Behind The Knife: The Surgery Podcast

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

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 complicatio

Surgical residency is hard. In some ways, intern year may be the hardest. We’ve been there. We’re a group of surgical residents formally known as the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional organization of surgical education research fellows working together to foster peer mentorship, networking, and scholarly collaboration. We’ve collectively reflected on our experiences as surgical interns across the country. Join Drs. Ananya Anand, Joe L’Huillier, and Rebecca Moreci as they discuss three tips for thriving as a surgical intern.  Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101 –Dr. Rebecca Moreci, Louisiana State University, @md_moreci –COSEF: @surgedfellows Learning Objectives:  Listeners will:  – List CoSEF’s three tips for thriving as a surgical intern – Challenge their definition of patient ownership – Recall the “Golden Rule” of treating others how you want to be treated – Appreciate the im

For patients with insufficient future liver remnant (FLR) volume, adequate hypertrophy after Portal Venous Embolization (PVE) is associated with reduced likelihood of post-operative hepatic insufficiency. But what happens when PVE isn’t enough to obtain adequate volume prior to surgery? In this episode from the HPB team at Behind the Knife, listen in on the discussion about advances in venous deprivation techniques that can potentially increase resection rates and hypertrophy  Hosts Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology. Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center.  Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Cha

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

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

We know cardiac surgery can seem a bit daunting on the surface. However, most surgeons will come across cardiac surgery patients at some point whether in the OR, ICU, ED, etc. As the FIRST cardiac surgery specialty team for Behind the Knife, we are excited to bring you episodes focused on high-yield topics to help you navigate common cardiac surgery challenges, discuss relevant literature to help you in practice, and help our listeners feel more comfortable around cardiac surgery patients.  In this episode we’ll discuss common cardiac surgery post-op problems. Whether you're on a cardiac surgery rotation or just covering an ICU with cardiac surgery patients for the night, these common post-op problems are bound to occur. Hosts:  - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 - Aaron William, MD- Cardiothoracic Surgery Fellow, Duke University, @AMWilliamsMD - Nick Teman, MD- Assistant Profressor of Thorasis and Cardiovascular Surgery, University of Virginia, @nic

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

In the fifth episode of the “Innovation in Surgery” series, Dan Scheese sits down with Dr. Jeffrey Ponsky to discuss his innovation, the PEG tube. Dr. Ponsky shares many stories about his work with endoscopy in the late 1970s and how the idea for the PEG tube originated. “The Development of PEG: How it was” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/ “Following the light: A history of the percutaneous endoscopic gastrostomy tube” https://www.facs.org/media/cyrndd5u/07_gastrostomy_tube.pdf Dr. Ponsky completed his surgical training at University Hospitals of Cleveland in 1976. In 1979, he became the Director of the Department of Surgery at The Mount Sinai Medical Center in Cleveland, where he remained through 1997. In 1997, Dr Ponsky joined The Cleveland Clinic as the Director of Endoscopic Surgery and Executive Director of the Minimally Invasive Surgery Center. In 2005, he assumed the Oliver H. Payne Professorship and Chair of the Department of Surgery at Case Western University School of Medicin

Have you ever struggled choosing which type of stoma to mature in an anatomically or medically challenging patient? What about wrestled with the associated postoperative complications? Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss ostomy creation and management of stoma complications. Hosts: - Susan Galandiuk MD, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky MD, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas MD, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon DO, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer: - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives:  - Review pre-operative stoma marking and ostomy education.  - Understand “bail-out” ostomy creation options in medically and anatomically challenging patients.  - Discuss common postoperative ostomy complications and management. - Review common peristomal sk

In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Part 1: https://behindtheknife.org/podcast/clinical-challenges-in-thoracic-surgery-complex-pleural-effusions-empyema-part-1-of-2/ Learning Objectives: -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions  -Review the evidence for fibrinolytic therapy for management of complex pleural effusions -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion Hosts: Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/15745977/

In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Learning Objectives: -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions  -Review the evidence for fibrinolytic therapy for management of complex pleural effusions -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion Hosts: Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD Referenced Material https://pubmed.ncbi.nlm.nih.gov/15745977/ Maskell NA, et al. First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. Controlled trial of intrapleural streptokinase

Entrustable Professional Activities, or EPAs, is a term you may have heard…or maybe not.  EPAs represent a tectonic shift in surgical training and how residents will be evaluated. So, what are EPAs?  How will they affect you?  And what do you need to know? We sat down with Dr. George Sarosi, previous member of the ABS EPA Advisory Council and current General Surgery Residency Program Director at the University of Florida, to answer all of our questions now that EPAs are here.  Guests: George Sarosi, MD- Professor of Surgery and General Surgery Residency Program Director- University of Florida Patrick Georgoff, MD- Trauma Surgery and Surgical Critical Care- WakeMed Hospital; Co-director and Host of Behind the Knife Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Daniel Scheese, MD- General Surgery Resident- Virginia Commonwealth University; Education Fellow- Behind the Knife Helpful Websites:  Resources Page - ABS EPA resources page for Programs and

An ever-present spectre looming over the hearts of general surgeons everywhere! Please join our Emergency General Surgery team for a journal review about Clostridium difficile (C. diff) infection. Dr. Ashlie Nadler and Dr. Jordan Nantais are joined by guest Dr. Marika Sevigny, recent graduate of trauma and acute care surgery at the University of Toronto, as Dr. Graham Skelhorne-Gross prepares for his upcoming fellowship at Harborview. Paper 1: Ahmed et al. Risk factors of surgical mortality in patients with Clostridium difficile colitis. A novel scoring system. Eur J Trauma Emerg Surg. 2022 Jun. - Risk score development study using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) - 525 adult (18-89) patients undergoing colectomy between 2012 and 2016 - Split data into training (80%) and testing (20%) datasets -  Identified mortality risk factors to create and validate a scoring system - Scores ranged from 0 to 37 with the highest score predicting an 83.9% risk

It’s that time of year (again!)- when medical students across the country are preparing their residency applications. The process can be a bit daunting, and there have been a number of changes to process for the 2024 application cycle. Join our education fellow, Dr. Jessica Millar, and Dr. David Hughes as they review the “nuts and bolts” of this year’s residency application cycle.  Guests: David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan  Important Dates: - June 7, 2023: ERAS application opens at 9 a.m. ET. - September 6, 2023: Residency applicants may begin submitting MyERAS applications to programs at 9 a.m. ET. - September 15, 2023: Registration for the NRMP Match Opens  - September 27, 2023: Residency programs may begin reviewing MyERAS applications, MSPEs, and supplemental ERAS application data (if applicable) at 9 a.m. ET. - October 26-31, 2023: Common Interview Release Window - January 31, 2024: Registration for th

The first BTK THROW DOWN!  A spicy debate…a war of words…a battle of ideas!  This fiery episode features leaders in the field of trauma surgery discussing the optimal approach to vascular access in trauma patients.  A recent study titled “Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video review” concluded that intraosseous access should be considered a first line therapy in hypotensive trauma patients.  Is this appropriate?  Crazy?  Just so crazy it might work?  Let’s get ready to ruuuummmmbbbbbbllllllleeeee! Hosts:  Patrick Georgoff, MD (@georgoff) Nina Clark, MD (@clarkninam) Guests:  Ryan Dumas, MD – UT Southwestern (@RPDumasMD) Michael Vella, MD, MBA – University of Rochester (@MichaelVella32) Bellal Joseph, MD – University of Arizona (@TopKnife_B) Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video revi

In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant re