Gupta for a discussion with Dr. Edward Barksdale on the important and sensitive topic of the underrepresented in medicine. Society of Black Academic Surgeons: https://www.sbas.net/ References: Yeo HL, Abelson JS, Symer MM, Mao J, Michelassi F, Bell R, Sedrakyan A, Sosa JA. Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors. JAMA Surg. 2018 Jun 1;153(6):511-517. doi: 10.1001/jamasurg.2017.6202. PMID: 29466536; PMCID: PMC5875388. McFarling, U.L. ‘It was stolen from me’: Black doctors are forced out of training programs at far higher rates than white residents. STAT . 6/20/2022. Accessed online: 10/1/2022. https://www.statnews.com/2022/06/20/black-doctors-forced-out-of-training-programs-at-far-higher-rates-than-white-residents/ Haruno LS, Chen X, Metzger M, et al. Racial and Sex Disparities in Resident Attrition Among Surgical Subspecialties. JAMA Surg. Published online February 08, 2023. doi:10.1001/jamasurg.2022.7640 **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other recent episodes here : https://behindtheknife.org/listen/

Apr 3, 2023

Please join Drs. Graham Skelhorne-Gross, Jordan Nantais and Ashlie Nadler from our Emergency General Surgery Team for a discussion on cirrhotic patients. Child-Pugh Score ( https://www.mdcalc.com/calc/340/child-pugh-score-cirrhosis-mortality ) · Bilirubin, albumin, INR, ascites, encephalopathy · Used to predict operative mortality based on cirrhosis severity · Mortality in EGS: - Child-Pugh A: 10% electively and 22% emergently - Child-Pugh B: 30% electively and 38% emergently - Child-Pugh C: 80% electively and up to 100% emergently Model for End Stage Liver Disease (MELD) ( https://www.mdcalc.com/calc/10437/model-end-stage-liver-disease-meld?utm_source=site&utm_medium=link&utm_campaign=meld_12_and_older ) · creatinine, bilirubin, INR, and sodium · MELD < 20 – 1% increase in mortality with each point increase · MELD > 20 – 2% increase in mortality with each point increase Pre-operative Planning · Identification of cirrhosis with physical examination, bloodwork and imaging · Involvement of other medical services (internal medicine, hepatology, ICU) as needed · Cirrhosis optimization, if possible · Abdominal wall mapping Unexpected Intraoperative Finding Communicate unexpected findings to the operative team and think of additional adjuncts you may need such as additional ports, topical hemostatic agents or energy devices. Think about why you are in the OR. If its an elective situation and can wait, consider bailing. If its emergent, you may have to do something more definitive. Exposure may be a challenge, you may have to alter your typical approach including where the assistant grabs and retracts. Extra hands are helpful. Bleeding can be a big deal. If possible, map out the abdominal wall ahead of time with cross-sectional imaging. Stay away from varices around the umbilicus or porta Ventral Hernia + Cirrhosis · Ideally, control ascites pre-operatively, if you can’t consider leaving drains · Small (< 2cm) hernias close primarily · Larger (>2cm) hernias repair with mesh unless infected filed (controversial) · Minimally invasive repairs can be performed Benign Biliary Disease + Cirrhosis · Incidence of gallstones is 4-5 times higher in cirrhotic patients · Prophylactic laparoscopic cholecystectomy (LC) generally not done · LC generally considered acceptable in CP A or B but not C (exceptions: HD instability, gangrenous cholecystitis, hemorrhagic cholecystitis) · Cholecystostomy and ERCP are safe References: Bleszynski, M. et. Al. Acute care and emergency general surgery in patients with chronic liver disease: how can be optimize perioperative care? A review of the literature. 2018. World Journal of Emergency Surgery; 13:32 Mansour A, Watson W, Shayani V, et al. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997;122:730–5. Yeom SK, Lee CH, Cha SH, Park CM. Prediction of liver cirrhosis, using diagnostic imaging tools. World J Hepatol. 2015 Aug 18;7(17):2069-79. doi: 10.4254/wjh.v7.i17.2069. PMID: 26301049; PMCID: PMC4539400. Jain D, Mahmood E, V-Bandres M, Feyssa E. Preoperative elective transjugular intrahepatic portosystemic shunt for cirrhotic patients undergoing abdominal surgery. Ann Gastroenterol. 2018 May-Jun;31(3):330-337. doi: 10.20524/aog.2018.0249. Epub 2018 Mar 15. PMID: 29720858; PMCID: PMC5924855. **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Emergency General Surgery episode here : https://behindtheknife.org/podcast-category/emergency-general-surgery/

Mar 30, 2023

In this episode, our team discusses the Checkmate 577 trial, the landmark paper which approved the use of nivolumab for adjuvant treatment of stage II & III esophageal & GE junction cancer. Listen as our team reviews the study population, methods and results of this trial & discusses its clinical application as well as potential areas of future research. Learning Objectives: -Review the staging and treatment of esophageal and GEJ cancer -Discuss the population, methods, and results of the Checkmate 577 trial -Understand the mechanism of action of nivolumab and the PD1 pathway -Discuss the implications of the Checkmate 577 trial in clinical practice and areas of future research Hosts: Kelly Daus MD, Megan Lenihan MD, Peter White MD, and Brian Louie MD Referenced Material https://www.nejm.org/doi/full/10.1056/NEJMoa2032125 Kelly RJ, Ajani JA, Kuzdzal J, et al. Adjuvant nivolumab in resected esophageal or gastroesophageal junction cancer. N Engl J Med . 2021;384(13):1191-1203. doi:10.1056/NEJMoa2032125 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136921/ Han Y, Liu D, Li L. PD-1/PD-L1 pathway: current researches in cancer. Am J Cancer Res. 2020 Mar 1;10(3):727-742. PMID: 32266087; PMCID: PMC7136921. Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed robotic general surgery procedures. If you are a general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com for more information on how you could be compensated $500 per video submitted of each (up to $1000 per surgeon). Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other thoracic surgery episodes here https://behindtheknife.org/podcast-category/cardiothoracic/

Mar 27, 2023

Please join BTK education fellow, Nina Clark, MD (University of Washington) along with Elina Serrano, MD, MPH (University of Washington) and Minerva Romero Arenas, MD (Weill Cornell Medicine) for a discussion inspired by the experience of trainees who are underrepresented in medicine. Latino Surgical Society: https://www.latinosurgicalsociety.org/ Society of Black Academic Surgeons: https://www.sbas.net/ References: Yeo HL, Abelson JS, Symer MM, Mao J, Michelassi F, Bell R, Sedrakyan A, Sosa JA. Association of Time to Attrition in Surgical Residency With Individual Resident and Programmatic Factors. JAMA Surg. 2018 Jun 1;153(6):511-517. doi: 10.1001/jamasurg.2017.6202. PMID: 29466536; PMCID: PMC5875388. McFarling, U.L. ‘It was stolen from me’: Black doctors are forced out of training programs at far higher rates than white residents. STAT . 6/20/2022. Accessed online: 10/1/2022. https://www.statnews.com/2022/06/20/black-doctors-forced-out-of-training-programs-at-far-higher-rates-than-white-residents/ Haruno LS, Chen X, Metzger M, et al. Racial and Sex Disparities in Resident Attrition Among Surgical Subspecialties. JAMA Surg. Published online February 08, 2023. doi:10.1001/jamasurg.2022.7640 **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other recent episodes here : https://behindtheknife.org/listen/

Mar 23, 2023

In this episode the Endocrine Surgery team at BTK goes over two cases to review the American Association of Endocrine Surgeons Guidelines for Adrenalectomy. Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established. Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. Na Eun Kim is an Endocrine Surgery Fellow at UCLA in his first year of fellowship Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research Dr. Max Schumm is a PGY-5 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon. Important Papers Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhits MJ, Han MA, Smith PW, Wilhelm S, Asa SL, Fahey TJ 3rd, McKenzie TJ, Strong VE, Perrier ND. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022 Oct 1;157(10):870-877. doi: 10.1001/jamasurg.2022.3544. PMID: 35976622; PMCID: PMC9386598. Schumm M, Hu MY, Sant V, Kim J, Tseng CH, Sanz J, Raman S, Yu R, Livhits M. Automated extraction of incidental adrenal nodules from electronic health records. Surgery. 2023 Jan;173(1):52-58. doi: 10.1016/j.surg.2022.07.028. Epub 2022 Oct 4. PMID: 36207197. M. Conall Dennedy, Anand K. Annamalai, Olivia Prankerd-Smith, Natalie Freeman, Kuhan Vengopal, Johann Graggaber, Olympia Koulouri, Andrew S. Powlson, Ashley Shaw, David J. Halsall, Mark Gurnell, Low DHEAS: A Sensitive and Specific Test for the Detection of Subclinical Hypercortisolism in Adrenal Incidentalomas, The Journal of Clinical Endocrinology & Metabolism , Volume 102, Issue 3, 1 March 2017, Pages 786–792, https://doi.org/10.1210/jc.2016-2718 Amar, L., Pacak, K., Steichen, O. et al. International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers. Nat Rev Endocrinol 17 , 435–444 (2021). https://doi.org/10.1038/s41574-021-00492-3 **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other endocrine episodes here : https://behindtheknife.org/podcast-category/endocrine/

Mar 20, 2023

In this episode the Critical Care BTK Team tackles nutrition in the ICU. High-yield journal articles will be presented, discussed, and reviewed. ICU nutrition myths will be busted, and listeners will learn about enteral nutrition, parenteral nutrition and other ICU nutrition pearls. References 1. Casaer, M.P., et al., Early versus Late Parenteral Nutrition in Critically Ill Adults. New England Journal of Medicine, 2011. 365 (6): p. 506-517. 2. Compher, C., et al., Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. Journal of Parenteral and Enteral Nutrition, 2022. 46 (1): p. 12-41. 3. McClave, S.A., et al., Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient. Journal of Parenteral and Enteral Nutrition, 2016. 40 (2): p. 159-211. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Surgical Critical Care episodes here : https://behindtheknife.org/podcast-category/surgical-critical-care/

Mar 16, 2023

In the third episode of the “Innovations in Surgery” series, Behind the Knife’s surgery education fellow, Dan Scheese, sits down with Adam Sachs and Dr. Igor Belyansky to discuss the current state and future of surgical robotics. They discuss the start up of Vicarious Surgical and how they are working to improve the current state of surgical robotics with their innovative ideas. Link for the Vicarious Surgical website which includes a short video demonstration of their single port design: https://www. vicarioussurgical.com/ Adam Sachs is the CEO and Co-founder of Vicarious surgical, a surgical robotics company founded in 2014. As an MIT trained roboticist, Adam has combined his passion for robots with this passion for helping patients and enhancing the work environment for surgeons through the development of proprietary surgical robotics. Dr. Igor Belyanksy, an internationally-recognized expert in the field of abdominal wall reconstruction and complex laparoscopic and robotic hernia repair. Dr. Belyansky has earned his medical degree from Virginia Commonwealth University, completed his residency at MedStar Union Memorial Hospital, and completed a minimally invasive fellowship at Carolinas Medical Center. Dr. Belyanksy is currently the Medical Director of Anne Arundel Medical Center in Annapolis Maryland. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Innovations in Surgery episodes here : https://behindtheknife.org/podcast-series/innovations-in-surgery/

Mar 13, 2023

You have a patient who underwent local excision of a rectal cancer. Final pathology demonstrates a T2 lesion. What is the rate of local recurrence? Is excision alone sufficient? Should the patient undergo radical resection or should chemoradiation be offered? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Jose Guillem MD, MPH, MBA as they discuss high yield papers discussing local excision for Rectal Cancer. You may follow along with the slides mentioned in this episode here : https://behindtheknife.org/video/journal-review-in-colorectal-surgery-local-excision-for-rectal-cancer/ Learning Objectives 1. Describe the features that increase risk of lymph node involvement in early stage rectal cancer 2. Discuss the different options for management of early-stage rectal cancer 3. Describe patient related factors that favor local excision of rectal cancer References: Kidane B, Chadi SA, Kanters S, Colquhoun PH, Ott MC. Local resection compared with radical resection in the treatment of T1N0M0 rectal adenocarcinoma: a systematic review and meta-analysis. Dis Colon Rectum. 2015 Jan;58(1):122-40. doi: 10.1097/DCR.0000000000000293. PMID: 25489704. Garcia-Aguilar J, Renfro LA, Chow OS, Shi Q, Carrero XW, Lynn PB, Thomas CR Jr, Chan E, Cataldo PA, Marcet JE, Medich DS, Johnson CS, Oommen SC, Wolff BG, Pigazzi A, McNevin SM, Pons RK, Bleday R. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol. 2015 Nov;16(15):1537-1546. doi: 10.1016/S1470-2045(15)00215-6. Epub 2015 Oct 22. PMID: 26474521; PMCID: PMC4984260. Friel CM, Cromwell JW, Marra C, Madoff RD, Rothenberger DA, Garcia-Aguílar J. Salvage radical surgery after failed local excision for early rectal cancer. Dis Colon Rectum. 2002 Jul;45(7):875-9. doi: 10.1007/s10350-004-6320-z. PMID: 12130873. Nascimbeni R, Burgart LJ, Nivatvongs S, Larson DR. Risk of lymph node metastasis in T1 carcinoma of the colon and rectum. Dis Colon Rectum. 2002 Feb;45(2):200-6. doi: 10.1007/s10350-004-6147-7. PMID: 11852333. O'Neill CH, Platz J, Moore JS, Callas PW, Cataldo PA. Transanal Endoscopic Microsurgery for Early Rectal Cancer: A Single-Center Experience. Dis Colon Rectum. 2017 Feb;60(2):152-160. doi: 10.1097/DCR.0000000000000764. PMID: 28059911. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other colorectal episodes here : https://behindtheknife.org/podcast-category/colorectal/

Mar 9, 2023

DO NOT MISS THIS EPISODE! Need a little inspiration? Tune in for Dave's story. Links from the show: Chasing My Cure: https://chasingmycure.com/ CDCN: https://cdcn.org/ Every Cure: https://everycure.org/ AMF: https://healgrief.org/actively-moving-forward/young-adult-grief/ David Fajgenbaum, MD, MBA, MSc, FCPP, is an Assistant Professor of Medicine in Translational Medicine & Human Genetics at the University of Pennsylvania, Founding Director of the Center for Cytokine Storm Treatment & Laboratory (CSTL), Associate Director, Patient Impact of the Penn Orphan Disease Center, and Co-Founder/President of the Castleman Disease Collaborative Network (CDCN) and co-founder of Every Cure. He is also the national bestselling author of 'Chasing My Cure: A Doctor's Race to Turn Hope Into Action' and a patient battling idiopathic multicentric Castleman disease (iMCD). He is in his longest remission ever thanks to a precision treatment that he identified, which had never been used before for iMCD. He has also identified and/or advanced 9 other treatment approaches for iMCD and cancer. One of the youngest individuals ever appointed to the faculty at Penn Medicine and in the top 1 percent youngest awardees of an NIH R01 grant, Fajgenbaum has published scientific papers in high-impact journals such as the New England Journal of Medicine, Journal of Clinical Investigation, and Lancet, been recognized with awards such as the 2016 Atlas Award along with then Vice President Joe Biden, and profiled in a cover story by The New York Times as well as by Good Morning America, CNN, Forbes 30 Under 30, and the Today Show. An authority on cytokine storms and their treatment, Fajgenbaum currently leads over 20 translational research studies including the CORONA Project, which is the world’s largest effort to identify, track, and advance COVID-19 treatments. He also serves on the Board of Directors for the Reagan-Udall Foundation for the FDA, co-Chair of the Advisory Board for the CURE Drug Repurposing Collaboratory, and co-Chair of the Scientific Advisory Board for the CDCN. Dr. Fajgenbaum earned a BS in Human Sciences with Distinction from Georgetown University, where he was USA Today Academic All-USA First Team and a Quarterback on the Division I football team, a MSc in Public Health from the University of Oxford as the 2007 Joseph L. Allbritton Scholar, a MD from the Perelman School of Medicine at the University of Pennsylvania, where he was a 21st Century Gamble Scholar, and a MBA from The Wharton School, where he was awarded the Joseph Wharton Award, Core Value Leadership Award, Kissick Scholarship, Wharton Business Plan Competition Social Impact Prize, Eilers Health Care Management Award, Mandel Fellowship, and Commencement Speaker. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other recent episodes here : https://behindtheknife.org/listen/

Mar 6, 2023

How do we actually improve wellness? How do surgery trainees advocate for themselves as both learners and employees? In this final surgical education episode with Matt Chia MD MS and Karl Bilimoria MD MS, we review two articles discussing unions and wellness in surgical training. We’re joined by Meg Smith MD MS, Brian Brajcich MD MS, and Darci Foote MD MS to tackle this difficult topic and open the discussion for what’s next in surgical education. Learning Objectives: · Identify potential benefits and limitations of unionization in surgery training · Describe strategies used by program leadership to improve wellness in surgery References: National Evaluation of the Association Between Resident Labor Union Participation and Surgical Resident Well-being https://doi.org/10.1001/jamanetworkopen.2021.23412 How Program Directors Understand General Surgery Resident Wellness - https://doi.org/10.1016/j.jsurg.2022.07.022 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical education episodes here : https://behindtheknife.org/podcast-category/surgical-education/

Mar 2, 2023

Join the Behind the Knife HPB team as we dive deeper into the complex world of IPMNs with a journal article review of a recent JAMA Surgery publication and the first author of the article! Learning Objectives : In this episode, we discuss the article, “Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery.” This article describes a multicenter retrospective study of centers in Italy, Korea, Singapore, and the US that specifically assessed what dynamic variables are associated with malignant progression in pathologically proven IMPNs under at least a year of initial surveillance. Hosts : Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Guest: Dr. Giovanni Marchegiani is a pancreas surgeon within the department of general and pancreatic surgery at the University of Verona in Italy. His research interests include exocrine and cystic neoplasms of the pancreas. He is the first author of the study discussed in the episode in addition to over 100 additional scientific, peer-reviewed articles. Journal Article: 1. Marchegiani G, Pollini T, Andrianello S, et al. Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery. JAMA Surg. 2021;156(7):654–661. doi:10.1001/jamasurg.2021.1802 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other HPB episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/

Feb 27, 2023

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here : https://behindtheknife.org/premium/vascular-surgery-oral-review/ Our Vascular Surgery Oral Board Book is available on Amazon here : https://www.amazon.com/Vascular-Surgery-Oral-Board-Review/dp/0578382296/ref=sr_1_4?crid=VUNDNTCJOH8M&keywords=behind+the+knife&qid=1675087641&sprefix=behind+the+knif%2Caps%2C82&sr=8-4&ufe=app_do%3Aamzn1.fos.f5122f16-c3e8-4386-bf32-63e904010ad0 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 23, 2023

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here : https://behindtheknife.org/premium/vascular-surgery-oral-review/ Our Vascular Surgery Oral Board Book is available on Amazon here : https://www.amazon.com/Vascular-Surgery-Oral-Board-Review/dp/0578382296/ref=sr_1_4?crid=VUNDNTCJOH8M&keywords=behind+the+knife&qid=1675087641&sprefix=behind+the+knif%2Caps%2C82&sr=8-4&ufe=app_do%3Aamzn1.fos.f5122f16-c3e8-4386-bf32-63e904010ad0 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 20, 2023

Surgery is a contact sport and can cause injuries that prevent us from taking care of our patients and even threaten our careers. Join Drs. Mike Weykamp, Nicole White, Nick Cetrulo, and Andrew Wright for a discussion on the ergonomic challenges of open, laparoscopic, and robotic surgery as well as some tips, tricks, and resources on how to protect yourself and your practice. *We apologize for some distracting background noise throughout the episode.* Referenced Articles & Websites: 1. Wells, A. C., Kjellman, M., Harper, S. J., Forsman, M., & Hallbeck, M. S. (2019). Operating hurts: a study of EAES surgeons. Surgical endoscopy , 33 , 933-940. 2. Davis, W. T., Fletcher, S. A., & Guillamondegui, O. D. (2014). Musculoskeletal occupational injury among surgeons: effects for patients, providers, and institutions. Journal of surgical research , 189 (2), 207-212. 3. Wright, A.S. Ergonomic Injury and Surgery: The Hidden Epidemic. Harkins Symposium at The University of Washington. October 21, 2022. https://www.youtube.com/watch?v=o1G1qGj4WaA 4. The Society of Surgical Ergonomics. https://www.societyofsurgicalergonomics.org/ 5. OR Stretch. https://www.mayo.edu/research/labs/human-factors-engineering/or-stretch/or-stretch-videos Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other MIS episodes here: https://behindtheknife.org/podcast-category/minimally-invasive/

Feb 16, 2023

Vascular surgery is full of awesome anatomy and big open vessel exposures, but endovascular surgery is here to stay and can be hard to get into, particularly as a learner. The basics of endovascular surgery share very little with the basics of open surgery and getting up to speed can be a big challenge. This episode is an introduction to all things endovascular surgery, from wires, catheters and sheaths to balloons and stents. Take a listen to get up to speed quickly in prep for an upcoming vascular rotation and skip the pain of trying to follow your attendings words so you can instead pay attention to the actual case. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan. Dr. Craig Brown is a PGY-7 in the General Surgery program and the upcoming 2023 vascular surgery fellow at the University of Michigan. Check out the accompanying video for this episode available here: https://behindtheknife.org/video-playlists/podcast-clips/ Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed robotic general surgery procedures. If you are a general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com for more information on how you could be compensated $500 per video submitted of each (up to $1000 per surgeon). To check out our Vascular Surgery Oral Board Audio Review and Book, please visit: https://behindtheknife.org/premium/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Feb 13, 2023

Interview season is over! There’s just one last hurdle in this residency application process to overcome- ranking and matching! Join our education fellow, Dr. Jessica Millar, and Dr. Charles Friel as they pull back the curtain on the ranking process and discuss how tooptimize your success in the match! Guest: Charles Friel, MD- Professor of Colorectal Surgery, Surgical Director - Digestive Center of Excellence, Chief - Section of Colon & Rectal Surgery, and General Surgery Residency Program Director- University of Virginia, Charlottesville, VA “How the NRMP Matching Algorithm Works”: https://www.youtube.com/watch?v=kvgfgGmemdA&list=PLr0LH_NifZSpvQTwTqXVYn9jXfUKOTFN6&index=11 Important Dates 1. Ranking opens 2/1 at 12PM 2. Rank lists are due 3/1 at 9PM 3. Match status available 3/13 at 10AM 4. Match day results available 3/17 at 12PM EST Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out the rest of our “Dominate the Match Series” here : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Feb 9, 2023

In this episode, our team discusses the recent paper from JAMA Surgery Association of Whole Blood With Survival Among Patients Presenting With Severe Hemorrhage in US and Canadian Adult Civilian Trauma Centers. Join us as we explore some of the history of blood transfusions, how we got to where we are today, and the role whole blood transfusion may play going forward Hosts: Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST) and editor-in-chief of Trauma Surgery and Acute Care Open. Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins. David Sigmon, MD, MMEd, a PGY-7 resident at the University of Illinois at Chicago who will be a fellow at Lincoln Medical Center in the Bronx next year. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education. LITERATURE Torres CM, Kent A, Scantling D, Joseph B, Haut ER, Sakran JV. Association of whole blood with survival among patients presenting with severe hemorrhage in US and Canadian adult civilian trauma centers. JAMA Surg. Published online January 18, 2023. https://pubmed.ncbi.nlm.nih.gov/36652255/ Sperry JL, Guyette FX, Brown JB, et al. Prehospital plasma during air medical transport in trauma patients at risk for hemorrhagic shock. N Engl J Med. 2018;379(4):315-326. https://pubmed.ncbi.nlm.nih.gov/30044935/ Moore HB, Moore EE, Chapman MP, et al. Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet. 2018;392(10144):283-291. https://pubmed.ncbi.nlm.nih.gov/30032977/ Cannon JW, Khan MA, Raja AS, et al. Damage control resuscitation in patients with severe traumatic hemorrhage: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):605-617. https://pubmed.ncbi.nlm.nih.gov/28225743/ Howley IW, Haut ER, Jacobs L, Morrison JJ, Scalea TM. Is thromboelastography (Teg)-based resuscitation better than empirical 1:1 transfusion? Trauma Surg Acute Care Open. 2018;3(1):e000140. https://pubmed.ncbi.nlm.nih.gov/29766129/ Guyette FX, Brown JB, Zenati MS, et al. Tranexamic acid during prehospital transport in patients at risk for hemorrhage after injury: a double-blind, placebo-controlled, randomized clinical trial. JAMA Surg. 2020;156(1):11-20. https://pubmed.ncbi.nlm.nih.gov/33016996/ Smart BJ, Haring RS, Zogg CK, et al. A faculty-student mentoring program to enhance collaboration in public health research in surgery. JAMA Surg. 2017;152(3):306-308. https://pubmed.ncbi.nlm.nih.gov/27973649/ National Academies of Sciences E. A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths after Injury.; 2016. https://nap.nationalacademies.org/catalog/23511/a-national-trauma-care-system-integrating-military-and-civilian-trauma Braverman MA, Smith A, Pokorny D, et al. Prehospital whole blood reduces early mortality in patients with hemorrhagic shock. Transfusion. 2021;61 Suppl 1:S15-S21. https://pubmed.ncbi.nlm.nih.gov/34269467/ **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other trauma episodes here : https://behindtheknife.org/podcast-category/trauma/

Feb 7, 2023

**Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions.

Feb 6, 2023

Join Patrick Georgoff and Kevin Kniery for a special conversation with the king and queen of medical comedy Dr. Will Flanary, aka Dr. Glaucomflecken (@drglaucomflecken), and Kristin Flanary, aka Lady Glaucomflecken (@Lglaucomflecken). Will is a practicing ophthalmologist and social media personality with over 4 million followers. During his 3rd year of medical school, he was diagnosed with testicular cancer, and he began using humor as a coping mechanism. Following a second bout with cancer three years into his medical career, he created a Twitter account under the pseudonym "Dr. Glaucomflecken"— because it is arguably the funniest word in ophthalmology. A cardiac event and near-death experience in 2020 only fueled his creativity. Kristin is formally trained in cognitive neuroscience and social psychology and now works in marketing and communications. Kristin is best known internationally as her social media alter ego, “Lady Glaucomflecken,” where she shares stories from her unique perspective of the healthcare system. She has been a patient, "married to medicine" through the entire medical training journey and beyond, a lay responder and CPR provider to her husband, and a caregiver and "co-survivor" of his two cancer occurrences and a sudden cardiac arrest. And, if that’s not enough, they also have a brand-new podcast called Knock, Knock – Hi! where they discuss quirky and unexpectedly hilarious medical stories. Check out their website here : https://glaucomflecken.com/ **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our library of episodes here : https://behindtheknife.org/listen/

Feb 2, 2023

Did you miss this year’s Eastern Association for the Surgery of Trauma meeting? Don’t sweat it! Behind the Knife has got you covered. In this episode we discuss “Scientific Papers that Should Change Your Practice” with EAST manuscript and literature committee members Drs. Laura Brown (@laurarbrownMD), Brittany Bankhead (@bbankheadMD), and Julia Coleman (@juliacolemanMD). Universal blunt cerebrovascular screening? Early renal replacement therapy? Artificial intelligence in emergency general surgery? This episode is PACKED with high-yield material. To learn more about all the good things happening at EAST visit www.east.org . Papers discussed: 1. Do not forget the platelets: The independent impact of red blood cell to platelet ratio on mortality in massively transfused trauma patients ( https://pubmed.ncbi.nlm.nih.gov/35313325/ ) 2. The 35-mm rule to guide pneumothorax management: Increases appropriate observation and decreases unnecessary chest tubes ( https://pubmed.ncbi.nlm.nih.gov/35125448/ ) 3. Timing of thromboprophylaxis in patients with blunt abdominal solid organ injuries undergoing nonoperative management ( https://pubmed.ncbi.nlm.nih.gov/33048907/ ) 4. Universal screening for blunt cerebrovascular injury ( https://pubmed.ncbi.nlm.nih.gov/33502144/ ) 5. A three-step support strategy for relatives of patients during in the intensive care unit: a cluster randomized trial ( https://pubmed.ncbi.nlm.nih.gov/35065008/ ) 6. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest ( https://pubmed.ncbi.nlm.nih.gov/34133859/ ) 7. Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury ( https://pubmed.ncbi.nlm.nih.gov/32668114/ ) 8. Disparities in Spatial Access to Emergency Surgical Services in the US ( https://pubmed.ncbi.nlm.nih.gov/36239953/ ) 9. Validation of the AI-based Predictive Optimal Trees in Emergency Surgery Risk (POTTER) Calculator in Patients 65 Years and Older ( https://pubmed.ncbi.nlm.nih.gov/33378309/ ) 10. Accuracy of Risk Estimation for Surgeons Versus Risk Calculators in Emergency General Surgery ( https://pubmed.ncbi.nlm.nih.gov/35594615/ ) **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other trauma episodes here : https://behindtheknife.org/podcast-category/trauma/

Jan 30, 2023

Please join Drs. Brian Gray, Amanda Jensen, and Manisha Bhatia from Indiana University as they discuss Hirschsprung disease in regard to variability of the transition zone and surgical operative and pathologic diagnosis reporting in pediatric surgery. Journal Article links: Veras LV, Arnold M, Avansino JR, Bove K, Cowles RA, Durham MM, et al. Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease. J Pediatr Surg 2019;54(10):2017-23. https://pubmed.ncbi.nlm.nih.gov/30935730/ Thakkar HS, Blackburn S, Curry J, De Coppi P, Giuliani S, Sebire N, et al. Variability of the transition zone length in Hirschsprung disease. J Pediatr Surg 2020;55(1):63-6. https://pubmed.ncbi.nlm.nih.gov/31706615/ Coyle D, O'Donnell AM, Tomuschat C, Gillick J, Puri P. The Extent of the Transition Zone in Hirschsprung Disease. J Pediatr Surg 2019;54(11):2318-24. https://pubmed.ncbi.nlm.nih.gov/31079866/ **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other pediatric surgery episodes here : https://behindtheknife.org/podcast-category/pediatric/

Jan 23, 2023

Join the Surgical Oncology team from UTSouthwestern and the University of Miami as they tackle a case of intrahepatic cholangiocarcinoma along with the data guiding current treatment paradigms. Listen in as they also review recent clinical trials changing the options available for patients with this dismal biliary tract cancer. Learning Objectives: In this episode, we review the workup and diagnostic approach to intrahepatic cholangiocarcinoma with emphasis on the role and benefits of biopsy, lymphadenectomy, operative approach, and the current treatment strategies involving chemotherapy, immunotherapy, and targeted therapies against actionable mutations. Hosts: Adam Yopp, MD, FACS (@AdamYopp) is an Associate Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a recent graduate of the MD Anderson Complex General Surgical Oncology fellowship and is now a new faculty member in the Division of Surgical Oncology within the Sylvester Cancer Center at the University of Miami where she specializes in surgery for cancers of the liver, pancreas, and other gastrointestinal sites. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-4 Research Fellow and General Surgery Resident at the UT Southwestern Medical Center. He is studying the pancreatic tumor microenvironment and targeted therapies in the lab of Rolf Brekken within the Hamon Center for Therapeutic Oncology Research. **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical oncology episodes here : https://behindtheknife.org/podcast-category/surgical-oncology/

Jan 19, 2023

Who is a candidate for metabolic and bariatric surgery and what has changed in the past 30 years? Find out in this review! Journal articles: Bariatric Surgery versus Intensive Medical Therapy for Diabetes – 5 Year Outcomes. https://pubmed.ncbi.nlm.nih.gov/28199805/ . Association of Metabolic Surgery with Major Adverse Cardiovascular Outcomes in Patients with Type 2 Diabetes and Obesity. https://pubmed.ncbi.nlm.nih.gov/31475297/ . Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. https://pubmed.ncbi.nlm.nih.gov/26544725/ . 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Indications for Metabolic and Bariatric Surgery. https://pubmed.ncbi.nlm.nih.gov/36336720/ . **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other bariatric surgery episodes here : https://behindtheknife.org/podcast/clinical-challenges-in-bariatric-surgery-revisional-bariatric-surgery/

Jan 16, 2023

You are faced with a patient complaining of pelvic fullness. On DRE, you feel a submucosal bulge without palpating a tumour in the lumen. A CT scan confirms a pelvic mass. The biopsy reveals a spindle cell type gastrointestinal stromal tumour (GIST) positive for CD117. Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about the diagnosis and management of rectal GIST. Learning objectives - To explain the origin of rectal GISTs - To recognize the prognostic factors associated with rectal GISTs - To understand the management of rectal GISTs in the era of Imatinib - To list the surgical approaches for rectal GIST resection *Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed robotic general surgery procedures. If you are a general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com for more information on how you could be compensated $500 per video submitted of each (up to $1000 per surgeon). **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other colorectal episodes here : https://behindtheknife.org/podcast-category/colorectal/

Jan 12, 2023

In this episode, our transplant team will discuss an article that reviews normothermic machine perfusion including how it has evolved over the years, current benefits and challenges, as well as future directions. Learning objectives: · Understand the current role of machine perfusion in renal transplantation · Describe historical and current limitations of machine perfusion for abdominal organ transplantation · Review the benefits of improved and expanded preservation techniques References: 1. Hamelink, T. L., Ogurlu, B., de Beule, J., Lantinga, V. A., Pool, M. B. F., Venema, L. H., Leuvenink, H. G. D., Jochmans, I., & Moers, C. (2022). Renal Normothermic Machine Perfusion: The Road Toward Clinical Implementation of a Promising Pretransplant Organ Assessment Tool. In Transplantation (Vol. 106, Issue 2). https://doi.org/10.1097/TP.0000000000003817 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other transplant episode here : https://behindtheknife.org/podcast-category/transplant/

Jan 9, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 8, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 7, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 6, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 5, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 4, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 3, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 2, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jan 1, 2023

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 31, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 30, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 29, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 28, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 27, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 26, 2022

Welcome to the fifth of a six-part series focused on the integration of palliative care into the practice of surgery. In this episode, we discuss nonbeneficial surgery (and how best to avoid it) as well as care of the imminently dying patient. Nonbeneficial surgery is best defined as surgery that fails to meet the goals of the patient. As our surgical patients become older and more medically complex, we must be aware of the factors which lead to nonbeneficial surgery – including patient, surrogate, system, and surgeon factors – and how best to approach each of these to avoid causing harm to our patients. Nonbeneficial surgery not only causes harm to the patient, but can also cause harm to the surgical team, in the form of moral distress/injury. Focusing on patients’ goals of care can help us to avoid nonbeneficial surgery. One of the benefits of integrating palliative medicine into the practice of surgery is that there is never “nothing left to do.” By learning how to recognize and then care for the imminently dying patient, as well as by having a basic understanding of the Medicare hospice benefit, we can support and care for the patient (and the family) beyond the operating room. Non-Beneficial Surgery: Pitfalls in communication that lead to nonbeneficial emergency surgery in elderly patients with serious illness: description of the problem and elements of a solution. https://pubmed.ncbi.nlm.nih.gov/24866541/ Surgeons’ perspectives on avoiding nonbeneficial treatments in seriously ill older patients with surgical emergencies: a qualitative study. https://pubmed.ncbi.nlm.nih.gov/27105058/ The association between factors promoting beneficial surgery and moral distress: a national survey of surgeons. https://pubmed.ncbi.nlm.nih.gov/33214444/ The Imminently Dying Patient and Hospice: Fast Fact #3: Syndrome of Imminent Death https://www.mypcnow.org/fast-fact/syndrome-of-imminent-death/ Fast Fact #82: Medicare Hospice Benefit – Part 1: Eligibility and Treatment https://www.mypcnow.org/wp-content/uploads/2019/01/FF-82-Medicare-Hospice.-1-3rd-Ed-1.pdf Fast Fact #87: Medicare Hospice Benefit – Part 2: Places of Care and Funding https://www.mypcnow.org/wp-content/uploads/2019/01/FF-87-Medicare-Hospic-2-4th-Ed.pdf Fast Fact #140: Medicare Hospice Benefit – Levels of Hospice Care https://www.mypcnow.org/fast-fact/medicare-hospice-benefits-levels-of-hospice-care/ Dr. Red Hoffman (@redmdnd) is an acute care surgeon and associate hospice medical director in Asheville, North Carolina, host of the Surgical Palliative Care Podcast (@surgpallcare) and co-founder of the recently launched Surgical Palliative Care Society ( www.spcsociety.org ). Dr. Zara Cooper (@zaracMD) is an acute care surgeon at Brigham and Women’s Hospital where she serves as Kessler Director for the Center of Surgery and Public Health (@csph_bwh). She is a Professor of Surgery at Harvard Medical School, associate faculty at Adriane Labs, and adjunct faculty at the Marcus Institute for Aging Research. Dr. Amanda Stastny (@manda_plez) is a PGY-2 in the General Surgery program at Mountain Area Health Education Center (MAHEC) in Asheville, NC. **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 25, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. We do apologize for the overall audio quality! We were spread out over a couple states and sometimes talk over one another. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 24, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 23, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 22, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 21, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0 **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 20, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 19, 2022

Join us for the BTK Throwback episode! Dr. Kenneth Mattox, a US legend in Trauma surgery, discusses retroperitoneal hematomas and the ever changing field of surgery. **Specialty team application link - https://forms.gle/DwrRcMYDaP3a3LaQA Please email hello@behindtheknife.org with any questions. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other trauma episodes here : https://behindtheknife.org/podcast-category/trauma/

Dec 18, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 17, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 16, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 15, 2022

Emergency abdominal wall surgery is a common scenario for all general surgeons. Decision making with regard to operative approach and mesh utilization can be confusing. This podcast will review the common circumstances and highlight advanced decision making. · Dr. Vahagn Nikolian is an Assistant Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. · Dr. Sean Orenstein is an Associate Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Clinical Challenge Episodes here : https://behindtheknife.org/podcast-series/clinical-challenges/

Dec 14, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 13, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 12, 2022

Dipping your toes in the water of surgical education research can be a daunting task if you have no prior experience, even if you have done basic or clinical research before. How do you create a good surgical education research project? How can clinicians get involved in and find mentors for surgical education research? Is formal postgraduate training becoming necessary for a career in surgical education? Luckily, we invite Dr. Jon Sherbino and Dr. Lara Varpio, hosts of the successful KeyLIME (Key Literature in Medical Education) podcast to share their valuable insights on medical education research with us. Check out KeyLIME on their website at https://keylimepodcast.libsyn.com/ and subscribe to KeyLIME on iTunes, Spotify, or Google podcasts! Learning Objectives 1. Listeners will identify that surgical education applies the same rigor as other areas of research. 2. Listeners will describe how observations within clinical practice and review of literature can lead to creation of a good research question. 3. Listeners will describe how research questions should align with theory and methodology, which then align with conclusions for a research project. 4. Listeners will identify that collaboration with colleagues with expertise in surgical education research, including education scientists, is important for successful completion of research with high rigor. 5. Listeners will recognize advantages and disadvantages to formal training in education research, including fellowship and master’s degree programs. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Surgical Education videos here : https://behindtheknife.org/podcast-category/surgical-education/

Dec 11, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 10, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 9, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 8, 2022

Join our Miami Trauma team including Drs. Urréchaga, Neeman, and Rattan as they dive into the literature regarding a topic that has become all too common to the US news cycle- gun violence. They will go over a recent paper from JAMA and include other important literature while trying to understand this complex problem that has been grappling US public policy. Quick Hits: 1. Firearm injury is the leading cause death in the US among ages 1-19 2. For every person killed violently by someone else with a firearm, there are 3 survivors. 3. Gun ownership triples the risk of homicide 4. Permit laws and preventing people convicted of a violent crime from owning a firearm decrease firearm-related death and have a positive ripple effect even outside state borders. In short, for effective reductions of firearm-related injury and death, federal legislation will be more effective than state-by-state References 1. Liu, Y, Siegel, M, Sen, B. Association of State-Level Firearm-Related Deaths With Firearm Laws in Neighboring States. JAMA Network Open. 2022;5(11):e2240750. doi:10.1001/jamanetworkopen.2022.40750 2. Goldstick, JE, Cunningham, RM, Carter, PM. Current Causes of Death in Children and Adolescents in the United States. N Engl J Med. 2022 May 19;386(20):1955-1956. doi: 10.1056/NEJMc2201761. 3. Kellermann, AL, Rivara, FP, Rushforth, NB, Banton, JG, Reay, DT, Francisco, JT, Locci, AB, Prodzinski, J, Hackman, BB, Somes, G. Gun Ownership as a Risk Factor for Homicide in the Home. N Engl J Med 1993; 329:1084-1091. DOI: 10.1056/NEJM199310073291506 4. Liu Y, Siegel, M, Sen, B. Neighbors do matter: between-state firearm laws and state firearm-related deaths in the US, 2000-2017. Am J Prev Med. 2020;59(5):648-657. doi:10.1016/j.amepre.2020.06.022 5. Siegel, M, Pahn, M, Xuan, Z, et al. Firearm-related laws in all 50 US states,1991-2016. Am J Public Health.2017; 107(7):1122-1129. doi:10.2105/AJPH.2017.303701 6. Kalesan, B, Mobily, ME, Keiser, O, Fagan, J, Galea, S. Firearm legislation and firearm mortality in the USA: a cross-sectional, state-level study. Lancet. 2016 Apr 30;387(10030):1847-55. doi: 10.1016/S0140-6736(15)01026-0. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Journal Review episodes here : https://behindtheknife.org/podcast-series/journal-review/

Dec 7, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 6, 2022

Behind the Knife ABSITE 2023 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Dec 5, 2022

De novo metastatic breast cancer represents 6% of all new breast cancer diagnoses. This figure has not changed at all over the past 20 years; however, systemic therapy options have evolved dramatically during this time and have significantly increased life expectancy for these patients. While surgical management of the primary tumor in the setting of metastatic disease has typically been reserved for palliative indications, surgeons are now being asked to consider resecting the primary tumor to potentially increase overall survival. In this episode, we will use a case study to examine the data that should inform our conversations and decisions when we encounter patients with metastatic breast cancer who are interested in having their primary tumor resected. Links: § Khan, S.A., S. Schuetz, and O. Hosseini (2022). Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review. Ann Surg Oncol ; 29: 5811-5820. https://link.springer.com/article/10.1245/s10434-022-11900-x § Khan, S.A. et al (2022). Early Local Therapy for the Primary Site in De Novo Stage IV Breast Cancer: Results of a Randomized Clinical Trial (E2108). J Clin Oncol ; 40(9): 978-987. https://ascopubs.org/doi/10.1200/JCO.21.02006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed § Badwe, R. et al (2015). Locoregional treatment versus no treatment of the primary tumor in metastatic breast cancer: an open-label randomized controlled trial. Lancet Oncol; 16: 1380-1388. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00135-7/fulltext § Fitzal, F. et al (2019). Impact of Breast Surgery in Primary Metastasized Breast Cancer: Outcomes of the Prospective Randomized Phase III ABCSG-28 POSYTIVE Trial. Ann Surg; 269(6): 1163-1169. https://journals.lww.com/annalsofsurgery/Abstract/2019/06000/Impact_of_Breast_Surgery_in_Primary_Metastasized.24.aspx § Soran, A. et al (2018). Randomized Trial Comparing Resection of Primary Tumor with No Surgery in Stage IV Breast Cancer at Presentation: Protocol MF07-01. Ann Surg Oncol; 25: 3141-3149. https://link.springer.com/article/10.1245/s10434-018-6494-6 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other clinical challenges episodes here: https://behindtheknife.org/podcast-series/clinical-challenges/

Dec 1, 2022

The cardiac OR can be a daunting place for any medical student or resident who finds themself on a cardiac surgery rotation. Have no fear, this Cardiac Surgery Crash Course is a short series focused on high-yield topics to help introduce students and residents to cardiac surgery prior to or during a cardiac surgery rotation. In this episode join Dr. Aaron Williams and our education fellow Dr. Jessica Millar as they break down ICU monitoring and hemodynamics of post-op cardiac surgery patients. If you have any suggestions or requests for this series, please feel free to reach out to us by email: Jessica Millar: millarje@med.umich.edu Inotrope/Pressor Reference Card: https://i0.wp.com/emcrit.org/wp-content/uploads/2020/02/pressortable.jpg?resize=1536%2C1345&ssl=1 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Nov 28, 2022

The cardiac OR can be a daunting place for any medical student or resident who finds themself on a cardiac surgery rotation. Have no fear, this Cardiac Surgery Crash Course is a short series focused on high-yield topics to help introduce students and residents to cardiac surgery prior to or during a cardiac surgery rotation. In this episode join Dr. Aaron Williams and our education fellow Dr. Jessica Millar as they break down the principles of Coronary Artery Bypass Grafting (CABG). If you have any suggestions or requests for this series, please feel free to reach out to us by email: Jessica Millar: millarje@med.umich.edu Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Nov 24, 2022

The cardiac OR can be a daunting place for any medical student or resident who finds themself on a cardiac surgery rotation. Have no fear, this Cardiac Surgery Crash Course is a short series focused on high-yield topics to help introduce students and residents to cardiac surgery prior to or during a cardiac surgery rotation. In this episode join Dr. Nick Teman and our education fellow Dr. Jessica Millar as they break down the principles of cardiopulmonary bypass. If you have any suggestions or requests for this series, please feel free to reach out to us by email: Jessica Millar: millarje@med.umich.edu Helpful Images: Cannula Insertion for Cardiopulmonary Bypass https://www.uptodate.com/contents/image?imageKey=CARD%2F97188 Cardiopulmonary Bypass Machine https://www.ebme.co.uk/images/arts/cpb/cardiopulmonary-bypass-machine-2.jpg Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

Nov 21, 2022

The cardiac OR can be a daunting place for any medical student or resident who finds themself on a cardiac surgery rotation. Have no fear, this Cardiac Surgery Crash Course is a short series focused on high-yield topics to help introduce students and residents to cardiac surgery prior to or during a cardiac surgery rotation. We will cover several of the most frequently performed operations, post-operative management, common consults, and other topics to help you ace your cardiac rotation. In this episode join Dr. Nick Teman and our education fellow Dr. Jessica Millar as they introduce you to the cardiac OR. If you have any suggestions or requests for this series, please feel free to reach out to us by email: Helpful Resources: https://www.tsranet.org/resources/tsra-resources-for-residents/ Jessica Millar: millarje@med.umich.edu Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our collection of episodes here : https://behindtheknife.org/listen/all-series/

Nov 17, 2022

Historically, a paucity of data has existed in the most appropriate modality of critical care management of brain dead organ donors prior to organ harvest. In this episode, Drs. Bankhead, Dumas, and Park are joined by special guest Dr. Ashley McGinity, a director in the donor management unit the Center for Life at the UT Health Science Center in San Antonio, joins us to discuss modern and current practices in the management of these patients to maximize the gift for patients and families. References: https://pubmed.ncbi.nlm.nih.gov/24980425/ https://pubmed.ncbi.nlm.nih.gov/25978154/ https://pubmed.ncbi.nlm.nih.gov/31957104/ https://pubmed.ncbi.nlm.nih.gov/23116641/ https://pubmed.ncbi.nlm.nih.gov/28318674/ https://pubmed.ncbi.nlm.nih.gov/25056510/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145376/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other surgical critical care episodes here : https://behindtheknife.org/podcast-category/surgical-critical-care/

Nov 14, 2022

The dreaded Surgical Site Complications! Join Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross from our Emergency General Surgery Team as they discuss surgical site complications and prevention techniques. Paper 1: Arnold et. al. (2019) Not a Routine Case, Why Expect the Routine Outcome? Quantifying the Infectious Burden of Emergency General Surgery Using the NSQIP. American Surgeon - NSQIP database 2005-2016 (>800,000 patients) including open/laparoscopic cholecystectomies, ventral hernia repairs, and partial colectomies - Comparing outcomes in emergent vs elective cases - Primary outcome: aggregate of SSIs which includes wound disruption, superficial SSI, deep SSI, and organ space SSI - Results: -- ↑SSI in the emergency group (5.3% vs 3.6%) -- When controlling for multiple variables, emergency surgery associated with more SSIs (OR 1.15). Paper 2: Lakhani et. al. (2022) Prophylactic negative pressure wound dressings reduces wound complications following emergency laparotomies: A systematic review and meta-analysis. Surgery - NPWD remove excess fluid from subcutaneous space, ↓ collections/contaminants, promote angiogenesis, fibroblast infiltration - Literature review 2005-2022 (NPWD, laparotomy, SSI) - 1199 patients included (566 NPWD, 633 standard dressings) - Results: -- NPWD ↓ wound infection (OR 0.43) and wound breakdown (OR 0.36) -- No change in LOS, readmission Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Emergency General Surgery episodes here : https://behindtheknife.org/podcast-category/emergency-general-surgery/

Nov 10, 2022

In this episode, our team provides a comprehensive review of the differential diagnosis for mediastinal masses, their workup, and biopsy considerations. Listen as we dive deeper into the perioperative planning and operative approach for resection of these masses with special considerations for patients with thymoma. Learning Objectives: -Discuss the differential diagnosis of a mediastinal mass -Review the workup of a mediastinal mass -Outline indications for biopsy and describe the various approaches -Describe the operative techniques for thymectomy, pearls & potential pitfalls Hosts: Megan Lenihan MD, Kelly Daus MD, Peter White MD, and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/21847052/ Detterbeck FC, Nicholson AG, Kondo K, Van Schil P, Moran C. The Masaoka-Koga stage classification for thymic malignancies: clarification and definition of terms. J Thorac Oncol. 2011 Jul;6(7 Suppl 3):S1710-6. doi: 10.1097/JTO.0b013e31821e8cff. PMID: 21847052. https://pubmed.ncbi.nlm.nih.gov/33468329/ Ahmad U. The eighth edition TNM stage classification for thymic tumors: What do I need to know? J Thorac Cardiovasc Surg. 2021 Apr;161(4):1524-1529. doi: 10.1016/j.jtcvs.2020.10.131. Epub 2020 Nov 13. PMID: 33468329. https://pubmed.ncbi.nlm.nih.gov/34695605/ Marx A, et al. The 2021 WHO Classification of Tumors of the Thymus and Mediastinum: What Is New in Thymic Epithelial, Germ Cell, and Mesenchymal Tumors? J Thorac Oncol. 2022 Feb;17(2):200-213. doi: 10.1016/j.jtho.2021.10.010. Epub 2021 Oct 22. PMID: 34695605. https://pubmed.ncbi.nlm.nih.gov/22882218/ Meriggioli MN, Sanders DB. Muscle autoantibodies in myasthenia gravis: beyond diagnosis? Expert Rev Clin Immunol. 2012 Jul;8(5):427-38. doi: 10.1586/eci.12.34. PMID: 22882218; PMCID: PMC3505488. https://pubmed.ncbi.nlm.nih.gov/34339670/ Raja SM, Guptill JT, McConnell A, Al-Khalidi HR, Hartwig MG, Klapper JA. Perioperative Outcomes of Thymectomy in Myasthenia Gravis: A Thoracic Surgery Database Analysis. Ann Thorac Surg. 2022 Mar;113(3):904-910. doi: 10.1016/j.athoracsur.2021.06.071. Epub 2021 Jul 30. PMID: 34339670. Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed general surgery procedures. If you are a PGY4/5 general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com, for more information on how you could be compensated up to $400 for recording and submitting those videos. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other clinical challenge episodes here : https://behindtheknife.org/podcast-series/clinical-challenges/

Nov 7, 2022

In this episode from the Endocrine Surgery team at BTK we discuss how Dr. Yeh built the section of endocrine surgery at UCLA. From Sydney, Australia to Santa Monica, he discusses the risks and challenges involved in becoming a leader in academic endocrine surgery. In this podcast we answer the question “why endocrine surgery,” and mention tips for success at all level of training from medical students to early faculty. Finally, we take a moment to honor and remember Dr. Orlo Clark. Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established. Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. Na Eun Kim is an Endocrine Surgery Fellow at UCLA in her first year of fellowship Dr. Rivfka Shenoy is a PGY-6 General Surgery Resident at UCLA who has completed two years of research Dr. Max Schumm is a PGY-6 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon. Important Papers Krishnamurthy VD, Gutnick J, Slotcavage R, Jin J, Berber E, Siperstein A, Shin JJ. Endocrine surgery fellowship graduates past, present, and future: 8 years of early job market experiences and what program directors and trainees can expect. Surgery. 2017 Jan;161(1):289-296. doi: 10.1016/j.surg.2016.06.069. Epub 2016 Nov 17. PMID: 27866719. Krishnamurthy VD, Jin J, Siperstein A, Shin JJ. Mapping endocrine surgery: Workforce analysis from the last six decades. Surgery. 2016 Jan;159(1):102-10. doi: 10.1016/j.surg.2015.08.024. Epub 2015 Oct 9. PMID: 26456130. Kulaylat AN, Kenning EM, Chesnut CH 3rd, James BC, Schubart JR, Saunders BD. The profile of successful applicants for endocrine surgery fellowships: results of a national survey. Am J Surg. 2014 Oct;208(4):685-9. doi: 10.1016/j.amjsurg.2014.03.013. Epub 2014 Jun 21. PMID: 25048570; PMCID: PMC4639920. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Endocrine Surgery episodes here : https://behindtheknife.org/podcast-category/endocrine/

Nov 3, 2022

You have a young patient with longstanding Crohn’s disease with a history of small bowel resections presenting with recurrent obstructions from a stricture. The patient has exhausted all medical options and requires surgery. How should you work up this patient prior to surgery? Should you perform a bowel resection or perform a strictureplasty? Which strictureplasty do you choose and why? Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Fabrizio Michelassi as they discuss the management of small bowel strictures in Crohn’s disease. Learning Objectives 1. Describe the evaluation for small bowel strictures and indications for operating in patients with Crohn’s disease 2. Discuss the different surgical options in managing small bowel strictures 3. Explain the rationale behind use of different strictureplasty approaches Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Colorectal Surgery episodes here : https://behindtheknife.org/podcast-category/colorectal/

Oct 31, 2022

On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill discuss hemodynamically unstable pelvic fractures. These patients are sick!! Really sick. Join us for a practical discussion about the best way to manage gnarly pelvic fractures. From binders to angioembolization to pelvic packing to REBOA, we cover it all. Papers: Burlew et al, Preperitoneal pelvic packing reduces mortality in patients with life-threatening hemorrhage due to unstable pelvic fractures. J Trauma 2017: https://pubmed.ncbi.nlm.nih.gov/27893645/ McDonogh et al, Preperitoneal packing versus angioembolization for the initial management of hemodynamically unstable pelvic fracture: A systematic review and meta-analysis. J Trauma 2022: https://pubmed.ncbi.nlm.nih.gov/34991126/ Li et al, Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis, J ournal of Orthopaedics and Traumatology 2022: https://pubmed.ncbi.nlm.nih.gov/35799073/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out the rest of the BIG T trauma series here : https://behindtheknife.org/podcast-series/big-t-trauma/

Oct 27, 2022

In the second episode of the “Innovations in Surgery” series, Behind the Knife’s surgical education fellow, Dr. Dan Scheese, sits down with Dr. Michael Amendola and Dr. Diana Otoya to discuss 3D Printing and its role in medicine and surgery. They speak on the history of this technology and the current utility in preoperative planning and intraoperative application. Looking for information on getting involved in 3D Printing? Link to the VHA Office of Advanced Manufacturing: https://www.innovation.va.gov/oam/views/about/whoweare.html Link to information regarding the 3D printing fellowship: https://www.innovation.va.gov/oam/views/training/training.html Additionally, you can contact Dr. Michael Amendola or Dr. Diana Otoya for more information regarding the 3D printing surgical fellowship. Dr. Michael Amendola: michael.amendola@va.gov Dr. Diana Otoya: Diana.Otoya@vcuhealth.org Dr. Amendola also has a website for mentorship and other information: https://michaelamendola.com/ Download free 3D designs that are ready to print at https://www.thingiverse.com/ Lastly, anyone that has access to a VA can take the TMS module Dr. Amendola created. TMS: 3D Printing in the VA Health Care System: Building the Hospital of the Future. Item: 45343 Goes through history, types of printers, and basic medical information you need for 3D printing. Good intro lecture/ free education to any trainee within the VA. https://www.tms.va.gov/SecureAuth35/ Dr. Amendola has received his medical degree, completed his general surgery residency and vascular surgery fellowship at Virginia Commonwealth University. He is board certified by the American Board of Surgery in both general and vascular surgery. In 2021 he was inducted into the American College of Surgeons Academy of Master Surgeon Educators. He maintains privileges at Central Virginia VA Health Care System in Richmond, Virginia and is a Professor of Surgery at VCU-SOM. Additionally, he is the program director of the Office of Advance Manufacturing’s Central Virginia VA Health Care System based 3D Printing Surgical Fellowship. Dr. Diana Otoya is a third-year general surgery resident at VCU. She spent her first research year as a Veterans Health Administration (VHA) Chief Resident in Quality and Safety at the Central Virginia Health Care System while also becoming the inaugural fellow for the VHA 3D Printing Surgical Fellowship. She is now currently in her second year in the 3D Printing fellowship program. Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed general surgery procedures. If you are a PGY4/5 general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com, for more information on how you could be compensated up to $400 for recording and submitting those videos. Please visit https://behindtheknife.org/ to access other high-yield surgical education podcasts, videos, and more. If you liked this episode, check out our latest episodes here: https://behindtheknife.org/listen/

Oct 24, 2022

Join our surgical education fellow, Dr. Dan Scheese as he kicks off a brand new BTK series titled “Innovations in Surgery.” This series will take a deeper look into past, present, and future innovations that have, or will, revolutionize the field of surgery. In this inaugural episode, Dr. Scheese and Dr. Patrick Georgoff sit down with a leader in the surgical artificial intelligence field, Dr. Daniel Hashimoto. They cover what surgical artificial intelligence is, go over some common terminology used in AI, talk about current applications of AI in the OR, and finally discuss the future of AI in surgery. “ Artificial Intelligence in Surgery: Promises and Perils” - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995666/ Video – Application of AI in the OR – https://youtu.be/kabcjtdI308 Daniel Hashimoto is assistant professor of surgery at the Hospital of the University of Pennsylvania and director of the Penn Computer Assisted Surgery and Outcomes (PCASO) Laboratory. He received his MD and MS in translational research from the University of Pennsylvania and completed his general surgery training at Massachusetts General Hospital and Harvard Medical School, where he was also associate director of research of the Surgical AI & Innovation Laboratory. He is vice-chair and co-founder of the Global Surgical AI Collaborative, a nonprofit that oversees and manages a global data-sharing and analytics platform for surgical data. His work focuses on the use of computer vision for the delivery of intraoperative decision support and assessment of surgical performance. He is editor of the textbook Artificial Intelligence in Surgery: Understanding the Role of AI in Surgical Practice, which provides a nontechnical foundation on key concepts in artificial intelligence as it applies to surgical care. Please visit https://behindtheknife.org/ to access other high-yield surgical education podcasts, videos, and more. If you liked this episode, check out our latest episodes here: https://behindtheknife.org/listen/

Oct 20, 2022

You get called to the ED to evaluate a patient with abdominal pain who is in extreme pain but without any helpful physical exam findings. Time is gut in mesenteric ischemia, so how do you prioritize your workup, initial treatment, and what do you do once you’ve made the diagnosis? In this episode of Behind the Knife, the vascular surgery team discusses all this and more by walking through a real case and talking through the principles of management as well as some helpful tips on how to actually get through these tough clinical scenarios. Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan. Dr. Craig Brown is a PGY-7 in the General Surgery program and recently matched 2023 vascular fellow at the University of Michigan. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. Check out our Vascular Surgery Oral Board Review Book here : https://www.amazon.com/Vascular-Surgery-Oral-Board-Review/dp/0578382296/ref=sr_1_3?crid=1IF8LX547EOEA&keywords=behind+the+knife&qid=1666184084&qu=eyJxc2MiOiIxLjM3IiwicXNhIjoiMC43MCIsInFzcCI6IjAuNTgifQ%3D%3D&sprefix=behind+the+knife%2Caps%2C57&sr=8-3&ufe=app_do%3Aamzn1.fos.f5122f16-c3e8-4386-bf32-63e904010ad0

Oct 17, 2022

What’s the one clinical scenario where you can really save a patient’s life with a pancreatectomy? An IPMN with high-grade dysplasia! Join the Behind the Knife HPB Team for a deep dive into the complex decision-making surgical management of IPMNs. Learning Objectives In this episode, we review the basics of intraductal papillary mucinous neoplasms, how to evaluate patients with a cystic mass of the pancreas, guidelines for surveillance, and indications for resection. We discuss key concepts such as Worrisome Features and High-Risk Stigmata and how those influence surgical decision-making, and tackle a few of the most challenging scenarios surgeons may face when treating patients with IPMNs. Hosts : Timothy Vreelant, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Links to Papers Referenced in this Episode Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas Pancreatology. 2017 Sep-Oct;17(5):738-753. https://pubmed.ncbi.nlm.nih.gov/28735806/ Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. J Am Coll Surg. 2022 Jun 1;234(6):1021-1030. https://pubmed.ncbi.nlm.nih.gov/35703792/ Extent of Surgery and Implications of Transection Margin Status after Resection of IPMNs. Gastroenterology Research and Practice 2014, 1–10. https://pubmed.ncbi.nlm.nih.gov/25276122/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Hepatobiliary Surgery episodes here : https://behindtheknife.org/podcast-category/hepatobiliary/

Oct 13, 2022

Gallbladders – bread and butter cases or underestimated challenges? Join Dr. Patrick Georgoff and Dr. Shanaz Hossain as they sit down with Dr. Eric Knauer to discuss difficult gallbladders. In this episode, we discuss the SAGES Safe Cholecystectomy program that were created in an effort to decrease the incidence of bile duct injuries. The six strategies outlined in the program include: 1. Use the Critical View of Safety (CVS) method of identification of the cystic duct and cystic artery during laparoscopic cholecystectomy. 2. Understand the potential for aberrant anatomy in all cases. 3. Make liberal use of cholangiography or other methods to image the biliary tree intraoperatively. 4. Consider an Intra-operative Momentary Pause during laparoscopic cholecystectomy prior to clipping, cutting or transecting any ductal structures. 5. Recognize when the dissection is approaching a zone of significant risk and halt the dissection before entering the zone. Finish the operation by a safe method other than cholecystectomy if conditions around the gallbladder are too dangerous. a. Subtotal Cholecystectomies – Learn more with this landmark paper: http://dx.doi.org/10.1016/j.jamcollsurg.2015.09.019 6. Get help from another surgeon when the dissection or conditions are difficult. Take a look at all their great explanations and catch all the important points by completing the online program: https://www.sages.org/safe-cholecystectomy-program/ Dr. Eric Knauer is an assistant professor surgery at Emory University. He has recently published regarding the management of laparoscopic common bile duct stones in General Surgery News and, more importantly, was awarded the junior residents’ teaching award. Check out his great educational videos to learn more: · Cholecystectomy: https://youtu.be/_oMNRINPY5I Laparoscopic Common Bile Duct Exploration: https://youtu.be/mXl11I7mya0 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other hepatobiliary episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/

Oct 10, 2022

Does surgery have a leaky pipeline problem? What is it like for LGBTQ+ students, trainees, and faculty to be in the field of surgery? In this Journal Club episode, we review recent research and calls to action that illuminate these and other questions in the field. We’re joined by a panel of guests from all levels of training, including Eric Pillado MD MS, Christopher Digesu MD, Jessica Halem MBA, and Michaela West MD PhD. Learning Objectives: · Identify hazards for LGBTQ+ trainees in surgery · Describe potential actions to improve LGBTQ+ inclusivity in surgery · Correlate the provision of LGBTQ+ health care and the wellbeing of LGBTQ+ staff References: Experiences of LGBTQ+ Residents in US General Surgery Training Programs - https://doi.org/10.1001/jamasurg.2021.5246 Invited Commentary - Discrimination, Harassment, and Bullying Is Reported to Be High by LGBTQ+ Surgical Residents – https://doi.org/10.1001/jamasurg.2021.5272 LGBTQ+ Inclusivity in Surgery—A Call to Action – https://doi.org/10.1001/jamasurg.2021.6777 Being queer without proximal or distal control - https://vascularspecialistonline.com/being-queer-without-proximal-or-distal-control/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Surgical Education episodes here : https://behindtheknife.org/podcast-category/surgical-education/

Oct 6, 2022

In this episode, our team discusses the management of traumatic rib fractures including pearls and pitfalls. Join as we discuss the current standards of treatment as well as controversies in how to manage these patients! Hosts: Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST) and incoming editor-in-chief of Trauma Surgery and Acute Care Open. Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins. David Sigmon, MD, MMEd, a PGY-7 resident at the University of Illinois at Chicago who will be a fellow at Lincoln Medical Center in the Bronx next year. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education. LITERATURE Terry SM, Shoff KA, Sharrah ML. Improving blunt chest wall injury outcomes: introducing the pic score. J Trauma Nurs. 2021;28(6):386-394. https://pubmed.ncbi.nlm.nih.gov/34766933/ Witt CE, Bulger EM. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma Surg Acute Care Open. 2017;2(1):e000064. https://tsaco.bmj.com/content/2/1/e000064 Utter GH, McFadden NR. Rib fractures, the evidence supporting their management, and adherence to that evidence base. JAMA Netw Open. 2020;3(3):e201591-e201591. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763488 Dehghan N, Nauth A, Schemitsch E, et al. Operative vs nonoperative treatment of acute unstable chest wall injuries: a randomized clinical trial. JAMA Surgery. Published online September 21, 2022. https://jamanetwork.com/journals/jamasurgery/article-abstract/2796556 Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):618-626. https://pubmed.ncbi.nlm.nih.gov/28030502/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other trauma episodes here : https://behindtheknife.org/podcast-category/trauma/

Oct 3, 2022

On the University of Washington Minimally Invasive Surgery team’s search for value no piggy bank is safe and no couch cushion will be left unturned. Tune in to hear Drs. Mike Weykamp, Nicole White, Nick Cetrulo, and Andrew Wright discuss the state of the literature regarding the cost-effectiveness of robot assisted surgery. Referenced Articles: 1. Ye L, Childers CP, de Vigilio M, Shenoy R, Mederos MA, Mak SS, Begashaw MM, Booth MS, Shekelle PG, Wilson M, Gunnar W, Girgis MD, Maggard-Gibbons M. Clinical Outcomes and Cost of Robotic Ventral Hernia Repair: Systematic Review. BJS Open. 2021. https://pubmed.ncbi.nlm.nih.gov/34791049/ 2. Finlayson SRG and Birkmeyer JD. Cost-effectiveness Analysis in Surgery. Surgery. 1998 https://pubmed.ncbi.nlm.nih.gov/9481400/ 3. Husereau D, Drummond M, Augustovski F, de Bekker-Grob E, Briggs AH, Carswell C, Caulley L, Chaiyakunapruk N, Greenberg D, Loder E, Mauskopf J, Mullins CD, Petrou S, Pwu R, Staniszewska S. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 Explanation and Elaboration: A Report of the ISPOR CHEERS II Good Practices Task Force. Value Heatlh. 2022. https://pubmed.ncbi.nlm.nih.gov/35031088/ Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed general surgery procedures. If you are a PGY4/5 general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com, for more information on how you could be compensated up to $400 for recording and submitting those videos. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other minimally invasive episodes here : https://behindtheknife.org/podcast-category/minimally-invasive/

Sep 26, 2022

You’ve finally submitted your ERAS application! As residency programs start to review your application, it’s time to start preparing for the next step- the interview. Join our education fellow, Dr. Jessica Millar, and Dr. Jeremy Lipman as they go over all the ways to start preparing to dominate your interviews. Guests: Jeremy Lipman, MD, MHPE- Professor of Colorectal Surgery, Designated Institutional Official, Director of Graduate Medical Education, and previous General Surgery Residency Program Director- Cleveland Clinic, OH Most Commonly Asked Interview Questions: · “Tell me about yourself”- have a 2-3 minute “elevator talk” rehearsed · “Where do you see yourself in 5/10-years” · “Why surgery?” · “Tell me about a challenge you’ve had to overcome” · “Tell me about a difficulty patient/team situation you’ve witnessed”- key here is to not throw anyone under the bus · “Why are you interested in our program” AAMC List of Common Interview Questions: https://students-residents.aamc.org/interviewing-residency-positions/questions-frequently-asked-applicants-during-interviews Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out the rest of our "Dominate the Match Series" here : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Sep 22, 2022

The number of patients seeking evaluation for revisional bariatric surgery is increasing. Wondering how to approach the work-up for these patients and what surgical options may be best for them? An introduction to the work-up and potential revisional bariatric surgery options are included in this episode from your bariatric surgery team at UNMC! Hosts: Ivy Haskins, MD Corrigan McBride, MD Tiffany Tanner, MD Journal Articles discussed: 1. Berger ER, Clements RH, Morton JH, Huffman KM, Wolfe BM, Nguyen NT, Ko CY, Hutter MM. The Impact of Different Surgical Techniques on Outcomes in Laparoscopic Sleeve Gastrectomies: The First Report from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Ann Surg. 2016; 264.3: 464-473. 2. Haskins IN, Jackson HT, Graham AE, Chen S, Sparks AD, Lin PP, Vaziri K. The Effect of Bougie Size and Distance from the Pylorus on Dehydration after Laparoscopic Sleeve Gastrectomy: An Analysis of the ACS-MBSAQIP Database. Surg Obes Relat Dis. 2019; 15.10: 1656-1661. 3. Toro JP, Lin E, Patel AD, Davis SS, Sanni A, Urrego HD, Sweeney JF, Srinivasan JK, Small W, Mittal P, Sekhar A, Moreno CC. Association of Radiographic Morphology with Early Gastroesophageal Reflux Disease and Satiety Control after Sleeve Gastrectomy. J Am Coll Surg. 2014; 219.3: 430-438. 4. Maselli DB, Alqahtani AR, Dayyeh BKA, Elahmedi M, Storm AC, Matar R, Nieto J, Teixeira A, Al Khatry M, Neto MG, Kumbhari V, Vargas EJ, Jaruvongvanich V, Mundi MS, Deshumkh A, Itani MI, Farha J, Chapman CG, Sharaiha R. Revisional Endoscopic Sleeve Gastroplasty of Laparoscopic Sleeve Gastrectomy: An International, Multicenter Study. 5. Campos GM, Mazzini GS, Altieri MS, Docimo S, DeMaria EJ, Rogers AM. ASMBS Position Statement on the Rationale for Performance of Upper Gastrointestinal Endoscopy Before and After Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2021; 17.5: 837-847. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other bariatric surgery episodes here : https://behindtheknife.org/podcast-category/bariatric/

Sep 19, 2022

In this episode we discuss two interesting cases in transplant surgery. In the first, we review a case in which a renal cell carcinoma was discovered during the backbench portion of a deceased donor kidney transplant procedure. In the second, we examine the unique challenges that are presented by simultaneous heart-liver transplantation. Learning Objectives: - Discuss renal cell carcinoma in the immunosuppressed patient - Review some of the logistical components that accompany dual organ transplants - Examine the clinical challenge of a heart-liver transplant Hosts: - Megan Lombardi, MD - Sasha McEwan, MD - Guilherme de Oliveira, MD - Alexander Toledo, MD - David Gerber, MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other transplant surgery episodes here : https://behindtheknife.org/podcast-category/transplant/

Sep 15, 2022

You are faced with a young patient with ileal Crohn’s disease. He requires an ileocolic resection. Which type of anastomosis do you perform? You also see another patient with complex perianal fistulas and the patient asks about the safety and efficacy of stem cells for fistula closure. What do you tell the patient? Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about the Kono-S anastomosis after ileocolic resections and stem cell therapy for perianal complex fistulas for Crohn’s disease. Learning objectives - To understand the rationale for the Kono-S anastomosis and the way it is fashioned. - To explain the possible advantages of the Kono-S anastomosis following ileocolic resection. - To explain the possible advantages of stem cell therapy for complex perianal fistulas. - To understand which patient population might be eligible for future stem cell therapy for complex perianal fistulas. References In order throughout the episode: Article 1: Luglio G, Rispo A, Imperatore N, Giglio MC, Amendola A, Tropeano FP, Peltrini R, Castiglione F, De Palma GD, Bucci L. Surgical Prevention of Anastomotic Recurrence by Excluding Mesentery in Crohn's Disease: The SuPREMe-CD Study - A Randomized Clinical Trial. Ann Surg. 2020 Aug;272(2):210-217. doi: 10.1097/SLA.0000000000003821. PMID: 32675483. Article 2: Panés J, García-Olmo D, Van Assche G, Colombel JF, Reinisch W, Baumgart DC, Dignass A, Nachury M, Ferrante M, Kazemi-Shirazi L, Grimaud JC, de la Portilla F, Goldin E, Richard MP, Leselbaum A, Danese S; ADMIRE CD Study Group Collaborators. Expanded allogeneic adipose-derived mesenchymal stem cells (Cx601) for complex perianal fistulas in Crohn's disease: a phase 3 randomised, double-blind controlled trial. Lancet. 2016 Sep 24;388(10051):1281-90. doi: 10.1016/S0140-6736(16)31203-X. Epub 2016 Jul 29. PMID: 27477896. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our library of colorectal episodes and videos here : https://behindtheknife.org/podcast-category/colorectal/

Sep 12, 2022

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss management of congenital diaphragmatic hernia in pediatric surgery. Journal Article links: Jancelewicz T, Brindle ME. Prediction tools in congenital diaphragmatic hernia. Semin Perinatol 2020;44(1):151165. https://pubmed.ncbi.nlm.nih.gov/31676044/ Deprest JA, Benachi A, Gratacos E, Nicolaides KH, Berg C, Persico N, et al. Randomized Trial of Fetal Surgery for Moderate Left Diaphragmatic Hernia. N Engl J Med 2021;385(2):119-29. https://pubmed.ncbi.nlm.nih.gov/34106555/ Deprest JA, Nicolaides KH, Benachi A, Gratacos E, Ryan G, Persico N, et al. Randomized Trial of Fetal Surgery for Severe Left Diaphragmatic Hernia. N Engl J Med 2021;385(2):107-18. https://www.nejm.org/doi/full/10.1056/NEJMoa2027030 Guner Y, Jancelewicz T, Di Nardo M, Yu P, Brindle M, Vogel AM, et al. Management of Congenital Diaphragmatic Hernia Treated With Extracorporeal Life Support: Interim Guidelines Consensus Statement From the Extracorporeal Life Support Organization. ASAIO J 2021;67(2):113-20. https://pubmed.ncbi.nlm.nih.gov/33512912/ Yang MJ, Russell KW, Yoder BA, Fenton SJ. Congenital diaphragmatic hernia: a narrative review of controversies in neonatal management. Transl Pediatr 2021;10(5):1432-47. https://pubmed.ncbi.nlm.nih.gov/34189103/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our other pediatric surgery podcast episodes here : https://behindtheknife.org/podcast-category/pediatric/

Sep 8, 2022

What is the value of completion lymph node dissection for patients with melanoma with sentinel-node metastases? The Multicenter Selective Lymphadenectomy Trial-1 (MSLT-1) confirmed that SLNB is an important part in the treatment of patients with melanoma, but what needed to be done beyond that in managing the axilla? Learning Objectives: In this episode, we review perioperative chemotherapy regimens for locally advanced, resectable Gastric cancer, standard of care, and the future role for immunotherapy. Hosts: Adam Yopp, MD, FACS (@AdamYopp) is an Associate Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a new Assistant Professor of Surgery at the University of Miami Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-4 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Papers Referenced in this Episode: Final Trial Report of Sentinel-Node Biopsy versus Nodal Observation in Melanoma Morton et al. https://www.nejm.org/doi/full/10.1056/nejmoa1310460 Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma Faries et al. https://www.nejm.org/doi/full/10.1056/nejmoa1613210 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Journal Review Series here : https://behindtheknife.org/podcast-series/journal-review/

Sep 5, 2022

Join BTK's Dr. Scott Steele and Dr. Jason Bingham as they discuss coding and billing with Dr. Sarah Vogler. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Financial Principles for Surgeons series here : https://behindtheknife.org/podcast-series/financial-principles-for-surgeons/

Sep 1, 2022

Our oral board review course includes 92 scenarios that meticulously cover 115 SCORE core topics . Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the Oral Board Review episodes at https://behindtheknife.org/premium/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 29, 2022

Our oral board review course includes 92 scenarios that meticulously cover 115 SCORE core topics . Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the Oral Board Review episodes at https://behindtheknife.org/premium/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Aug 25, 2022

Welcome to the second Surgical Palliative Care Journal Club, number four of a six-part series focused on the integration of palliative care into the practice of surgery. Join us as we discuss the value of utilizing an advance care planning video during surgical oncologic care and define the similarities and differences between advance care planning and serious illness communication. We then explore how a multidisciplinary committee may improve perioperative decision making and discuss the importance of the interdisciplinary palliative care team. Please use the links below to learn more about advance care planning and serious illness conversation. Integrating Advance Care Planning Videos into Surgical Oncologic Care: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/30964385/ A Multidisciplinary High-Risk Surgery Committee May Improve Perioperative Decision Making for Patients and Physicians https://pubmed.ncbi.nlm.nih.gov/34851187/ What’s Wrong with Advance Care Planning? https://pubmed.ncbi.nlm.nih.gov/34623373/ Shifting to Serious Illness Conversation https://pubmed.ncbi.nlm.nih.gov/34994773/ Serious Illness Care Program/ Serious Illness Communication Guide https://www.ariadnelabs.org/serious-illness-care/serious-illness-care-program/ Vital Talk https://www.vitaltalk.org/ Dr. Red Hoffman (@redmdnd) is an acute care surgeon and associate hospice medical director in Asheville, North Carolina, host of the Surgical Palliative Care Podcast (@surgpallcare) and co-founder of the recently launched Surgical Palliative Care Society ( www.spcsociety.org ). Dr. Zara Cooper (@zaracMD) is an acute care surgeon at Brigham and Women’s Hospital where she serves as Kessler Director for the Center of Surgery and Public Health (@csph_bwh). She is a Professor of Surgery at Harvard Medical School, associate faculty at Adriane Labs, and adjunct faculty at the Marcus Institute for Aging Research. Dr. Amanda Stastny (@manda_plez) is a PGY-3 in the General Surgery program at Mountain Area Health Education Center (MAHEC) in Asheville, NC. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Palliative Care episodes here : https://behindtheknife.org/podcast-category/palliative-care/

Aug 22, 2022

Surgical training is evolving, and with advancing surgical techniques, the traditional “time-served” model of residency may not best serve the needs of our learners or patients. In this episode, we discuss recent efforts at the Indiana University surgical education program to implement a comprehensive laparoscopic cholecystectomy that utilizes all of the best practices of competency-based education. We’re joined by first author Dr. Betsy Huffman, along with her mentors Drs. Jennifer Choi, Matthew Ritter, and Dimitrios Stefanidis for a practical review of their pioneering work. Learning Objectives: · Review challenges to the current paradigm of surgical education · Define competency-based education · Discuss practical challenges facing surgical educators when implementing new curricula References: A competency-based laparoscopic cholecystectomy curriculum significantly improves general surgery residents’ operative performance and decreases skill variability – https://doi.org/10.1097/SLA.0000000000004853 Ad referenced in episode: A team at the Brooke Army Medical Center is working to better define proficiency-based metrics for competency in commonly performed general surgery procedures. If you are a PGY4/5 general surgery resident or practicing surgeon who performs robotic assisted cholecystectomies or inguinal hernia repairs, reach out to the PI, Robert Laverty, MD, at rblaverty@gmail.com, for more information on how you could be compensated up to $400 for recording and submitting those videos. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out additional BTK surgical education episodes here : https://behindtheknife.org/podcast-category/surgical-education/

Aug 18, 2022

Ductal carcinoma in situ, or DCIS, is a precursor lesion to invasive breast cancer; however, not all DCIS becomes invasive cancer. Given our inability to accurately determine which DCIS lesions will progress, current clinical management consists of surgical resection for everyone with the possible additions of radiation and endocrine therapy. Multiple clinical trials and leaders in the field of breast surgical oncology are challenging our assumptions about the uniform approach to DCIS and are attempting to design treatment based on biology— tune in to hear about the evolving approach to management of DCIS! Hosts: Alexa Glencer, MD Michael Alvarado, MD Rita Mukhtar, MD Laura Esserman, MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other breast surgery episodes here : https://behindtheknife.org/podcast-category/breast/

Aug 15, 2022

We are facing a difficult case tonight: stab wound to the base of the left neck. Hope you know your anatomy well and are ready for a ride. Let’s see how one manages a patient whose injury is life threatening, a challenge to correctly diagnose, approach and repair. Join Drs. Urréchaga, Neeman, and Rattan from Ryder Trauma Center in Miami as they go through a real case trying to save a life and dominate the day. Learning Objectives: Reviewing thoracic outlet anatomy. Simplifying primary survey and immediate care for penetrating great vessel injuries. Discussing possible surgical approaches for various great vessel injuries, incisions, extensions, tips and tricks. References 1) Feliciano DV, DuBose JJ. Cardiac, great vessel, and pulmonary injuries. In: Rasmussen TR, Tai NRM, eds. Rich’s Vascular Trauma . 4th ed. Philadelphia: Elsevier, 2022: 171-198. 2) Karmy-Jones R, Namias N, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating chest trauma. J Trauma Acute Care Surg . 2014;77(6):994-1002. 3) Sperry JL, Moore EE, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating neck trauma. J Trauma Acute Care Surg . 2013;75(6):936-940. 4) Wall MJ, Ghanta RK, Mattox KL. Heart and thoracic vessels. In: Feliciano DV, Mattox K L, Moore EE, eds. Trauma . 9th ed. New York: McGraw-Hill, 2021: 599- 628. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Big T Trauma Series here : https://behindtheknife.org/podcast-series/big-t-trauma/

Aug 11, 2022

Personal Statements and Letters of Recommendations- two things that can make or break any residency or fellowship application. Join our education fellow, Dr. Jessica Millar, Dr. David Hughes, and Dr. Gifty Kwakye as they discuss what makes a truly great personal statement and how to compile a strong team for your letters of recommendation. Guests: David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan GIfty Kwakye, MD, MPH- Clinical Assistant Professor of Colon and Rectal Surgery, Surgical Clerkship Director- University of Michigan Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Medical Student and Intern Survival Guide here : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Aug 8, 2022

It’s that time of year- when medical students across the country are preparing their residency applications. The process can be a bit daunting, and there have been a number of changes to process over the past few years. Join our education fellow, Dr. Jessica Millar, and Dr. David Hughes as they review the “nuts and bolts” of this year’s residency application cycle. Guests: David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan Important Dates: · June 8, 2022: ERAS application opens at 9 a.m. ET. · August 1, 2022: Supplemental ERAS application opens for applicants. · September 7, 2022: Residency applicants may begin submitting ERAS applications to programs at 9 a.m. ET. · September 16, 2022: Supplemental ERAS application closes for applicants at 5 p.m. ET. · September 28, 2022: Residency programs may begin reviewing ERAS applications, MSPEs, and supplemental ERAS application data at 9 a.m. ET. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our Medical Student and Intern Survival Guide here : https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Aug 4, 2022

Bringing back an oldie but a goodie - Join Dr. Patrick Georgoff and Dr. Vahagn Nikolian as they discuss common and critical intern dilemmas. This episode is Part 2 of 2. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our entire Medical Student and Intern Survival Guide series here - https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Aug 1, 2022

Bringing back an oldie but a goodie - Join Dr. Patrick Georgoff and Dr. Vahagn Nikolian as they discuss common and critical intern dilemmas. This episode is Part 1 of 2. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our entire Medical Student and Intern Survival Guide series here - https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

Jul 28, 2022

Pilonidal cysts – a simple disease or a sneaky nuanced problem? Drs. Shanaz Hossain, Patrick Georgoff and Scott Steele sit down to discuss the difficulties encountered in the management of pilonidal cysts and the myriad of treatment options available, ranging from non-operative management to outpatient pit picking to major operations involving flaps. Dr. Steele dropped his “8 Key Principles for Pilonidal Cyst Management”: 1. Control Sepsis 2. Do the Least Amount of Work Possible 3. Avoid Too Much Excision 4. Remove All Hair, Un-Roof All Disease, and Debride Granulation Tissue 5. Use Off-Midline Excision and Closure 6. Tension Must Be Minimized with Primary Wound Closure 7. Change the Anatomy – Flatten the Natal Cleft 8. Never Underestimate the Impact of Postoperative Care Tune in for detailed insights regarding management and learn about all the options for surgical treatment! Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episode on Necrotizing Soft-Tissue Infections - https://behindtheknife.org/podcast/clinical-challenges-in-emergency-general-surgery-necrotizing-soft-tissue-infections/

Jul 25, 2022

Join our Emergency General Surgery team as they discuss Necrotizing Soft-Tissue Infections. Hosted by Drs. Jordan Nantais, Ashlie Nadler, Stephanie Mason and Graham Skelhorne-Gross. Necrotizing Soft-Tissue Infections: - Also known as “flesh eating disease”, gas gangrene, necrotizing fasciitis/myositis, Fournier’s gangrene. - Early findings are non-specific - Rapidly fatal - diagnostic delay can lead to tremendous additional morbidity and mortality Classification: - Type 1 - polymicrobial category (most common) found in immunosuppressed or elderly - Type 2 - monomicrobial infection [Group A Streptococcus > Methicillin-resistant Staphylococcus aureus (MRSA)] - Type 3 - monomicrobial infection (Vibrio or Clostridium) - Type 4 - fungal (rare) in immunocompromised or after penetration or trauma from candida or Zygomycetes. Initial Workup - History: (comorbidities, immunosuppression, recent infections or trauma) - Exam: swelling, open lesions, drainage, erythema, crepitus, and pain out of proportion - Most common: swelling, pain, erythema - Bullae, skin necrosis, crepitus are less common - Labs: Hb, wbc, Na, Creat, glucose, and CRP - Imaging: CT, MRI *sensitive and specific but may not change management - Cut-down: bedside vs in OR - Gm stain Management - Initially: two large bore IVs, foley catheter, aggressive fluid resuscitation, broad spectrum antibiotics, vasopressors PRN - Abx choices: carbopenem or piperacllin-tazobactam or cefotaxime plus metronidazole. Clindamycin (antitoxin effect) and vancomycin (MRSA) should be considered. - OR: must debride all dead/infected tissue, involve other surgical specialties as needed - Mark edge of cellulitis and use as initial debridement - Healthy dermis – pearly and white - Healthy fat – pale, yellow, glistening - Healthy fascia – should bleed, doesn’t easily separate from muscle - Healthy muscle – contract with cautery - Dressing: betadine-soaked gauze on the wound - Most patients will need at least 3 ORs (second OR generally 8-12 hours after the first) - No VAC or stoma at first OR References: 1. Pelletier J, Gottlieb M, Long B, Perkins JC Jr. Necrotizing Soft Tissue Infections (NSTI): Pearls and Pitfalls for the Emergency Clinician. J Emerg Med. 2022 Apr;62(4):480-491. doi: 10.1016/j.jemermed.2021.12.012. Epub 2022 Jan 31. 2. Sarani B, Strong M, Pascual J, Schwab CW. Necrotizing fasciitis: current concepts and review of the literature. J Am Coll Surg. 2009 Feb;208(2):279-88. 3. Edlich RF, Cross CL, Dahlstrom JJ, Long WB 3rd. Modern concepts of the diagnosis and treatment of necrotizing fasciitis. J Emerg Med. 2010 Aug;39(2):261-5 4. Hoesl V, Kempa S, Prantl L, Ochsenbauer K, Hoesl J, Kehrer A, Bosselmann T. The LRINEC Score-An Indicator for the Course and Prognosis of Necrotizing Fasciitis? J Clin Med. 2022 Jun 22;11(13):3583 5. Bulger EM, May A, Bernard A, Cohn S, Evans DC, Henry S, Quick J, Kobayashi L, Foster K, Duane TM, Sawyer RG, Kellum JA, Maung A, Maislin G, Smith DD, Segalovich I, Dankner W, Shirvan A. Impact and Progression of Organ Dysfunction in Patients with Necrotizing Soft Tissue Infections: A Multicenter Study. Surg Infect (Larchmt). 2015 Dec;16(6):694-701. 6. LRINEC Score from: https://www.mdcalc.com/calc/1734/lrinec-score-necrotizing-soft-tissue-infection#:~:text=Patients%20were%20classified%20into%20three,%25%20and%20NPV%20of%2096%25 . Retrieved July 2022. If you liked this episode, check out our recent episode titled, "Journal Review in Colorectal Surgery: Timing of Biologics and Surgery in the Setting of Crohn’s Disease" - https://behindtheknife.org/podcast/journal-review-in-colorectal-surgery-timing-of-biologics-and-surgery-in-the-setting-of-crohns-disease/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 21, 2022

You get consulted on a 34-year-old with ileocolic Crohn’s disease on Humira. You determine he needs surgery for recurrent partial obstructions. When do you do the surgery? How long should he be off his biologic medication? When to restart it post op? Join Drs. Abelson, Marcello and Aulet as they take us through two articles to help us figure it out! Learning Objectives: 1. Describe the complications of biologic medications in the peri-operative period 2. List the different classifications of medications for Crohn’s disease 3. Discuss the approach to managing timing of surgery for patients with crohn’s disease Articles: Cohen BL, Fleshner P, Kane SV et al. Prospective Cohort Study to Investigate the Safety of Preoperative Tumor Necrosis Factor Inhibitor Exposure in Patients With Inflammatory Bowel Disease Undergoing Intra-abdominal Surgery. Gastroenterology. 2022 Apr 10;S0016-5085(22)00359-6. doi: 10.1053/j.gastro.2022.03.057. Online ahead of print. Brouquet A, Maggiori L, Zerbib P, Lefevre JH, Denost Q, Germain A, Cotte E, Beyer-Berjot L, Munoz-Bongrand N, Desfourneaux V, Rahili A, Duffas JP, Pautrat K, Denet C, Bridoux V, Meurette G, Faucheron JL, Loriau J, Guillon F, Vicaut E, Benoist S, Panis Y; GETAID chirurgie group. Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease: Results of a Prospective Nationwide Cohort. Ann Surg. 2018 Feb;267(2):221-228. doi: 10.1097/SLA.0000000000002017. PMID: 29300710. Steele S, et al. The ASCRS Textbook of Colon and Rectal Surgery, fourth ed. 2022. https://link.springer.com/book/10.1007/978-3-030-66049-9 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 18, 2022

Want to learn more about achalasia and its procedural management? Excited about the POEM procedure? Learn what the current literature says when it comes to recommending POEM or the tried-and-true Heller myotomy from the Swedish Thoracic surgery team. Learning objectives - Review basics of achalasia - Discuss the current literature comparing POEM and Heller myotomy with fundoplication - Understand the major differences in outcomes for these procedures Hosts: Peter White, MD Megan Lenihan, MD Brian Louie, MD Kelly Daus, MD Referenced Material Werner YB, Hakanson B, Martinek J, et al. Endoscopic or Surgical Myotomy in Patients with Idiopathic Achalasia. N Engl J Med. 2019 Dec 5;381(23):2219-2229. doi: 10.1056/NEJMoa1905380. PMID: 31800987. Gu L, Ouyang Z, Lv L, et al. Safety and efficacy of peroral endoscopic myotomy with standard myotomy versus short myotomy for treatment-naïve patients with type II achalasia: a prospective randomized trial. Gastrointest Endosc. 2021 Jun;93(6):1304-1312. doi: 10.1016/j.gie.2020.10.006. Epub 2020 Oct 13. PMID: 33058884. Shemmeri E, Aye RW, Farivar AS, Bograd AJ, Louie BE. Use of a report card to evaluate outcomes of achalasia surgery: beyond the Eckardt score. Surg Endosc. 2020 Apr;34(4):1856-1862. doi: 10.1007/s00464-019-06952-2. Epub 2019 Jul 8. PMID: 31286258. Mota RCL, de Moura EGH, de Moura DTH, Bernardo WM, de Moura ETH, Brunaldi VO, Sakai P, Thompson CC. Risk factors for gastroesophageal reflux after POEM for achalasia: a systematic review and meta-analysis. Surg Endosc. 2021 Jan;35(1):383-397. doi: 10.1007/s00464-020-07412-y. Epub 2020 Mar 23. PMID: 32206921. McKay SC, Dunst CM, Sharata AM, Fletcher R, Reavis KM, Bradley DD, DeMeester SR, Müller D, Parker B, Swanström LL. POEM: clinical outcomes beyond 5 years. Surg Endosc. 2021 Oct;35(10):5709-5716. doi: 10.1007/s00464-020-08031-3. Epub 2021 Jan 4. PMID: 33398572. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 14, 2022

The utilization of point-of-care ultrasound and other non-invasive cardiac output monitoring technologies varies because of knowledge, resource availability and cultural practices. In this Clinical Challenge in Surgery episode from the Surgical Critical Care team at Behind the Knife, we provide a brief history of the use of cardiac-output monitoring in the ICU, introduce a few clinical scenarios in the context of point of care ultra-sound and other less-invasive cardiac-output monitoring technologies. Learning Objectives: In this episode, we review the historical uses of central venous pressure monitoring, pulmonary-artery catheters and the more frequently utilized point-of-care-ultrasound (or POCUS) in managing complex ICU patients. We review the outcomes behind these technologies, describe the views and utility of POCUS, and introduce less-invasive or completely non-invasive ways to measure cardiac-output monitoring. Hosts: Brittany Bankhead, MD, MS (@BBankheadMD) is an Assistant Professor of Surgery at Texas Tech University Health Sciences Center. Ryan Dumas, MD, FACS (@PMH_Trauma_RPD) is an Assistant Professor of Surgery at the University of Southwestern Medical Center and Parkland Memorial Hospital. Caroline Park, MD, MPH, FACS (@CPark_MD) is an Assistant Professor of Surgery at the University of Southwestern Medical Center and Parkland Memorial Hospital. Links to Papers Referenced in this Episode: National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med. 2006 May 25;354(21):2213-24. doi: 10.1056/NEJMoa061895. Epub 2006 May 21. PMID: 16714768. Yildizdas D, Aslan N. Ultrasonographic inferior vena cava collapsibility and distensibility indices for detecting the volume status of critically ill pediatric patients. J Ultrason. 2020 Nov;20(82):e205-e209. doi: 10.15557/JoU.2020.0034. Epub 2020 Sep 28. PMID: 33365158; PMCID: PMC7705480. Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol. 1990 Aug 15;66(4):493-6. doi: 10.1016/0002-9149(90)90711-9. PMID: 2386120. Marik PE, Cavallazzi R. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense. Crit Care Med. 2013 Jul;41(7):1774-81. doi: 10.1097/CCM.0b013e31828a25fd. PMID: 23774337. Acknowledgements: We would like to acknowledge Dr. Hassan Mashbari and the Department of Surgical Critical Care and Anesthesia at the Massachusetts General Hospital and Dr. Christopher Choi and the Department of Anesthesiology at the University of Texas Southwestern for their ultra-sound video contributions. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 11, 2022

Dr. Jordan Frey, a Plastic Surgeon in Buffalo NY, joins us to talk about how he uses investments in real estate to diversify his portfolio. We discuss: -Types of real estate investments and the pros and cons -Books to read on real estate investing -How to get started in real estate -Criteria he uses to choose a property and more Books recommended: The Millionaire Real Estate Investor - Gary Keller https://www.amazon.com/Millionaire-Real-Estate-Investor/dp/0071446370 Doctor's Guide to Real Estate Investing - Cory Fawcett https://www.amazon.com/Dr-Cory-S-Fawcett/e/B01FGK0IC8/ref=aufs_dp_fta_dsk Find Dr. Frey at his website or on social media. Prudentplasticsurgeon.com or @JordanFreyMD Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 7, 2022

Dr. Jill Streams, Trauma Surgeon at Vanderbilt, takes us through the ins and outs of understanding your first contract and how and when to negotiate. In this episode we cover -When/how to apply for your first job -Break down each part of a contract -Why you should negotiate -What and how to negotiate -Salary expectations -Contract landmines and more! You can connect with Dr. Streams on Twitter @JCRStreams Read more at WCI https://www.whitecoatinvestor.com/things-to-ask-for-in-a-physician-contract/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jul 4, 2022

Kevin interviews Dr. Adam Tanious a Vascular Surgeon at MUSC about the ins and outs of managing student debt. Adam is passionate about personal finance and student debt and is happy to discuss further with our listeners, please reach out at tanious@musc.edu . Want to learn more at student debt? Check out White Coat Investor resources on student debt. https://www.whitecoatinvestor.com/ultimate-guide-to-student-loan-debt-management-for-doctors/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 30, 2022

Kevin Kniery and Jason Bingham interview Larry Keller of Physician Financial Services on how and when to choose the right disability policy. You can reach Larry here Lkeller@physicianfinancialservices.com or at his website. https://www.physicianfinancialservices.com/ White Coat Investor Article breaking down Disability Insurance https://www.whitecoatinvestor.com/what-you-need-to-know-about-disability-insurance/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 28, 2022

Kevin Kniery and Jason Bingham interview Dr. Jason Mizell, a colorectal surgeon at University of Arkansas and pioneer in finance education for surgeons. He won the 2020 White Coat Investor Award for excellence in financial education. In this episode they discuss how to invest, and what to invest in, also cover topics regarding real estate, and biggest financial regrets. Links to articles discussed Financial Waterfall for Docs https://www.whitecoatinvestor.com/financial-waterfalls-for-new-residents-and-attendings/ Backdoor Roth IRA Point/Counter Point https://www.physicianonfire.com/the-backdoor-roth/ Simple Path to Wealth https://jlcollinsnh.com/stock-series/ Dr. Mizell can be reached at jsmizell@uams.edu Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 27, 2022

Kevin Kniery and Jason Bingham interview Dr. Jason Mizell, a colorectal surgeon at University of Arkansas and pioneer in finance education for surgeons. He won the 2020 White Coat Investor Award for excellence in financial education. In this episode they discuss his lecture "How to Resuscitate Your Critically Ill Finances". Dr. Mizell can be reached at jsmizell@uams.edu Book Recommendation: The Psychology of Money https://www.amazon.com/Psychology-Money-Timeless-lessons-happiness/dp/0857197681 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 24, 2022

Join the BTK leadership team for a quick update on what's happening at Behind the Knife! Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 20, 2022

In this episode from the Endocrine Surgery team at BTK we invited Dr. Kepal Patel to join us to discuss two endocrine surgery cases while discussing pertinent literature. We discuss the work-up and surgical decision making for a case of medullary thyroid cancer and a Bethesda III thyroid nodule. Dr. Kepal Patel is the Chief of the Division of Endocrine Surgery and a Professor of Surgery, Otolaryngology and Biochemistry at NYU Langone Health. Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established. Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. Vivek Sant is an Endocrine Surgery Fellow at UCLA in his first year of fellowship Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research Dr. Max Schumm is a PGY-5 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon. Important Papers Miyauchi, A., Matsuzuka, F., Hirai, K., Yokozawa, T., Kobayashi, K., Ito, Y., ... & Yamaguchi, K. (2002). Prospective trial of unilateral surgery for nonhereditary medullary thyroid carcinoma in patients without germline RET mutations. World journal of surgery , 26 (8), 1023-1028. Cibas, E. S., Baloch, Z. W., Fellegara, G., LiVolsi, V. A., Raab, S. S., Rosai, J., ... & Alexander, E. K. (2013). A prospective assessment defining the limitations of thyroid nodule pathologic evaluation. Annals of internal medicine , 159 (5), 325-332. Papazian, M. R., Dublin, J. C., Patel, K. N., Oweity, T., Jacobson, A. S., Brandler, T. C., & Givi, B. (2022). Repeat Fine-Needle Aspiration With Molecular Analysis in Management of Indeterminate Thyroid Nodules. Otolaryngology–Head and Neck Surgery , 01945998221093527. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 16, 2022

The grind of surgical training has been celebrated in the past, but to what end? With mounting evidence that supports a high prevalence of burnout in the surgical community, surgical educators and leaders are often called to develop initiatives to address the detrimental and potentially irreversible effects on trainees’ wellness during surgical training. We invite Dr. David Rogers, who has personally experienced burnout, to share his insight and expertise in improving workplace wellness. Spoiler: it’s not as easy as group yoga sessions and daily donuts. Hosts: Dr. David Rogers Dr. Jeremy Lipman Dr. Judith French Dr. Amy Han Learning Objectives 1. Listeners will be able to define wellness in the context of surgical training. 2. Listeners will be able to better characterize and recognize signs of burnout among surgeons and surgical trainees. 3. Listeners will be able identify strategies for overcoming burnout. 4. Listeners will be able to apply conceptual frameworks from workplace wellness outside of medicine that can guide developing effective programs that promote wellness in surgical education community. References: Torres-Landa S, Moreno K, Brasel KJ, Rogers DA. Identification of Leadership Behaviors that Impact General Surgery Junior Residents' Well-being: A Needs Assessment in a Single Academic Center. J Surg Educ . 2022;79(1):86-93. doi:10.1016/j.jsurg.2021.07.017 Coverdill JE, Bittner IV JG, Park MA, Pipkin WL, Mellinger JD. Fatigue as impairment or educational necessity? Insights into surgical culture. Acad Med . 2011;86:S69-72. Dyrbye LN, Thomas MR, Harper W, et al. The learning environment and medical student burnout: a multicentre study. Med Educ . 2009;43(3):274-282. doi:10.1111/j.1365-2923.2008.03282.x Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ . 2016;50(1):132-149. doi:10.1111/medu.12927 Bordage G. Conceptual frameworks to illuminate and magnify. Med Educ . 2009;43(4):312 319. doi:10.1111/j.1365-2923.2009.03295.x Bakker AB, de Vries JD. Job Demands–Resources theory and self-regulation: New explanations and remedies for job burnout. Anxiety, Stress, & Coping . 2021;34: 1-21. Georgiadis F. Author Dr Amit Sood: Rising Through Resilience; Five Things You Can Do To Become More Resilient. Medium. https://medium.com/authority-magazine/author-dr-amit-sood-rising-through-resilience-five-things-you-can-do-to-become-more-resilient-673b0a1e9f2a . Published 2020. Accessed May 10, 2022. Gino F. Are You Too Stressed to Be Productive? Or Not Stressed Enough? Harvard Business Review. Published October 5, 2017. https://hbr.org/2016/04/are-you-too-stressed-to-be-productive-or-not-stressed-enough Goleman D. Primal Leadership, with a New Preface by the Authors : Unleashing the Power of Emotional ... Intelligence. Harvard Bus Review Press; 2016. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 13, 2022

Colorectal liver metastasis (CRLM) is a complex clinical situation requiring multidisciplinary management. In this episode from the Hepato-Pancreato-Biliary team at Behind the Knife , we review the genomics of CRLM, discuss a journal article investigating the frequency and impact of these mutations on survival in patients with stage IV disease, and interview the senior author Dr. Jean-Nicholas Vauthey about this research and his career in HPB. Hosts : Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-5 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-3 General Surgery resident at Brooke Army Medical Center Guest: Jean-Nicholas Vauthey, MD (@VautheyMD) is a Professor of Surgical Oncology, Chief of HPB, and Dallas/Fort Worth Living Legend Chair for Cancer Research at MD Anderson. He is the Principal Investigator of the study discussed in the episode in addition to numerous other articles describing the genomics of colorectal liver metastases. Learning Objectives: In this episode, we review basic mutations found in metastatic colorectal cancer and broadly discuss these in a clinical context. We review a journal article from Kawaguchi et al. in which authors analyze prognostic relevance of signaling pathways in patients undergoing resection of CRLM, later validated in an external cohort of unresected patients. We conduct an interview with the senior author of the study regarding relevant methodologic details, next steps in his research, and how to apply this information now and in the future to the care of patients with CRLM. Links to Papers Referenced in this Episode: Journal Article: Kawaguchi Y, Kopetz S, Kwong L, Xiao L, Morris JS, Tran Cao HS, Tzeng CD, Chun YS, Lee JE, Vauthey JN. Genomic Sequencing and Insight into Clinical Heterogeneity and Prognostic Pathway Genes in Patients with Metastatic Colorectal Cancer. J Am Coll Surg. 2021 Aug;233(2):272-284.e13. doi: 10.1016/j.jamcollsurg.2021.05.027. Epub 2021 Jun 7. PMID: 34111531; PMCID: PMC8666966. Recommended Additional Podcasts on CRLM: The AHPBA Podcast: 1. Episode 1: Dr. Jean Nicolas Vauthey - Colorectal Liver Metastases ( https://podcasts.apple.com/us/podcast/episode-1-dr-jean-nicolas-vauthey-colorectal-liver/id1501441845?i=1000467381474 ) Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 9, 2022

Acute limb ischemia is simultaneous one of the most fun but frustrating diseases to treat in vascular surgery. In this episode of Behind the Knife, the vascular surgery team gives a concise overview of the diagnosis/workup and treatment of patients with acute limb ischemia and talks about some of the difficult decision making regarding treatment modality given all the exciting technology available today. Dr. Nicholas Osborne is an Associate Professor of Vascular Surgery at the University of Michigan and the Chief of Vascular Surgery at the Ann Arbor Veteran’s Affairs Healthcare System. Dr. Frank Davis is a Chief Resident in the Integrated Vascular Surgery program at the University of Michigan. Dr. Craig Brown is a PGY-6 in the General Surgery program at the University of Michigan. Papers discussed in this Episode: AHA/ACC/SVS, etc Guidelines on the Management of Patients with Lower Extremity Peripheral Artery Disease https://pubmed.ncbi.nlm.nih.gov/27851992/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 6, 2022

It’s 1AM and the emergency department is calling about *insert terrifying foregut problem you haven’t seen since you were an intern here* and you wake up in a cold sweat to realize it was just a dream…this time. Tune in to this clinical challenge episode for some tips and tricks for managing foregut nightmares with Drs. Mike Weykamp, Nicole White, Andrew Wright, and Nick Cetrulo from the University of Washington’s Minimally Invasive Surgery team. Referenced articles and videos: 1. Rodriguez-Garcia HA, Wright AS, Yates RB. Managing obstructive gastric volvulus: challenges and solutions. Open Access Surgery. 2017 https://www.dovepress.com/getfile.php?fileID=35414 2. Yates RB. Giant PEH: Management Principles for Unique Clinical Circumstances. 2017 SAGES Annual Meeting. Houston, TX. 2017 https://www.youtube.com/watch?v=vq6cZL2-pho 3. Millet I, Orliac C, Alili C, Guillon F, Taourel P. Computed tomography findings of acute gastric volvulus. Eur Radiol. 2014. https://pubmed.ncbi.nlm.nih.gov/25278244/ 4. Mazaheri P, Ballard DH, Neal KA, Raptis DA, Shetty AS, Raptis CA, Mellnick VM. CT of Gastric Volvulus: Interobserver Reliability, Radiologists' Accuracy, and Imaging Findings. AJR Am J Roentgenol. 2019. https://pubmed.ncbi.nlm.nih.gov/30403524/ 5. Barmparas G, Alhaj Saleh A, Huang R, Eaton BC, Bruns BR, Raines A, Bryant C, Crane CE, Scherer EP, Schroeppel TJ, Moskowitz E, Regner JL, Frazee R, Campion EM, Bartley M, Mortus JR, Ward J, Margulies DR, Dissanaike S. Empiric antifungals do not decrease the risk for organ space infection in patients with perforated peptic ulcer. Trauma Surg Acute Care Open. 2021. https://pubmed.ncbi.nlm.nih.gov/34079912/ 6. Horn CB, Coleoglou Centeno AA, Rasane RK, Aldana JA, Fiore NB, Zhang Q, Torres M, Mazuski JE, Ilahi ON, Punch LJ, Bochicchio GV. Pre-Operative Anti-Fungal Therapy Does Not Improve Outcomes in Perforated Peptic Ulcers. Surg Infect (Larchmt). 2018. https://pubmed.ncbi.nlm.nih.gov/30036134/ 7. Wee JO. Gastric Volvulus in Adults. In: UpToDate, Louie BE (Ed), UpToDate, Waltham, MA. (Accessed on May 15, 2022.) https://www.uptodate.com/contents/gastric-volvulus-in-adults Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Jun 2, 2022

Determining when to order imaging for blunt cerebrovascular injury is a diagnostic quandary that has long engendered controversy. Today we discuss a paper that introduced universal CT angiogram of the neck to screen for BCVI in all blunt trauma patients and then compared the result to what would have happened if some of the current screening guidelines were utilized. Join us as we discuss their fascinating results and what it means for blunt trauma patients going forward. Hosts: Elliott R. Haut, MD, Ph.D., a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST). Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Master's in Education in the Health Professions from Johns Hopkins. David Sigmon, MD, MMEd, a PGY-6 resident at the University of Illinois at Chicago who plans on going into trauma surgery. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education. LITERATURE Black JA, Abraham PJ, Abraham MN, et al. Universal screening for blunt cerebrovascular injury. J Trauma Acute Care Surg. 2021;90(2):224-231. https://pubmed.ncbi.nlm.nih.gov/33502144/ Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(6):875-887. https://pubmed.ncbi.nlm.nih.gov/32176167/ Biffl WL, Moore EE, Offner PJ, Brega KE, Franciose RJ, Elliott JP, Burch JM. Optimizing screening for blunt cerebrovascular injuries. (1999) American journal of surgery. 178 (6): 517-22. https://pubmed.ncbi.nlm.nih.gov/10670864/ Geddes AE, Burlew CC, Wagenaar AE, Biffl WL, Johnson JL, Pieracci FM, Campion EM, Moore EE. Expanded screening criteria for blunt cerebrovascular injury: a bigger impact than anticipated. (2016) American journal of surgery. 212 (6): 1167-1174. https://pubmed.ncbi.nlm.nih.gov/27751528/ Ciapetti M, Circelli A, Zagli G et-al. Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria. Scand J Trauma Resusc Emerg Med. 2010;18 (1): 61. https://pubmed.ncbi.nlm.nih.gov/21092211/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 30, 2022

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss TEF management and the use of a post-operative transanastomotic feeding tubes in pediatric surgery. Journal Article links: Wang, C., Feng, L., Li, Y., & Ji, Y. (2018). What is the impact of the use of transanastomotic feeding tube on patients with esophageal atresia: a systematic review and meta-analysis. BMC Pediatr, 18 (1), 385. doi:10.1186/s12887-018-1359-5 https://pubmed.ncbi.nlm.nih.gov/30541487/ Bence, C. M., Rymeski, B., Gadepalli, S., Sato, T. T., Minneci, P. C., Downard, C., . . . Midwest Pediatric Surgery, C. (2021). Clinical outcomes following implementation of a management bundle for esophageal atresia with distal tracheoesophageal fistula. J Pediatr Surg, 56 (1), 47-54. doi:10.1016/j.jpedsurg.2020.09.049 https://pubmed.ncbi.nlm.nih.gov/33131776/ LaRusso, K., Joharifard, S., Lakabi, R., Nimer, N., Shahi, A., Kasasni, S. M., . . . Emil, S. (2022). Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula: The Quebec experience. J Pediatr Surg, 57 (1), 41-44. doi:10.1016/j.jpedsurg.2021.09.014 https://pubmed.ncbi.nlm.nih.gov/34666898/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 26, 2022

Join Shreya Gupta, MD and Jonathan Abelson, MD as they discuss highlights from the American Society of Colon and Rectal Surgeons. Dr. Sharon Stein and Dr. Erin King-Mullins are the guest speakers. They are discussing female leadership, diversity and inclusion topics, and much more! This is episode 2 of 2. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 23, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** Join Shreya Gupta, MD and Jonathan Abelson, MD as they discuss highlights from the American Society of Colon and Rectal Surgeons. This is episode 1 of 2. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 19, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** Subjective and objective GERD are common amongst bariatric surgery patients. Is weight loss alone enough to improve GERD symptoms? Is the vertical sleeve gastrectomy really associated with worsening GERD? What technical factors of the vertical sleeve gastrectomy lead to improved or worsening GERD? Listen to find out! Journal articles: The Impact of Sleeve Gastrectomy on Gastroesophageal Reflux Disease in Patients with Morbid Obesity https://pubmed.ncbi.nlm.nih.gov/35048247/ Effect of Concomitant Laparoscopic Sleeve Gastrectomy and Hiatal Hernia Repair on Gastroesophageal Reflux in Patients with Obesity: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/34254259/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 16, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** How do you decide if a pancreatic head mass is resectable? Does vascular involvement matter? What impacts survival? Join the Surgical Oncology team as they dive into operative considerations when operating on borderline resectable and locally advanced pancreatic cancer. Break the nihilism and find out about the options available for patients with this dreaded malignancy. Learning Objectives: In this episode, we review the various definitions for resectability in pancreatic cancer, as well as the various prognostic markers and decision points to consider when deciding which patients may benefit from an operation. Hosts: Adam Yopp, MD, FACS (@AdamYopp) is an Assistant Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a 2nd Year Complex General Surgical Oncology Fellow at the MD Anderson Cancer Center. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-3 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 12, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** In January 2022, the University of Maryland Medical Center performed the world’s first transplant involving a genetically modified animal heart. Join Behind the Knife as we discuss this significant transplant milestone with the 2 surgeons who led this historic case - Dr. Bartley Griffith and Dr. Muhammad M. Mohiuddin! Dr. Bartley Griffith is the Thomas E. and Alice Marie Hales Distinguished Professor in Transplant Surgery at UMSOM. Dr. Muhammad Mohiuddin is a Professor of Surgery at UMSOM and established the Cardiac Xenotransplantation Program with Dr. Griffith, the first in the United States. Tune in to learn about the history of xenotransplantation and the barriers that have been overcome to make xenotransplantation a reality. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 9, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** Inspired by recent transplant surgery headlines, in this episode we briefly review the history and challenges of xenotransplantation. We discuss an article recently published in the American Journal of Transplantation describing the transplant of a porcine kidney into a human decedent model. Learning Objectives · Understand the timeline of xenotransplantation and its historical challenges · Review a recent article that describes the transplantation of a genetically-modified porcine kidney into a brain-dead human model · Discuss ongoing obstacles to successful xenotransplantation and next steps References Porrett, P. M., Orandi, B. J., Kumar, V., Houp, J., Anderson, D., Cozette Killian, A., Hauptfeld-Dolejsek, V., Martin, D. E., Macedon, S., Budd, N., Stegner, K. L., Dandro, A., Kokkinaki, M., Kuravi, K. v., Reed, R. D., Fatima, H., Killian, J. T., Baker, G., Perry, J., … Locke, J. E. (2022). First clinical-grade porcine kidney xenotransplant using a human decedent model. American Journal of Transplantation , 22 (4). https://doi.org/10.1111/ajt.16930 Schlich, T., & Lutters, B. (2022). Historical perspectives on xenotransplantation. The Lancet , 399 (10331). https://doi.org/10.1016/s0140-6736(22)00529-3 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 5, 2022

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** You are faced with a young patient with an advanced colon cancer. You suspect Lynch syndrome. He asks if he should undergo total colectomy as opposed to segmental colectomy. How do you approach such a patient? Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about Lynch syndrome, also known as Hereditary Non-polyposis Colorectal Cancer (HNPCC). Learning objectives - To understand the rationale for universal testing for MMR deficiency of newly diagnosed colorectal cancers. - To know when to recommend screening for CRC for patients with LS and to those who have undergone resection - To understand the prevalence of cancers other than CRCs associated with Lynch syndrome, especially endometrial cancer. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

May 2, 2022

The landscape of surgery is shifting, reflecting the diverse composition of graduating medical students and the efforts to recruit the most talented people into the field. It is one thing to have a diverse group of people within surgery, but it is an entirely different thing to ensure a welcoming, supportive environment for them. In this Journal Club episode, we review these topics from the perspective of eminent surgeons Drs. Caprice and Jake Greenberg, who share with us their insights on recent articles examining the experience of women surgeons and trainees. We’re joined by Dr. Cary Schlick, who authored one of these articles, to shed light on a key issue for the field. Learning Objectives: · Identify some of the challenges for women in surgical training programs · Discuss how stereotype threat can impact performance · Suggest ways to advocate for equity in surgery References: Experiences of Gender Discrimination and Sexual Harassment Among Residents in General Surgery Programs Across the US - https://doi.org/10.1001/jamasurg.2021.3195 Effects of Gender Bias and Stereotypes in Surgical Training: A Randomized Clinical Trial - https://doi.org/10.1001/jamasurg.2020.1127 Gender Bias and Stereotypes in Surgical Training: Is It Really Women Residents We Need to Worry About? - https://doi.org/10.1001/jamasurg.2020.1561 The effect of gender on operative autonomy in general surgery residents - https://doi.org/10.1016/j.surg.2019.06.006 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 28, 2022

Mattox Vegas TCCACS 2022: Ep. 2 The Trauma, Critical Care, and Acute Care Surgery conference (aka the MATTOX conference, named after trauma surgery legend Kenneth L Mattox) is the longest running show in Las Vegas at 55 consecutive years. The MATTOX conference is unique in its focus on clinical topics. Every talk, every panel, and every case discussion is relevant and practical. Join Behind the Knife as we use case-based discussions to hammer home key points from lectures given by some of the biggest names in trauma, critical care, and acute care surgery. This is episode 2 of 2. The lineup: Hasan Alam, MD (@DrHasanAlam) Scott Steele, MD (@ScottRSteeleMD) Joseph Dubose, MD (check out his exceptional podcast here: https://www.tiger-country.org/ ) Mathew Martin, MD (@docmartin22) Red Hoffman, MD (@redMDND, check out her amazing podcast here: https://thesurgicalpalliativecarepodcast.buzzsprout.com/ ) Bellal Joseph, MD (@TopKnife_B) Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 25, 2022

The Trauma, Critical Care, and Acute Care Surgery conference (aka the MATTOX conference, named after trauma surgery legend Kenneth L Mattox) is the longest running show in Las Vegas at 55 consecutive years. The MATTOX conference is unique in its focus on clinical topics. Every talk, every panel, and every case discussion is relevant and practical. Join Behind the Knife as we use case-based discussions to hammer home key points from lectures given by some of the biggest names in trauma, critical care, and acute care surgery. This is episode 1 of 2. The lineup: Dennis Kim, MD (@traumaicurounds, check out his amazing podcast here: https://www.traumaicurounds.ca/ ) Ali Salim, MD (@alisalimMD) Jason Smith, MD (@DrJTrauma) Andre Campbell, MD (@TraumaDocSF) Meghan Lewis, MD Demetrios Demetriades, MD Alexander Eastman, MD (@PMHTrauma_ALE) Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 21, 2022

The mortality rate for unstable pelvic hemorrhage due to blunt trauma remains around 30 percent. However, technological advances promise to finally make a dent. But on the cutting edge, it’s not clear which treatments should be used when to maximize lives saved. With life-threatening pelvic exsanguination, time is critical. Do you know when to rush to pack the pelvis? Do you know when to deploy a REBOA instead? Are there scenarios where you should do both? Join Drs. Urréchaga, Neeman, and Rattan from Ryder Trauma Center in Miami as they try to tease out answers using two studies hot off the presses with seemingly contradictory results. Learning Objectives: Blunt Pelvic Hemorrhage · Expanding knowledge of management strategies for blunt pelvic hemorrhage · Describe propensity score matching and its use in non-randomized studies · Compare outcomes of REBOA and preperitoneal pelvic packing (PPP) · Critically appraise study design and methods of studies References 1. S. Mikdad, I.A.M. van Erp, M.E. Moheb, et al. Pre-peritoneal pelvic packing for early hemorrhage control reduces mortality compared to resuscitative endovascular balloon occlusion of the aorta in severe blunt pelvic trauma patients: A nationwide analysis. Injury. 2020; 51:1834–1839. doi.org/10.1016/j.injury.2020.06.003 2. S. Asmar, L. Bible, M. Chehab, et al. Resuscitative Endovascular Balloon Occlusion of the Aorta vs Pre-Peritoneal Packing in Patients with Pelvic Fracture. Journal of the American College of Surgeons. 2021; 232(1):17-26. doi.org/10.1016/j.jamcollsurg.2020.08.763 3. B. Joseph, M. Zeeshan, J.V. Sakran, et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surg. 2019;154(6):500-508. doi:10.1001/jamasurg.2019.0096 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 18, 2022

EPAs are coming in 2023. This isn’t about your carbon emissions, but it will dramatically impact surgery training programs. Join Drs. Karen Brasel, Jeremy Lipman, Judith French, and Amy Han as they discuss Entrustable Professional Activities (EPAs) and how they will change the way we assess trainees. Learning Objectives 1. Listeners will be able to define entrustable professional activities (EPAs) within the context of competency-based education during General Surgery residency training 2. Listeners will be able to understand the impetus behind adopting EPA assessments for surgical trainees. 3. Listeners will be able to interpret and apply EPA assessment data based on the discussion of the example scenarios. References: Brasel KJ, Klingensmith ME, Englander R, Grambau M, Buyske J, Sarosi G, Minter R. Entrustable professional activities in general surgery: development and implementation. Journal of surgical education. 2019 Sep 1;76(5):1174-86. Lindeman B, Brasel K, Minter RM, Buyske J, Grambau M, Sarosi G. A Phased Approach: The General Surgery Experience Adopting Entrustable Professional Activities in the United States. Acad Med . 2021;96(7S):S9-S13. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 14, 2022

Dr. Michael Rosen returns to Behind the Knife – this time to discuss his RCT investigating biologic vs. synthetic mesh for single-stage repair of contaminated ventral hernias. Read the full article here in JAMA Surgery: https://jamanetwork.com/journals/jamasurgery/article-abstract/2788222 Dr. Rosen is the director for the Center of Abdominal Core Health at the Cleveland Clinic and has written the “Atlas of Abdominal Wall Reconstruction”. Want to learn more about his work and the Hernia Quality Collaborative? Catch up on Dr. Rosen’s previous episode on Behind the Knife: Episode #21 (August 15, 2015): Hernias, Abdominal Wall Reconstruction, and Quality Collaboratives https://behindtheknife.org/podcast/21-hernias-abdominal-wall-recon-and-quality-collaboratives-dr-michael-rosen/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 11, 2022

Welcome to the third of a six-part series focused on the integration of palliative care into the practice of surgery. Malignant bowel obstructions occur in 5-43 percent of patients with a diagnosis of advanced primary or metastatic intra-abdominal malignancy and both acute care surgeons and surgical oncologists are called upon to manage this condition. Using the case of an elderly gentleman with gastric outlet obstruction secondary to gastric cancer, in this episode we discuss how to approach a patient with a malignant bowel obstruction, review the medical and surgical options for management, discuss the importance of primary palliative care, define palliative surgery and conclude with a short rant about the necessity of being cognizant of one’s feelings and of taking the time and creating the space to discuss them. Fast Fact #45: Medical Management of Bowel Obstructions https://www.mypcnow.org/fast-fact/medical-management-of-bowel-obstructions/ Chapter 8, Malignant Bowel Obstruction in Surgical Palliative Care: A Resident’s Guide https://www.facs.org/~/media/files/education/palliativecare/surgicalpalliativecareresidents.ashx Palliative surgery and the surgeon’s role in the palliative care team: a review. https://apm.amegroups.com/article/download/72758/pdf Dr. Red Hoffman (@redmdnd) is an acute care surgeon and associate hospice medical director in Asheville, North Carolina, host of the Surgical Palliative Care Podcast (@surgpallcare) and co-founder of the recently launched Surgical Palliative Care Society ( www.spcsociety.org ). Dr. Fabian Johnston (@fabianjohnston) is Associate Professor of Surgery and Oncology and Chief, Division of GI Surgical Oncology at Johns Hopkins University. Dr. Amanda Stastny (@manda_plez) is a PGY-2 in the General Surgery program at Mountain Area Health Education Center (MAHEC) in Asheville, NC. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 7, 2022

Umbilical hernias a common diagnoses that general surgeons must manage. Though these hernias are considered relatively simple problems to resolve, certain populations of patients are prone to higher rates of complications. As abdominal wall surgery has advanced, so to have the options that exist in management of primary umbilical hernias. The session will review common clinical circumstances and high-risk patient presentations. We will generally review the approaches to repair and the thought processing and data driving decision making. · Dr. Vahagn Nikolian is an Assistant Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. · Dr. Sean Orenstein is an Associate Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. · Dr. Shahrose Rahman is a resident in General Surgery at Oregon Health & Science University. Seminal Papers in Umbilical Hernia Management Guidelines for treatment of umbilical and epigastric hernias ( Henriksen et al. Br J Surg. 2020.) : https://pubmed.ncbi.nlm.nih.gov/31916607/ Hernia-Neck Ratio: Predicting Factors for Complications of Umbilical Hernias ( Fueter et al. WJS. 2016. ): https://pubmed.ncbi.nlm.nih.gov/27194561/ Safety and effectiveness of umbilical hernia repair in patients with cirrhosis ( Hew et al. Hernia. 2018. ): https://pubmed.ncbi.nlm.nih.gov/29589135/ Fix it while you can...Mortality after umbilical hernia repair in cirrhotic patients ( Hill et al. Amer Journal of Surgery. 2020. ): https://pubmed.ncbi.nlm.nih.gov/32988606/ Postoperative complications with retromuscular mesh placement in emergency incisional hernia repair ( Juul et al. Scand J Surg. 2021. ): https://pubmed.ncbi.nlm.nih.gov/33092472/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Apr 4, 2022

Warning! There is magic contained in this podcast. Real magic. The kind of magic that allows you to understand how to manage the axilla in breast cancer patients. The standard of care approach to management of the axilla in patients with breast cancer has evolved rapidly. While a complete axillary dissection was historically indicated following identification of any positive nodes, that is no longer the case; indeed, axillary dissections are now uncommonly performed. Join Drs. Michael Alvarado, Rita Mukhtar, and Alexa Glencer as they discuss the impact of the ACOSOG Z0011, AMAROS, and ACOSOG Z1071 trials in defining the role of sentinel lymph node dissection and radiotherapy in patients with early-stage breast cancer with limited lymph node involvement as well as the approach when neoadjuvant chemotherapy has been received. Learning Objectives: · Describe the study design and results of the ACOSOG Z0011 trial and its impact on the use of sentinel lymph node biopsy as an alternative to complete axillary lymph node dissection in clinically node-negative patients with T1 or T2 breast cancer · Describe the study design and results of the AMAROS trial and its implications for use of axillary radiation as an alternative to axillary lymph node dissection for patients with clinically node-negative T1 or T2 breast cancer · Understand the risk of lymphedema related to complete axillary lymph node dissection, as demonstrated by the AMAROS trial · Describe the study design and results of the ACOSOG Z1071 trial and how interpretation of its subgroup analysis has been applied to our approach of offering sentinel lymph node biopsy as a means of staging the axilla following neoadjuvant chemotherapy in patients with clinical node-positive disease at the time of diagnosis Journal Article Links: ACOSOG Z0011: https://jamanetwork.com/journals/jama/article-abstract/2653737 AMAROS: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)70460-7/fulltext ACOSOG Z1071: https://jamanetwork.com/journals/jama/fullarticle/1748149%20 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 31, 2022

Join our Emergency General Surgery Team as they discuss EGS in patients > 65. Introduction - > 65 = 40% of EGS admissions - In-hospital mortality for EGS in older adults is approximately 7-12% and the one-year mortality is around 30-38%. - High risk due to decreased reserve, poor nutritional status, and chronic medical conditions - Frailty correlates with poor post-operative outcomes Paper #1: Mehta A, Dultz LA, Joseph B, Canner JK, Stevens K, Jones C, Haut ER, Efron DT, Sakran JV. Emergency general surgery in geriatric patients: A statewide analysis of surgeon and hospital volume with outcomes. J Trauma Acute Care Surg. 2018 Jun;84(6):864-875. - retrospective population-based cross-sectional study using administrative data. - looks at the association between surgeon and hospital annual experience with outcomes in geriatric patients with EGS conditions. - Note Table 2 provides outcomes broken down by type of surgery - Key finding: patients operated on by a low-volume surgeon had about twice the odds of mortality, and 1.7X the odds of failure to rescue Paper #2: Guttman MP, Tillmann BW, Nathens AB, Saskin R, Bronskill SE, Huang A, Haas B. Alive and at home: Five-year outcomes in older adults following emergency general surgery. J Trauma Acute Care Surg. 2021 Feb 1;90(2):287-295. - large-scale population-based retrospective cohort study looking at long-term outcomes of older adults with admissions for emergency general surgery diagnoses - primary outcome of interest is “aging in place” or being able to reside in one’s home for as long as possible. - Key finding: being admitted for an EGS diagnosis reduces your survival and time in your home by about 7 months. - Very little reduction in low-risk diagnoses (acute appendicitis/cholecystitis) - 57% of patients were alive and in their home 5 years later Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 28, 2022

Thoughts of esophageal perforations keeping you up at night? Actual esophageal perforations keeping you up at night? Drs. Brian Louie, Peter White, and Megan Lenihan discuss both the tried-and-true and the cutting-edge management of this challenging problem. Learning Objectives - Understand basic principles of management - Review differences in management based on different underlying pathology and location - Learn indications and techniques for advanced endoscopic interventions for perforations - Discuss nutrition planning Referenced Material - Thornblade LW, Cheng AM, Wood DE et al. A Nationwide Rise in the Use of Stents for Benign Esophageal Perforation. Ann Thorac Surg 2017; 104(1):227-233. DOI: 10.1016/j.athoracsur.2017.03.069 http://dx.doi.org/10.1016/j.athoracsur.2017.03.069 - Watkins JR and Farivar AS. Endoluminal Therapies for Esophageal Perforations and Leaks. Thorac Surg Clin 2018; 28(4):541-554. DOI: 10.1016/j.thorsurg.2018.07.002 https://doi.org/10.1016/j.thorsurg.2018.07.002 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 24, 2022

A trauma patient rolls into the bay. CPR started 10 minutes ago. They are pulseless, the entire trauma team is looking to you for leadership, and the thoracotomy tray is prepped and ready. Do you pick up the knife and cut? Welcome back to the BIG T TRAUMA series. Join Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill for a high-level discussion on the one surgical procedure that trumps them all – the ED thoracotomy. This is episode 2 of 2. In episode 1 we discussed who should get an ED thoracotomy. Today, we cover how to do it. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 21, 2022

A trauma patient rolls into the bay. CPR started 10 minutes ago. They are pulseless, the entire trauma team is looking to you for leadership, and the thoracotomy tray is prepped and ready. Do you pick up the knife and cut? Welcome back to the BIG T TRAUMA series. Join Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill for a high-level discussion on the one surgical procedure that trumps them all – the ED thoracotomy. This is episode 1 of 2. In episode 1 we discuss who should get an ED thoracotomy and in episode 2 we cover how to do it. Listen to learn about the guidelines, signs of life, ultrasound, survival, and when NOT to do an ED thoracotomy. EAST: https://www.east.org/education-career-development/practice-management-guidelines/details/emergency-department-thoracotomy WTA: https://www.westerntrauma.org/wp-content/uploads/2020/08/Resuscitative-Thoracotomy_FINAL.svg WakeMed Blunt Pulseless Trauma Resuscitation Guideline: https://www.wakemed.org/sites/default/files/hg_features/mercury_standard_layout/031abaa9027e1685ad340ac8f662e86a.pdf Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 17, 2022

In the episode we will cover the following learning objectives: · Listeners should be able to describe the evolution and changes in definitions sepsis over the past three decades · Listeners should be familiar with the three randomized controlled trials that studies early-goal directed therapy · Listeners should be able to describe the major changes in the new 2021 SCCM Sepsis Guidelines · Listeners should be able to describe the fundamental principles of sepsis management in the ICU References: https://www.nejm.org/doi/full/10.1056/nejmoa1500896 https://www.nejm.org/doi/full/10.1056/nejmoa1404380 https://www.nejm.org/doi/full/10.1056/nejmoa1701380 https://www.nejm.org/doi/full/10.1056/nejmoa1401602 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 14, 2022

You are seeing a young female patient in the clinic with rectal prolapse. When do you offer surgery? Does she get a perineal approach or a transabdominal approach? Open or minimally invasive? Mesh or no mesh? Sigmoid resection or no resection? Join Drs. Abelson, Marcello and Aulet as they take us through the wide world of rectal prolapse! Learning Objectives: 1. Describe the difference between rectal prolapse and hemorrhoidal prolapse 2. List the different approaches to surgical management of rectal prolapse 3. Discuss the approach to recurrent rectal prolapse Be sure to check out the associated video below. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 10, 2022

In this episode from the Endocrine Surgery team at BTK we go through three controversial topics in endocrine surgery and cite pertinent articles during a lively debate format. We debate the role of four-gland exploration versus focused exploration for parathyroid disease. Indications for parathyroidectomy are hotly contested. And finally, we discuss the role and relevance of using a nerve monitor. Tune in to see if Dr. Yeh and Dr. Wu remain collegiate after recording this episode… Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established. Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. Vivek Sant is an Endocrine Surgery Fellow at UCLA in his first year of fellowship Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research Dr. Max Schumm is a PGY-5 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon. Important Papers Norlén O, Wang KC, Tay YK, Johnson WR, Grodski S, Yeung M, Serpell J, Sidhu S, Sywak M, Delbridge L. No need to abandon focused parathyroidectomy: a multicenter study of long-term outcome after surgery for primary hyperparathyroidism. Ann Surg. 2015 May;261(5):991-6. doi: 10.1097/SLA.0000000000000715. PMID: 25565223. Schneider DF, Mazeh H, Sippel RS, Chen H. Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1,000 cases. Surgery. 2012 Dec;152(6):1008-15. doi: 10.1016/j.surg.2012.08.022. Epub 2012 Oct 12. PMID: 23063313; PMCID: PMC3501613. Jinih M, O'Connell E, O'Leary DP, Liew A, Redmond HP. Focused Versus Bilateral Parathyroid Exploration for Primary Hyperparathyroidism: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2017 Jul;24(7):1924-1934. doi: 10.1245/s10434-016-5694-1. Epub 2016 Nov 28. PMID: 27896505. Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP. A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999 Oct 21;341(17):1249-55. doi: 10.1056/NEJM199910213411701. Erratum in: N Engl J Med 2000 Jan 13;342(2):144. PMID: 10528034. Seib CD, Meng T, Suh I, Harris AHS, Covinsky KE, Shoback DM, Trickey AW, Kebebew E, Tamura MK. Risk of Fracture Among Older Adults With Primary Hyperparathyroidism Receiving Parathyroidectomy vs Nonoperative Management. JAMA Intern Med. 2022 Jan 1;182(1):10-18. doi: 10.1001/jamainternmed.2021.6437. PMID: 34842909; PMCID: PMC8630642. Yeh MW, Zhou H, Adams AL, Ituarte PH, Li N, Liu IL, Haigh PI. The Relationship of Parathyroidectomy and Bisphosphonates With Fracture Risk in Primary Hyperparathyroidism: An Observational Study. Ann Intern Med. 2016 Jun 7;164(11):715-23. doi: 10.7326/M15-1232. Epub 2016 Apr 5. PMID: 27043778. Zanocco K, Butt Z, Kaltman D, Elaraj D, Cella D, Holl JL, Sturgeon C. Improvement in patient-reported physical and mental health after parathyroidectomy for primary hyperparathyroidism. Surgery. 2015 Sep;158(3):837-45. doi: 10.1016/j.surg.2015.03.054. Epub 2015 May 29. PMID: 26032828. Barczyński M, Konturek A, Cichoń S. Randomized clinical trial of visualization versus neuromonitoring of recurrent laryngeal nerves during thyroidectomy. Br J Surg. 2009 Mar;96(3):240-6. doi: 10.1002/bjs.6417. PMID: 19177420. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 7, 2022

Our oral board review course includes 92 scenarios that meticulously cover 115 SCORE core topics . Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the Oral Board Review episodes at https://behindtheknife.org/premium/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Mar 3, 2022

The Vascular Surgery Oral Board Review Book has 60 of the highest yield scenarios that cover the majority of the VSCORE topics in an easy-to-read question and answer format that highlights the most important clinical concepts, concise procedural descriptions, and common surgical complications that everyone should know about the field of Vascular Surgery. Whether you are looking to excel on the wards or crush the boards, this book was created to help you Dominate the Day. https://behindtheknife.org/premium/ https://www.amazon.com/dp/0578382296?ref_=pe_3052080_397514860 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.