Behind The Knife: The Surgery Podcast

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

Making a discovery that changes how we practice is one of the most exciting things about the fields of medicine and surgery. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Samantha Ruff from The Ohio State University. Hear Dr. Phay tell the story of how parathyroid autofluorescence was discovered and the work that has gone on since that day. The group discusses several articles focusing on intraoperative adjuncts used to identify parathyroid tissue during thyroid and parathyroid surgery.  Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Samantha Ruff, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio. Twitter handles:  Barbra Miller - @OSUEndosurgBSM John Phay – @JohnPhayMD Priya Dedhia – @priyaknows  Samantha Ruff -

What is the best surgical treatment for a vasculopathy with critical limb threatening ischemia? In this episode of Behind the Knife the vascular surgery subspecialty team discusses two pivotal trials (BEST-CLI and BASIL-2) and how the findings of these trials can help answer this question. In this episode, we will discuss the age old question: open bypass versus best endovascular treatment.  Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives Review the definition, prevalence, and prognosis of critical limb threatening ischemia Review basic treatment options for patients with critical limb threatening ischemia Understand the methodology, findings, limitations, and clinica

If you operate for long enough, chances are you will come across the unique, and potentially daunting scenario of operating on a pregnant patient. If, and when, you do, would you know what to do? Join University of Washington and MIS faculty Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and residents Drs. Ben Vierra and Paul Herman as they discuss non-obstetric surgery in the pregnant patient so that you will be better informed when the challenge arises. Hosts: 1. Andrew Wright, UW Medical Center—Montlake and Northwest, @andrewswright 2. Nick Cetrulo, UW Medical Center—Northwest, @Trules25 3. Nicole White, UW Medical Center—Northwest, @NicoleWhiteTho1 4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm 5. Ben Vierra, UW General Surgery Resident PGY-2 Learning Objectives 1. Describe important physiologic changes in pregnancy that are relevant for the surgeon to know. 2. Review the epidemiology of non-obstetric general surgery in the pregnant patient. 3. Discuss specific imaging considerations

Join the Hernia Team from Carolinas Medical Center as they discuss applications of artificial intelligence in predicting outcomes for patients undergoing abdominal wall reconstruction. Emerging technologies are allowing us to understand hernia patients who are at risk for increased surgical complexity and postoperative complications – find out more in this Journal Review episode. Hosts: Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD   Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford   Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein  Dr. Monica Polcz, Attending Surgeon, Baptist Health (FL)  Learning Objectives: Provide and introduction to artificial intelligence Develop an understanding of the applications of artificial intelligence in surgical outcome prediction for patients undergoing hernia repair Learn how risk stratification of hernia patients can affect their care References: Elhage et al, Developme

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? And how do you leverage those relationships into getting research experience and lines on your CV?  Hosts:  Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests:  Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Get involved Even if you’re not destined for an academic career, getting involved in research early on can help you to participate with the scientific literature, understand data, and incorporate new research into your practice.   Realistically, research is an important component of your ERAS application and your CV. It’s also a great opportunity to learn new skills and develop strong relationships with mentors. Remember why you’re in medical school You came to medical school to become a doctor first – don’t forget that or let research take away from it. Your mentors have been through

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? In this episode, our surgical education fellows and two expert mentors talk through the ins and outs of mentors – who are they, what can they do for you, how do you find one, and what do you do once you have one.  Hosts:  Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests:  Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Mentorship teams: think about 4-5 people who can help you in different ways.  Research mentor who can help you find opportunities and be productive 1-2 people who support you in all things (these might be residents!)  1-2 higher level sponsors who facilitate opportunities and pay for things Discipline and accountability RESPOND TO EMAILS. If you get an indication that a potential mentor would like to meet with you, take them up on the offer and be prompt with your replie

Challenges continue to plague the residency application process, with programs receiving increased application volume that makes holistic review difficult, and medical student applicants burdened with application costs and uncertainty about what programs best align with their values. As a specialty, Ob/Gyn is facing these problems head on, and have united within their field to create a new independent residency application system, ResidencyCAS. While substantial changes to an already stressful process can be intimidating, the new platform offers many advantages that hope to improve the residency application experience for applicants, programs, and the Ob/Gyn community as a whole. We’re joined by Dr. Maya Hammoud and Dr. AnnaMarie Connolly, two of the leaders in this effort, to break down the creation of ResidencyCAS, plans for its implementation starting in the 2024-2025 application cycle, and the reaction of the Ob/Gyn and medical education communities to this change. Learning Objectives 1.     Listeners wi

Direct Peritoneal Resuscitation!  We’re not just dumping fluids into the open abdomen.  What is DPR?  Why do it?  Who should get it?  Does it work? Come try and stay awake for some basic science talk before then learning all about why you should consider adopting DPR into your Trauma/EGS practice? Join Drs. Cobler-Lichter, Kwon, Meizoso, Urréchaga, and Rattan as they guide you through all this and more!  Hosts: Michael Cobler-Lichter, MD, PGY2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (twitter) Eva Urrechaga, MD, PGY6/R4: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @urrechisme (twitter) Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 3 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Rishi Rattan, MD, Attending Surgeon in Trauma/Critical Care, 7 years in practice

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Episode 2 outlines the radical technical approaches to anteriorly invasive tumours, including en bloc cystectomy, perineal urethrectomy, inter-labial vaginectomy and radical pubic bone resections. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Paul Sutton from The Christie Hospital, Manchester, UK. Technical videos: Solomon MJ, Däster S, Loizides S, Sutton P, Brown KGM, Austin KKS, Lee PJ. Access to the anterior pelvic compartment in pelvic exenteration in women-the interlabial approach: video vignette. Br J Surg. 2021 Aug 19;108(8):e

Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes, that we learn during surgical training, and into all compartments of the pelvis. Episode 1 provides listeners with an overview of the principles of exenteration surgery and preoperative patient assessment and selection. Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Elaine Burns from St Mark's Hospital, London, UK. References and further reading: -Burns EM, Quyn A; Lexicon Collaboration of UKPEN and the ACPGBI Advanced Cancer subcommittee. The 'Pelvic exenteration lexicon': Creating a common language for complex pelvic cancer surgery. Colorectal Dis. 2023 May;25(5):888-896. doi: 10.1111/codi.16476.  -Brown KGM, S

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

Has the pendulum swung too far?  Is it time to put the drill down??  Or, drill, baby, drill!  While the number of rib plating cases has exploded the data supporting the practice is less-than-stellar.  On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill bring you up to speed on rib plating. If you haven’t already, we recommend you listen to Behind the Knife episode 298, published in May 2020. (https://behindtheknife.org/podcast/big-t-trauma-series-ep-10-rib-fractures/)  This episode covers comprehensive management of rib fractures, including multimodal pain control, regional blocks, pulmonary toilet, BiPAP, etc.   REFERENCES: GUIDELINES EAST PMG Rib Plating (2017): https://www.east.org/education-resources/practice-management-guidelines/details/rib-fractures-open-reduction-and-internal-fixation-of-update-in-process EAST PMG Rib Fracture Non-Surgical Management (2022): https://www.east.org/education-resources/practice-management-guidelines/details/nonsurgical-managem

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

To close or not to close - that is the question!  Internal hernias following bariatric surgery can be a vexing source of delayed postoperative morbidity.  Join Drs. Matthew Martin, Kunoor Jain-Spangler, Adrian Dan, and Vincent Cheng for this EXCELLENT Journal Review in Bariatric Surgery.   Article #1: Stenberg 2023 - Long-term Safety and Efficacy of Closure of Mesenteric Defects in Laparoscopic Gastric Bypass Surgery Two mesenteric defects are created during Roux-en-Y gastric bypass (RNYGB) Petersen’s Defect Jejuno-jejunostomy mesenteric defect  Consensus does not exist regarding the standard of care for mesenteric defect closure (e.g., closure of one or both defects, material used for closure).  Risks of leaving defects open: internal herniation with or without bowel ischemia  Risks of closing defects Kinking the bowel (especially near the jejunojejunostomy) leading to obstruction  Chronic abdominal pain This article discusses a randomized controlled trial of obese patients undergoing bariatric RNY

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

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management.  We discuss key concepts including the genetic

How do you counsel the patient with a large painful hernia who still smokes a pack of cigarettes every day? Join Drs. Michael Rosen, Clayton Petro, Sara Maskal, and Ryan Ellis as they discuss some of the highlights in the literature on smoking and its impact on postoperative outcomes in elective, clean open ventral hernia repairs.  Hosts:  - Michael Rosen, Cleveland Clinic - Clayton Petro, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan Ellis, Cleveland Clinic, @ryanellismd Learning objectives:  - Evaluate historical data on smoking in surgery - Compare with newer literature specific to contemporary ventral hernia repairs - Understand how the historical and new data can be applied in clinical practice References:  Møller AM, Villebro N, Pedersen T, Tønnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002 Jan 12;359(9301):114-7. doi: 10.1016/S0140-6736(02)07369-5. PMID: 11809253. Kubasiak JC, Landin M, Schimpke S, Poirier J, M

Surgeons are trained to, well…do surgery, but is that always the right treatment for the patient? Not offering surgery can be a challenge, especially when you’re consulted about a sick patient in the middle of the night and the clinical momentum is moving toward the OR. Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington as we discuss how to recognize when a surgery is potentially not beneficial and communicate serious news with the patient and consulting team. Hosts: Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow.  Dr. Lindsay Dickerson (@l

While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries.  Hosts: - Dr. Tam Pham: UW Medicine Regional Burn Center - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center - Dr. Alex Morzycki: UW Medicine Regional Burn Center - Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: - Review the epidemiology and common mechanisms for electrical injuries  - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release - Recognize possible long-term complicati