Podcasts about gastrointestinal surgery

SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here's where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It's all about helping the body maintain balance during a time when it's incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body's anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you've lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it's really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it's effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you're planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition supplement in the 5-7 days pre op. These are the supplements loaded with arginine, n3s, glutamine and nucleotides to support the immune system and reduce inflammatory responses, potentially leading to fewer infections and better recovery.Step 3: Build Your Strength & Energy Stores prior to surgery Carb load with food in the days leading up to surgery - think that big bowl of pasta a footy player would have the night before the grand final. ERAS protocols have significantly reduced or eliminated long periods of "nil by mouth" (NBM) before surgery.Ask your surgical team exactly when you need to stop eating solid food – it might be much later than you think, often around 6 hours before surgery for a light meal. For clear fluids, it could be as little as 2 hours before!We'll make the most of every second to prevent unnecessary dehydration, hunger, anxiety, and preserve your body's energyStep 4: The Pre-Surgery Carb Load using clear fluidsMany ERAS protocols include a special carbohydrate-rich drink taken a few hours before surgery. Your hospital may provide this, but if they don't, we can organise orders for you or point you in the right direction.  It's usually a clear, sweet drink. Think of it as topping off your fuel tank right before the 'race'."These have been shown to reduce post-operative insulin resistance (which can slow healing), help maintain muscle strength, can reduce nausea, and improve overall wellbeing. It basically tells your body it's in a 'fed' state, not a 'starvation' state, heading into surgery.This is best done with tailor made medical nutrition drinks as they come prepped with the correct doses of maltodextrin-polymer carbs and a lower osmolality than other solutions, which essentially means they gentler on your gut and better for gastric emptying so they don't linger in your gut during surgery. Always follow surgical instructions, but ideally we're aiming for 100 grams of carbohydrate the night before surgery and about 50 grams of carbohydrate in clear fluids approximately 2 hours before anesthesia. This might look like 4 x 200ml drinks the night before, and 2 the morning of surgery If you can't access these drinks, apple or cranberry juice are reasonable replacements.  Drop us an email or message or give us a call if you'd like advice on where to get pre-op and immunonutrition supplement drinks. Then we move on to post op and Step 5 which is aiming to eat early.  ERAS encourages starting to eat and drink as soon as it's safe after surgery – often within hours, not days!As soon as your team says it's okay, try sipping water, then progress to other clear fluids, and then light foods as tolerated. Even small, frequent amounts help. This helps to stimulates your gut to start working again, reducing the risk of ileus – a slow, sleepy bowel, provides energy for healing, and can help you feel more normal, faster.If you haven't been told you can eat or drink, keep asking the question! You are your best advocate! Another tip that can help here is step 6:  Chew GumIf your team allows it, start chewing sugar-free gum several times a day once you're able. It sounds simple, but it can be surprisingly helpful in mimicking eating even when you're not allowed to, and can stimulate your digestive system to return to usual function sooner and reduce the risk of ileus.Step 7 is to Nourish to Heal This is where we bring in our good friend protein to optimise tissue repair and recovery Include protein rich food at each meal, and chat to us if you're finding this difficult because there are plenty of hacks if you're not feeling up to chicken breast and steak! And finally step 8 is to Listen to Your BodyWhile ERAS encourages early eating, we always want you to be tuned in to your body's cues and speaking up to your medical team and us if something doesn't feel right. There are plenty of interventions that can be used to keep you comfortable while still optimising your nutrition to get the best outcomes from surgery. Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., et al. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745-4761.Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Laviano, A., Ljungqvist, O., et al. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623-650.Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., et al. (2019). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. Clinical Nutrition, 38(2), 576-586. (Note: The ERAS® Society website, erassociety.org, is the primary source for the most current and comprehensive suite of procedure-specific guidelines.)Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292-298.Thiele, R. H., Raghunathan, K., Brudney, C. S., Campos, S., Candiotti, K., Chaves, S., et al. (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management in adults. Perioperative Medicine, 5, 26. (Note: This is an example of ASER/POQI consensus; look for other relevant POQI statements on specific surgical procedures and their nutritional components.)Soon, K., Levy, G. M., Cusack, L. A., Varma, S., & Nicholson, G. A. (2020). The effect of preoperative carbohydrate loading on patient outcomes in elective surgery: A systematic review and meta-analysis. Systematic Reviews, 9(1), 254.Lewis, S. J., Egger, M., Sylvester, P. A., & Thomas, S. (2001). Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ, 323(7316), 773-776.Osland, E. J., Hossain, M. A., Khan, S., & Memon, M. A. (2014). Effect of timing of oral feeding on patient outcomes after elective colorectal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 18(5), 1039-1051.Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of Surgery, 137(2), 174-180.Marimuthu, K., Varadhan, K. K., Ljungqvist, O., & Lobo, D. N. (2012). A meta-analysis of the effect of combinations of enhanced recovery after surgery (ERAS) interventions on postoperative outcomes. Annals of Surgery, 255(4), 640-649.

There have been monumental advancements in treatments for diseases and disorders of the pancreas in recent decades. In this episode of Advance with MUSC Health, Katherine Morgan, MD, professor of surgery and chief of the Division of Gastrointestinal Surgery and Laparoscopic Surgery at MUSC Health, talks about the function of the pancreas, causes of pancreatic disorders, and the different treatment options available at MUSC Health.

In this episode of the Better Edge podcast, Srinadh Komanduri, MD, professor of Gastroenterology and Hepatology, and of Gastrointestinal Surgery at Northwestern Medicine, discusses Barrett's esophagus. He covers the diagnosis progress, the treatment options at Northwestern Medicine for the disease and how they screen for signs of esophageal adenocarcinoma.

This week, Jonathan is joined by Monica Jain, Assistant Professor of Surgery, Division of Minimally Invasive, Gastrointestinal and Endocrine Surgery, and Surgical Innovation Officer at the Cedars-Sinai Health System, Beverly Hills, California, USA. They discuss the development of new healthcare innovations, human-centred design, and the role of women in biomedical engineering and technology.

Dr. Martin Adel Makary, M.D. is a British-American surgeon, professor, author and medical commentator. He practices surgical oncology and gastrointestinal laparoscopic surgery at the Johns Hopkins Hospital, is Mark Ravitch Chair in Gastrointestinal Surgery at Johns Hopkins School of Medicine, and teaches public health policy as Professor of Surgery and Public Health at the Johns Hopkins Bloomberg School of Public Health. Makary was named one of the most influential people in healthcare by HealthLeader magazine.(2) In 2018, Makary was elected to the National Academy of Medicine.(3) During the COVID-19 pandemic, Makary has been a prolific pundit discussing the topics of COVID-19 and mitigation strategies. He was an early advocate for universal masking to control the pandemic and recommends vaccines for adults,(4) but has been an outspoken opponent of broad vaccine mandates and some COVID restrictions at schools.(5)(6)

Dr. Martin Adel Makary, M.D. is a British-American surgeon, professor, author and medical commentator. He practices surgical oncology and gastrointestinal laparoscopic surgery at the Johns Hopkins Hospital, is Mark Ravitch Chair in Gastrointestinal Surgery at Johns Hopkins School of Medicine, and teaches public health policy as Professor of Surgery and Public Health at the Johns Hopkins Bloomberg School of Public Health. Makary was named one of the most influential people in healthcare by HealthLeader magazine.(2) In 2018, Makary was elected to the National Academy of Medicine.(3) During the COVID-19 pandemic, Makary has been a prolific pundit discussing the topics of COVID-19 and mitigation strategies. He was an early advocate for universal masking to control the pandemic and recommends vaccines for adults,(4) but has been an outspoken opponent of broad vaccine mandates and some COVID restrictions at schools.(5)(6) This podcast discusses COVID, what we did right and what we did wrong.

In this episode, Kyle H. Mueller, MD, assistant professor of Gastrointestinal Surgery at Northwestern Medicine, discusses updates in robotic cholecystectomy. Dr. Mueller covers the advantages of a robotic-assisted laparoscopic cholecystectomy compared to a standard laparoscopic cholecystectomy, how this approach may evolve in the future and more.

This month, Drs. Daniel Nelson and Jessica Zaman are joined by Dr. James Ellsmere. In this episode, Dr. Ellsmere talks about the recent article published in the Journal of Gastrointestinal Surgery titled, "Morbid Obesity and Severe Knee Osteoarthritis: Which Should Be Treated First"

In this episode, Vitaliy Y. Poylin, MD, associate professor of Gastrointestinal Surgery at Northwestern Medicine, discusses how the diagnosis and treatment of colorectal cancer has evolved over the years, particularly advances in surgical interventions. Dr. Poylin highlights Lynch syndrome, adenomatous polyposis syndromes and more.

This month, Drs. Jessica Zaman and Connie Shao are joined by Dr. Phillip Fleshner In this episode, Dr. Fleshner talk about the recent article published in the Journal of Gastrointestinal Surgery titled, "A Single-Center Comparative Study of Open Transabdominal and Laparoscopic Transanal Ileal Pouch-Anal Anastomosis with Total Mesorectal Excision. Has the Bar Been Raised?”

In this episode, Mohammad Ali Abbass, MD, assistant professor of Gastrointestinal Surgery, Charles M. Muller, MD, instructor of Medicine in the Department of Gastroenterology and Hepatology, and Brittany M. Szymaniak, PhD, CGC, instructor of Urology with a focus in Genetics, discuss how the diagnosis and treatment of colorectal cancer have evolved over the years, and the latest advancements made at Northwestern Medicine.

This month, Drs. Young K. Hong and Daniel W. Nelson are joined by Drs. Ching-Wei D. Tzeng & Timothy J. Vreeland. In this episode, Drs. Tzeng & Vreeland talk about the recent article published in the Journal of Gastrointestinal Surgery titled, "Contemporary Assessment of Need for Palliative Bypass After Aborted Pancreatoduodenectomy Following Neoadjuvant Therapy."

In this episode, Ezra N. Teitelbaum, MD, MEd, assistant professor of Gastrointestinal Surgery at Northwestern Medicine, discusses what makes a patient a good candidate for anti-reflux surgery. Dr. Teitelbaum shares the surgical and endoscopic options available for patients requiring treatment, and what patients can expect in terms of recovery, outcomes and side effects after surgery.

This month, Drs. Daniel Nelson and Connie Shao are joined by Dr. Russell Hodgson. In this episode, Dr. Hodgson. talks about the recent article published in the Journal of Gastrointestinal Surgery titled, "Reduced Laparoscopic Intra-Abdominal Pressure during Laparoscopic Cholecystectomy and Its Effect on Post-Operative Pain: A Double-Blinded Randomised Control Trial."

Dr. Pat Sylla (https://twitter.com/patsyllamd?s=20&t=_w5QG96wjQE-0ttVJJaUmw) is a minimally invasive and colorectal surgeon at Mount Sinai Hospital in New York. She is a world famous innovator and was the first surgeon in the world to perform a transanal total mesorectal excision for rectal cancer. We caught up with her in-person (!) at the recent Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) annual meeting. Shout out to SAGES for putting on a great conference! Links: 1. Pat Sylla talk on Truths, Half-Truths, Fake News about taTME https://www.youtube.com/watch?v=ahWOaKa5WeQ 2. Sylla P, Rattner DW, Delgado S et al. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc 2010;24:1205–10. https://pubmed.ncbi.nlm.nih.gov/20186432/ 3. Urethral Injury and Other Urologic Injuries During Transanal Total Mesorectal Excision: An International Collaborative Study. https://pubmed.ncbi.nlm.nih.gov/31567502/ 4. Consensus on structured training curriculum for transanal total mesorectal excision (TaTME). https://pubmed.ncbi.nlm.nih.gov/28462478/ 5. SAGES 2022 Presidential Address with Dr. Liane Feldman: https://vimeo.com/showcase/9362041/video/689727749 6. SAGES 2022 Gerald Mark Lecture by KMarie King: https://vimeo.com/showcase/9362041/video/689071108 7. SAGES 2022 General Session on Worldwide Variation in TME. Dr. Sylla is one of the panelists: https://vimeo.com/showcase/9362041/video/689468095 Bio (from https://www.mountsinai.org/profiles/patricia-sylla) Dr. Sylla has been a leader in developing minimally invasive approaches to the surgical treatment of colon and rectal cancer. She joins Mount Sinai from Massachusetts General Hospital, where she practiced for seven years within the Division of General and Gastrointestinal Surgery and was an Assistant Professor of Surgery at Harvard Medical School. While there, Dr. Sylla developed a research and clinical program using Natural Orifice Translumenal Endoscopic Surgery (NOTES). NOTES represents an innovative approach to transanal surgery, which may allow for faster recovery and fewer operative complications. In 2009, Dr. Sylla performed the first-ever rectal cancer surgery on a human using this approach. She has since extended this in a pilot study and is helping train surgeons in this technique. Dr. Sylla's clinical interests include laparoscopic and robotic surgery for colon and rectal cancer, diverticulitis, rectal prolapse, ulcerative colitis and Crohn's disease, transanal endoscopic microsurgery (TEM), and treatment of benign anorectal disorders. Dr. Sylla received a Bachelor of Science degree Cum Laude in Biology from Georgetown University. She earned a Doctor of Medicine from Weill Cornell Medical College. Dr. Sylla completed residency training in Surgery at Columbia University Medical Center. Subsequently, she completed two fellowship training programs; Colon & Rectal Surgery at The Mount Sinai Hospital and Minimally Invasive Surgery at Massachusetts General Hospital. Furthermore, Dr. Sylla has is highly trained and experienced in treating rectal prolapse and performing transanal endoscopic surgery.

This month, Dr. Young Hong and Dr. Connie Shao are joined by Dr. Annabelle Fonseca. In this episode, Dr. Fonseca talks about the recent article published in the Journal of Gastrointestinal Surgery titled "Surgical Resection of Colorectal Liver Metastases: Attitudes and Practice Patterns in the Deep South"

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. Lee M. Ocuin. In this episode, Dr. Ocuin talks about the recent article published in the Journal of Gastrointestinal Surgery titled "Association Between Operative Approach and Venous Thromboembolism Rate Following Hepatectomy: a Propensity-Matched Analysis"

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. David Watson. In this episode, Dr. Watson talks about the recent article published in the Journal of Gastrointestinal Surgery titled "Laparoscopic Fundoplication Is Effective Treatment for Patients with Gastroesophageal Reflux and Absent Esophageal Contractility".

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. David L. Berger. In this episode, Dr. Berger talks about the recent article published in the Journal of Gastrointestinal Surgery titled "Adjuvant Chemotherapy Benefits on Patients with Extramural Vascular Invasion in Stages II and III Colon Cancer".

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. Ajay V. Maker. In this episode, Dr. Maker talks about the recent article published in the Journal of Gastrointestinal Surgery titled "Epidural Analgesia Is Associated with Prolonged Length of Stay After Open HPB Surgery in Over 27,000 Patients".

The Perioperative Exercise Testing and Training Society (POETTS) presents "Nutrition and patient living with and beyond cancer" in partnership with the Macmillan Trust. A real stand out moment from this year's Evidence Based Perioperative Medicine (EBPOM) London. This discussion is essential listening for anyone interested in pre-optimisation, muscle mass, nutrition, malnourishment - how to spot it and what to do about it, surgery and the importance of protein. Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands, Steven Olde Damink, Consultant HBP Surgeon, University of Maastricht, Dileep Lobo, Professor of Gastrointestinal Surgery, Faculty of Medicine & Health Sciences, University of Nottingham and Consultant Hepatopancreaticobiliary Surgeon at Queen's Medical Centre, Chelsia Gillis, Registered Dietician, McGill University, Ca.

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. Michael Cavnar, Assistant Professor of Surgery and surgical oncologist at the University of Kentucky Markey Cancer Center. In this episode, Dr. Cavnar's recent article published in the July issue of the Journal of Gastrointestinal Surgery titled "Prognostic Factors After Neoadjuvant Imatinib for Newly Diagnosed Primary Gastrointestinal Stromal Tumor" was discussed.

This month, Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. Vlad Simianu. Dr. Simianu is a colon and rectal surgeon at Virginia Mason Franciscan Health in Seattle, WA who also has a special interest in population health, health-services research and surgical education. In this episode the recent review article published in the July issue of the Journal of Gastrointestinal Surgery titled "A Cost Effectiveness Evaluation of Surgical Approaches to Proctectomy" is discussed. Dr. Simianu presents his data from a unique decision-analytic model that was used to evaluate one-year costs and outcomes of robotic, laparoscopic, and open proctectomy based on data from a previously published literature. Which approach is more cost effective and how do different variables affect these outcomes? Listen to find out.

This month Dr. Jessica Zaman and Dr. Daniel Nelson are joined by Dr. Rohan Jeyarajah, Chair of Surgery at the Texas Christian University School of Medicine and Program Director of the HPB and Advanced GI Fellowship programs. This episode focuses on the review article, "Training Paradigms in Hepato-Pancreatico-Billiary Surgery: An Overview of the Different Fellowship Pathways," published in the June issue of the Journal of Gastrointestinal Surgery. In this wide-ranging discussion, Dr. Jeyarajah reviews the current pathways available for specialized training in HPB surgery and outlines common elements as well as unique differences of each. In addition, Dr. Jeyarajah provides insight on optimizing operative experience during residency training and factors involved in selecting a pathway to becoming an HPB surgeon.

Jenny Shao MD discusses complex hernia repair at Penn Medicine. She examines a report calling incisional hernia an epidemic in the US and she tells us about the tool developed by the Penn Hernia Program to predict the risk of incisional hernia. Finally, she shares what can be done to prevent incisional hernia and its recurrence.

Bariatric Surgery is a type of Gastrointestinal Surgery done for the purpose of reducing weight and weight-related co-morbidities, Liposuction is a Cosmetic Surgery done for body shaping and contouring. Liposuction is a purely ‘Cosmetic' Procedure where excess fat deposits under the skin are sucked out through small cuts. This procedure is only and must only be performed for the purpose of body shaping/contouring. Bariatric Surgeries are a set of techniques that are designed to give the person complete and lasting weight loss along with the resolution of all the weight-related problems. ======================================= About Dr. B K Garg(Best Plastic Surgeon in Delhi & Gurgaon): Dr. B K Garg is a Plastic and Cosmetic surgeon practicing in New Delhi and the National capital Region of Delhi. Dr. Garg has close to two decades of experience in cosmetic surgery and aesthetics. Dr. Garg has an unparalleled passion for plastic surgery and aesthetic solutions. Dr. B K Garg puts a lot of faith in the patient safety process and wellbeing of his patients and compassionately guides his patients through recovery following surgery or aesthetic treatments. To Book an Appointment or For any query: Iconique by Dr. BK Garg | Best Cosmetic Surgeon In India 7003, Block C2, DLF Phase IV, Sector 43, Gurugram, Haryana 122002 Tel : 9818152059

Minimally invasive robotic surgery has revolutionized gastrointestinal surgery by offering greater precision for complex procedures, resulting in improved patient outcomes. In this panel interview, Vitaliy Poylin MD, assistant professor of Surgery in the Division of Gastrointestinal Surgery, and Jonah Stulberg, MD, PhD, MPH, assistant professor of Surgery in the Division of Gastrointestinal Surgery, expand on the utility of robotic-assisted minimally invasive gastrointestinal surgery. They review the latest advances and outcomes and share how Northwestern Medicine is bringing robotic surgery for diseases affecting the GI tract to the forefront of care.

In this episode of ASCO eLearning Weekly Podcast Dr. Alessandro Fichera, Division Chief of Gastrointestinal Surgery at University of North Carolina at Chapel Hill, discusses clinical choices in managing rectal cancer. When is surgery the correct choice? When can we put down the knife?

Show Notes and Links here: https://www.chrisbeatcancer.com/dr-kristi-funk-author-of-breasts-the-owners-manual/ You are in control of you. Not genes, not your doctor, not fate, you. -Dr. Kristi Funk Kristi Funk, MD is a board-certified surgical breast specialist and an expert in minimally-invasive diagnostic and treatment methods for all types of breast disease. She has helped thousands of women through breast cancer treatment, including well-known celebrities, including Sheryl Crow and Angelina Jolie. Her published works have appeared in Advanced Therapy of Breast Disease, Surgical Clerkship Manual, Archives of Surgery, the Journal of Gastrointestinal Surgery and the Journal of Clinical Microbiology. She is also the go-to breast expert for Good Morning America and frequently co-hosts The Doctors. She’s also been on Dr. Oz, The Today Show, The View, and CNN. Kristi recently authored the national bestseller, Breasts: The Owner’s Manual – Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes.  Micah and I met Kristi at Fran Drescher’s Cancer Schmancer event in Los Angeles last fall and we immediately hit it off. She’s a brilliant doctor and an incredible person. I just know you’re gonna love her. If you only listen to one part, listen to her talk about soy starting at 35:14. It’s fascinating… Enjoy!

A hernia is a common medical condition that happens when part of an internal organ or tissue pushes through a weak area of muscle, creating a bulge. It is caused by a combination of muscle weakness and straining, like lifting something heavy. Most hernias occur in the abdomen, between the chest and the hips, and they can develop in men, women and children. How common are hernias? Who's at risk? and is surgery the only way to treat hernias? Joining me today to talk more about hernias is Abhishek Parmar, MD, Dr. Parmar is assistant professor in the Division of Gastrointestinal Surgery at the University of Alabama at Birmingham.

Professor Tim Underwood takes us through the history of oesophageal cancer, where we are now, and some of the science that is done to ask questions about where we might go with the treatment of oesophageal cancer. Professor Tim Underwood is professor of Gastrointestinal Surgery at the University of Southampton.

On this episode of the SO Files, Brad and Linda discuss the current state and future of surgical lymph node management. The SO Files welcome special guest, Dr. William Hawkins, Neidorff Family and Robert C. Packman Professor of Surgery and Chief, Section of Hepatobiliary-Pancreatic and Gastrointestinal Surgery at the Washington University School of Medicine/ Siteman Cancer Center. We hope you enjoy this interesting discussion!

Dr. Steele is the Chairman of Colorectal Surgery at the Cleveland Clinic (although at the time of recording this interview, he was the Division Chief of Colon & Rectal Surgery at University Hospitals Cleveland Medical Center) and Professor of Surgery at Case Western Reserve University School of Medicine in Cleveland, OH. Dr. Steele completed his undergraduate degree at the United States Military Academy at West Point in 1994; completed his medical degree at the University of Wisconsin School of Medicine in 1998; completed a general surgery residency at Madigan Army Medical Center in Tacoma, Washington in 2003; then completed a colon and rectal surgery fellowship in 2005. Following completion of his fellowship, Dr. Steele became the Chief of Colorectal Surgery at Madigan Army Medical Center through until 2015, a decade of service which saw him deployed as a staff surgeon to Iraq and Afghanistan four times and for which he received the Bronze Star among many other military awards. Then in late 2016, after a short tenure at UH Cleveland Medical Center, Dr. Steele accepted the position of Chairman of Colorectal Surgery at the Cleveland Clinic where he remains today. Of note, Dr. Steele is currently working toward his Executive MBA at Case Western Reserve University Weatherhead School of Management, which is right down the street from the hospital. Dr. Steele is actively involved in the colorectal community. He serves on several editorial boards including that of the Journal of Gastrointestinal Surgery, and is also the American College of Surgeons’ web porter for the colorectal community. His literary contributions include over 200 articles, reviews, chapters, and Clinical Practice Guidelines, as well as five complete Colorectal Surgery textbooks. Lastly, Dr. Steele is also the co-founder of the podcast, Behind the Knife (at BehindTheKnife.org) which discusses topics related to all things surgery and which boasts 20,000 downloads each month. Enjoy! Part 1 - About the specialty [7:23] Part 2 - How the specialty was the right choice [33:14] Part 3 - Long-term career planning [53:57]

Interview with Rupert M. Pearse, MD, author of Effect of a Perioperative, Cardiac Output-Guided Hemodynamic Therapy Algorithm on Outcomes Following Major Gastrointestinal Surgery: A Randomized Clinical Trial and Systematic Review

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us. Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, discusses with Mark new research that suggests that giving heart attack victims drugs to ease their chest pain could hamper the heart's ability to heal itself. The standard approach to appendicitis is to remove the inflamed organ. But a new review argues that antibiotics could be an alternative to surgery in some cases. Dileep Lobo, Professor of Gastrointestinal Surgery at the University of Nottingham, explains his team's findings. GP Margaret McCartney is on her soapbox about sick notes, following regulatory pressure from Europe that could allow people who fall ill on holiday getting compensatory time off work. Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, looks into the evidence that the change from sick notes to fit notes two years ago has had an impact on people returning to work. Mark visits the pathology laboratories at St Thomas' Hospital in London to find out from Senior Biomedical Scientist Diane Murley how blood is analysed. And Dr Andrew Moore from the Pain Research Unit at the Churchill Hospital in Oxford talks about which over the counter painkillers are likely to work best for acute pain. Producer: Deborah Cohen.