Sinopsis
Behind the Knife is a podcast aimed for everyone interested in not only an in-depth look at the broad range of surgical topics, but a "behind the scenes" look at the interesting, controversial and humanistic side of surgery from some of the giants in the field. Come along with Kevin Kniery, Jason Bingham, John McClellan and Scott Steele on a journey that explores all the disciplines of General Surgery in this informal discussion and interview format. We feel that this is the perfect medium not only to cover important educational topics for all stages of your professional career, but allow you to listen to a first-hand account of not only where we have been from those that pioneered the way, but also an opportunity to explore where we are now and are headed in the not so distant future from surgical leaders.
Episodios
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Clinical Challenges in Vascular Surgery: The Risk & Reality of EVAR Complications
10/07/2025 Duración: 26minIt’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
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Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!
07/07/2025 Duración: 31minIn 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 pa
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1: Intern Bootcamp: Dominate Intern Year
05/07/2025 Duración: 12minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GENERAL TIPS FOR SUCCESS ON THE WARDS Spend time with the patient! Trust, but verify. Be kind to everyone. Stay humble. Be flexible. Seek and apply feedback. HOW TO LEARN IN THE OR Double scrub as many cases as you can. Write down/record everything after a case. MAINTAIN YOUR PERSONAL SANITY Figure out your stress outlets and what brings you joy. Decompress after work. Maintain work/life boundaries. Keep in touch with loved ones. Vacations are meant for relaxation.Repeat after me: NO WORK ON VACATION! Please visit https://behindtheknife.o
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Intern Bootcamp: Scary Pages
04/07/2025 Duración: 23minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. Today, we’re hitting the wards and tackling some of the scary clinical scenarios you will see as an intern. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: THINGS TO REMEMBER · BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn’t help anybody. · See the patient. Getting a bunch of pages? Worried about someone? Confused as to what’s going on? Go see the patient and chat with the bedside team. · Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients. · Load the boat. You’ve heard th
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Intern Bootcamp: Consults
03/07/2025 Duración: 14minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll talk about how to give and receive consults in the hospital like a pro. We’ll also provide some tips on how to make those long call days a little more manageable. Hosts: Shanaz Hossain, Nina Clark Tips for New Interns: GIVING CONSULTS Clear and Concise Question! Develop a script, such as: “Hi, this is XX with the general surgery team. We’re calling to request an evaluation for a patient presenting with XX. I can give you the MRN whenever you are ready…” Follow this with a brief H&P. If you are asking another team to perform a procedure on your patient, be prepared with the following information: NPO Status Ability to Consent or Proxy Contact Blood Thinners Urgency of Procedure RECEIVING CONSULTS Make sure you are clear on what th
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Intern Bootcamp: Medical Students
02/07/2025 Duración: 17minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. You’ve been a doctor for about 3.5 seconds, and suddenly that bright eyed, bushy-tailed medical student on service is looking to you for advice? Don’t fret, in this episode we’ll give you some tips for how to handle it. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: REMEMBER HOW INTERNS DO AND DO NOT TEACH - Nobody, not even the med students, expect you to be an expert in everything or give a fully-planned formal lecture - You WILL however spend a ton of time working with students on your team – and via modeling and teachable moments, you can help them learn how it’s done! MODELING - Remember how hard everything has been in the few days since you started residency? Think about all the information you’ve picked up, tips and tricks you’re developing for effi
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Intern Bootcamp: Resource Overload
01/07/2025 Duración: 18minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. This episode, we’ll tackle the resources that you should know about to support your own learning throughout residency. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: STRUCTURE YOUR STUDYING - 2 things you need to do: (1) develop a knowledge base and (2) answer questions - Knowledge base Pick a level-appropriate textbook, read it (ideally all of it) yearly. Ideally, lead a little bit every day - 10 pages/day is a good goal to start with and you may need to adjust. - Questions Do some questions every week – 50/week is a good goal to start Plan to do more questions closer to ABSITE! Consider storing everything you learn in one place – either a notebook you carry with you or a cloud-based note app Share this with others, use it to take notes while reading,
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Intern Bootcamp: The First Day
30/06/2025 Duración: 15minRE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency. First up, the first day of intern year. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: BRING WHAT YOU NEED Name badge Scrubs, white coat, and extra clinic clothes Comfortable shoes - even on clinic days Pager Phone Pen Bonus stuff that’s good to keep in your bag: Snacks, extras of everything, toothbrusth/toothpaste/deodorant, suture STAY ORGANIZED Preround purposefully and systematically Look at the same things in the same order every day on every patient Write data in the same physical location on your sheet so you can quickly find information on the fly Keep track of to-do’s from rounds Check box system: Nina’s system: empty = not done, half full = ordered/needs follow up, full = completely done and followed up on Don’t forget to look at th
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Journal Review in Surgical Education: Resident Autonomy in the Good Ole Days
26/06/2025 Duración: 40minIn this surgical education episode, the Cleveland Clinic General Surgery Education Team explores the past, present, and future of resident autonomy in the operating room. With guest colorectal surgeons Dr. Tracy Hull (recently retired) and Dr. David Rosen (early career faculty), we discuss how autonomy was granted in “the good ole days,” how educational culture and institutional pressures shape current practice, and what thoughtful autonomy looks like moving forward. Through candid stories—from emergent cases and missed enterotomies to thumbtacks pulled off the wall to stop bleeding—we get a nuanced look at what surgical independence really means, and how to responsibly develop it. Join hosts Pooja Varman, MD, Judith French, PhD, and Jeremy Lipman, MD, MHPE, for this conversation about what it means to train competent, confident, and independent surgeons. Learning Objectives By the end of this episode, listeners will be able to 1. Define operative autonomy and its educational value in surgical training
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Journal Review in Surgical Oncology: Neuroendocrine Tumors of the Small Bowel
23/06/2025 Duración: 30minJoin the Behind the Knife Surgical Oncology Team as we discuss the two key studies investigating optimal management strategies of neuroendocrine tumors of the small bowel. Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center - Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. - Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson. - Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode we review two important papers that discuss optimal management strategies of neuroendocrine tumors (NET) of the small bowel. The first paper by Singh and colleagues discusses the NETTER-
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Journal Review in Colorectal Surgery: Hand Assist Laparoscopy in Colon and Rectal Surgery
19/06/2025 Duración: 36minYou have a patient with complicated diverticulitis s/p IR drain with colo-cutaneous fistula and colo-vaginal fistula. They are scheduled for surgery. How will you do it? What is the role for hand assist? How can hand assist help? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, and Tess Aulet as they discuss high yield papers discussing hand assist laparoscopy in Colon and Rectal surgery. Learning Objectives 1. Describe the technical considerations and how to do hand assist laparoscopic surgery (HALS) 2. Discuss the indications for use of HALS 3. Review literature supporting use of HALS Video Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-hand-assist-laparoscopy-in-colon-and-rectal-surgery References: Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, Feingold DL, Lee SW, Mutch MG, Sonoda T, Yan Y, Whelan RL. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum.
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From Cringe to Competent: Surviving Intern Year
16/06/2025 Duración: 31minIntern year: where the learning curve is steep and you’re not sure if the patient is crashing or you are. In this episode of Behind the Knife, our surgical education fellows reflect on what they wish they had known before Day 1—and all the humbling, hilarious, and genuinely formative moments along the way. From getting lost wheeling a critical patient through the hospital, to triple-scrubbing just to be acknowledged, to accidentally spraying TPA into your own eye (yes, really)—this episode is a candid conversation about the highs, lows, and everything in between. Whether you're gearing up to start your intern year or reflecting on how far you've come, this is the episode we all needed. Hosts: Elizabeth Maginot, MD – General Surgery Resident, University of Nebraska Medical Center @e_magination95 Nina Clark, MD – General Surgery Resident, University of Washington @clarkninam Ayman Ali, MD – General Surgery Resident, Duke University Michelle LaBella, MD – General Surgery Resident, University of North Carol
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Hot Topics from the Annals of Surgery Ep. 1: Robotic Surgery
12/06/2025 Duración: 22minThis new series will be a collaboration between BTK and Annals of Surgery, where we will be discussing hot topics in surgery research. No, we won’t be getting into the nitty gritty of methods of individual papers but rather will focus on high-level discussions of contemporary topics that are moving our field forward. Hosts: Cody Mullens, MD is a general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens) Justin B. Dimick, MD MPH is the Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of Michigan. He also serves as the Editor in Chief at Annals of Surgery. (@jdimick1) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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USA vs. UK: ASGBI Ep. 5 - Sustainable Surgical Practices
09/06/2025 Duración: 42minThe evidence for climate change is irrefutable. But how does surgical care contribute to global emissions, and is there anything we can do to make surgery more sustainable? Join Jon Williams and our ASGBI partners for the next installment of our BTK/ASGBI collaborative series, where we discuss how to make surgical care greener. Mrs. Cleo Kennington from the UK and Dr. Benjamin Miller from the US are our guest experts, and provide valuable insights into local sustainability efforts you can take home to your hospital, broader concepts of how high-quality care is sustainable, innovations in sustainability, and what the future of sustainable surgery may look like. After listening, you get to decide–Who has more sustainable surgical practices? The UK or US? Mrs. Cleo Kenington is a Consultant Emergency General and Trauma Surgeon at St George’s Hospital, London and was the recent ASGBI Sustainability Lead. She is a big advocate for practicing what she preaches, focusing on how we can reduce the environmental impac
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Clinical Challenges in Hernia Surgery: Mesh Selection for Hernia Repair
05/06/2025 Duración: 40minJoin Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan Ellis as they review mesh materials used in hernia repair and the general properties surgeons who perform hernia repairs should know. Hosts: - Sara Maskal, MD, Cleveland Clinic - Ryan Ellis, MD, Cleveland Clinic - Benjamin T. Miller, MD, Cleveland Clinic - Michael Rosen, MD, Cleveland Clinic Learning Objectives: - Understand common mesh materials - Review properties of the different mesh materials - Understand how to apply knowledge of the different mesh properties to different patient scenarios References: - Ellis R, Miller BT. Mesh selection in abdominal wall reconstruction: an update on biomaterials. Surgical Clinics. 2023 Oct 1;103(5):1019-28. https://pubmed.ncbi.nlm.nih.gov/37709387/ - Krpata DM, Petro CC, Prabhu AS, Tastaldi L, Zolin S, Fafaj A, Rosenblatt S, Poulose BK, Pierce RA, Warren JA, Carbonell AM. Effect of hernia mesh weights on postoperative patient-related and clinical outcomes after open ventral hernia repair:
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Artificial Intelligence for the Clinician Ep. 3: Natural Language Processing and Large Language Models
02/06/2025 Duración: 45minWelcome back to our series on AI for the clinician! Large language models, like ChatGPT, have been taking the world by storm, and healthcare is no exception to that rule – your institution may already be using them! In this episode we’ll tackle the fundamentals of how they work and their applications and limitations to keep you up to date on this fast-moving, exciting technology. Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-3 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. Ruchi Thanawala, MD: @Ruchi_TJ Ruchi Thanawala is an Assistant Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU. Phillip Jenkins, MD: @PhilJenkinsMD Phil Jenkins is a general sur
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10 Consult Commandments to Dominate the Day
29/05/2025 Duración: 14minMastering the surgical consult is a true milestone in every young surgeon’s career. But it’s not easy! It is a difficult transition from lowly data gatherer to mighty data synthesizer. It is, in many ways, an art form. Is there anything more beautiful than breaking down a complex, convoluted patient presentation into an immaculate assessment and plan? Something so bullet proof that the attending surgeon has been left speechless. Perhaps not! Join Drs. Joey Lew and Patrick Georgoff as they review 10 CONSULT COMMANDMENTS TO DOMINATE THE DAY: Have a System Trust No One, Expect Sabotage Always Ask at Least One Why Always Look at the Imaging Yourself Don’t Worry Alone Don’t Bury the Lead Never Lie Include a Real Assessment and Plan in Your Note Goals of care are important and individual Over-communicate Hosts: Dr. Joey Lew, MD, MFA, PGY2, Duke University (@LewActually) Dr. Patrick Georgoff, MD, Duke University (@georgoff) Insensible Losses – Poems by Joey Lew: https://www.amazon.com/Insensible-Losses-
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The Silent Partner: Ambient listening AI in Outpatient Clinics, Inpatient Wards, and the Operating Room
26/05/2025 Duración: 31minIn this episode, we dive into the rapidly evolving world of ambient listening AI in healthcare. From outpatient clinics to inpatient wards and operating rooms, this technology is reshaping how care is delivered, documented, and experienced. We explore how ambient listening AI is improving clinic flow by streamlining documentation and reducing interruptions, allowing clinicians to stay more present with their patients. The technology is increasingly adaptive to individual provider styles, learning preferences and workflows to deliver more personalized support. Plus, we share practical tips for new users to get the most out of their ambient listening AI systems from day one. Join us as we hear from experts on the front lines and debate the future of ambient listening AI in medicine—where the walls really do have ears, but for all the right reasons. Host: - Nicole Petcka, MD – General Surgery Resident, Emory University, @npetcka2022 Guests: - Samuel R. Torres Landa Fernández, MD – Minimally Invasive Surger
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Journal Review and Clinical Challenges in Surgical Palliative Care: Assessing Decision-Making Capacity
22/05/2025 Duración: 25minJoin the University of Washington Surgical Palliative Care Team for their final episode of this series — a dual journal review and clinical challenges discussion on assessing medical decision-making capacity. Using Dr. Paul Applebaum’s foundational framework, the team outlines the four key criteria for evaluating capacity and brings the topic to life through two contrasting standardized patient scenarios. This episode highlights why capacity assessment is not only relevant but essential for surgeons navigating complex, high-stakes decisions. Hosts: Dr. Katie O’Connell (@katmo15) is an associate professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA. Dr. Ali Haruta is an assistant professor of surgery at the University of Washington. She is a trauma and emergency general surgeon and palliative care physician. Ali recen
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Journal Review in Hernia Surgery: Quality Improvement in Abdominal Wall Reconstruction
19/05/2025 Duración: 24minIn their last Behind the Knife episode, the Hernia Content Team from Carolinas Medical Center discusses quality improvement in abdominal wall reconstruction (AWR). The complexity of AWR patients makes this discipline a perfect match for quality improvement efforts. The group review two papers published by their group: one that tracks patient outcomes over time and then another that reviews a specific quality improvement initiative (penicillin allergy protocol). Hosts: · Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) · Dr. Monica Polcz, Assistant Professor, University of South Florida (Tampa, FL) · Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center (Charlotte, NC), @VedraAugenstein (Twitter) · Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center (Charlotte, NC), @THeniford (Twitter) Learning Objectives: - Define Quality Improvement and its Importance in Surgical Practice - Identify Ke