Behind The Knife: The Surgery Podcast

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“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

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

Joining Dr. Scott Steele today on Behind the Knife is Steve Crandall, a former medical negligence DEFENSE lawyer who, for reasons we will discuss, switched sides and now represents the patient who is suing care providers.  He is a founding partner of Crandall & Pera Law and also has been ranked as both one of the Top 5 Lawyers in Cleveland and Top 10 best Lawyers in Ohio for over 15 years. Crandall, a seasoned plaintiff attorney specializing in medical malpractice, joins the hosts to illuminate the key factors behind common lawsuits in surgery, the pivotal role of informed consent, standout cases with crucial learning points, expert witness strategies, and practical advice for surgeons to stay out of legal trouble. 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

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

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

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

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

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

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

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

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

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

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

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.  

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.  

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.  

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.  

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

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

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

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

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

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

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

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

Join us as we dissect the use of robotics in bariatric surgery – where precision meets programming, and the scalpel gets a software upgrade.  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

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

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