Behind The Knife: The Surgery Podcast

Join for the forth episode in the Association of Out Surgeons & Allies (AOSA) series for a discussion on gender affirming care and gender affirming surgery. Host: Dan Scheese, MD Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center Guests: 1. Dr. Megan Lane (She/her) megalane@med.umich.edu Dr. Lane is a Plastic Surgery resident at the University of Michigan who is planning on going into Gender Affirming Surgery and general reconstruction, she completed a research fellowship in the National Clinician Scholars Program and focused primarily on patient-reported outcomes in gender affirming surgery.  2. Dr. Scott Chaiet (he/him/his/himself) chaiet@surgery.wisc.edu Dr. Chaiet is double board certified by the American Board of Otolaryngology and the American Board of Facial Plastic & Reconstructive Surgery and is currently at the University of Wisconsin. His areas of expertise include rhinoplasty and facial gender surgery. He also practices reconstructive surgery includi

Interested in cardiac surgery? The training paradigm for cardiac surgery has changed significantly over the past decade and we know may students often struggle when deciding what pathway is best for them. For this episode, we assembled a robust team of attendings, fellows, and residents to discuss their journey as well as some of the research that has been conducted about these different pathways to help guide students navigating this decision.  Hosts:  - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15 Guests:  - Nick Teman, MD- Assistant Professor of Thoracic and Cardiovascular Surgery, University of Virginia, @nickteman - Jolian Dahl, MD, MSc- Integrated Thoracic Surgery Resident (PGY-6), University of Virginia, @JolianDahl - Lyndsey Wessels, MD- Traditional Thoracic Surgery Resident (CT-1), University of Virginia, @LyndseyWessels  Articles Referenced:  - Pathways to Certification: https://www.abts.org/ABTS/CertificationWebPages/Pathways%20to%20Certification.

Bariatric surgery is an evolving field with new procedures, or variations of old ones, being developed to meet the needs of patients with obesity. The single anastomosis duodenoileal bypass (SADI) and one anastomosis gastric bypass (OAGB) are two such procedures which have recently entered the mainstream conversation. In this episode we will give a brief overview of the SADI and OAGB, go over some short and long term studies evaluating safety and efficacy, and discuss current sentiments about these options and how they may fit into bariatric practice.  Show Hosts: Matthew Martin, MD Adrian Dan, MD Crystal Johnson-Mann, MD Paul Wisniowski, MD Article #1: Chao 2024 - Outcomes of SADI and OAGB Compared to RYGB from the Metabolic and Bariatric Surgery Quality Improvement Program: The North American Experience Roux-en-Y gastric bypass (RYGB) and duodenal switch are well described procedure for weight loss; however, associated postoperative complications have led to the development of simpler techniques Single a

Join Drs. Jason Bingham (@BinghamMd) and Patrick Georgoff (@georgoff) for a thought-provoking discussion with titans of hernia surgery Drs. Todd Heniford (@THeniford) and Michael Rosen (@MikeRosenMD).  You don't want to miss this one!  This episode goes deep, touching on some of the most vexing questions in the world of abdominal wall reconstruction.   Highlights:  Hernia is chronic disease process.  Surgeons should act like it and patients need to understand this.   Follow-up data is hard to come by and therefore limited.  Studies must be interpreted with this in mind. Hernia surgery is sexy, which is both exciting and concerning. "Technology is not useful until it is boring."  New techniques and devices can hurt patients.   Complicated hernias should be sent to hernia centers.  Otherwise, general surgeons are more than capable of doing the repair. Link to paper: https://jamanetwork.com/journals/jamasurgery/fullarticle/2816986 Link to ACHQC: https://achqc.org/ Please visit https://behindtheknife.org to

Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastric cancer. 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 - 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 gastric cancer, including presentation, work-up, staging, and treatment modalities as well as high yield topics including the Siewert classification system. We also briefly discuss trials establishing peri-operative chemotherapy regimens for gastric cancer and the controversy of D1 vs. D2 lymphadenectomy. Links

Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Philip Fleshner as they discuss the management of small bowel strictures in Crohn’s disease.  Learning Objectives 1.    Discuss the role for J-pouch in a patient with inflammatory bowel disease 2.    Identify the key steps in creation of the J-pouch and technical considerations. 3.    Describe post operative complications and management in patients with a J-pouch Video Link: https://www.youtube.com/watch?v=_PMFaQHah5A 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

How is each release of the TAR contributing to the final tension on the anterior and posterior fascia? Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan C. Ellis as they discuss their group’s recent cohort study of tensiometry in 100 TARs.  Hosts:  - Michael Rosen, Cleveland Clinic - Benjamin T. Miller, Cleveland Clinic - Sara Maskal, Cleveland Clinic - Ryan C. Ellis, Cleveland Clinic, @ryanellismd Learning objectives:  - Review the steps of a TAR - Understand the changes in tension on the anterior and posterior fascia with each step of the TAR - Think about the application this data has to similar operations References:  Miller BT, Ellis RC, Petro CC, Krpata DM, Prabhu AS, Beffa LRA, Huang LC, Tu C, Rosen MJ. Quantitative Tension on the Abdominal Wall in Posterior Components Separation With Transversus Abdominis Release. JAMA Surg. 2023 Dec 1;158(12):1321-1326. doi: 10.1001/jamasurg.2023.4847. PMID: 37792324; PMCID: PMC10551814. https://pubmed.ncbi.nlm.nih.gov/37792324/ Miller BT, Ellis

Welcome to Humanism in Surgery, a new series where we take a deep dive into the extremes of humanity within the field of surgery. As surgeons, there are times when we feel deeply human and times when we feel we have lost our humanity. These experiences impact us immensely and shape our careers in important ways. It's time these stories are told! For those of you who are fans of NPR, think of this as Story Core for surgery.  Today, Dr. Patrick Georgoff is joined by Dr. Tamara Fitzgerald, Associate Professor of Pediatric Surgery at Duke University, and Dr. Ted Pappas, Professor of Surgery and Master Surgeon at Duke University.  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

A patient with a large TBSA burn injury presents to a local emergency department and you are the only surgeon on duty that evening. With snow covered roads and poor visibility, the patient requires initial stabilization prior to transfer to the regional burn center. You are faced with some difficult clinical decisions as you begin their resuscitation. Join Drs. Tam Pham, Rob Cartotto, Julie Rizzo, Alex Morzycki and Jamie Oh as they discuss the clinical challenges in initiating burn resuscitation, pitfalls in long-distance transport, and more.  Hosts: ·       Dr. Tam Pham: UW Medicine Regional Burn Center ·       Dr. Robert Cartotto: University of Toronto, Ross Tilley Burn Centre  ·       Dr. Julie Rizzo: Brooke Army Medical Center  ·       Dr. Alex Morzycki: UW Medicine Regional Burn Center ·       Dr. Jamie Oh: UW Medicine Regional Burn Center Learning Objectives: ·       Describe initial fluid strategies, including the recommendations of the Advanced Burn Life Support (ABLS) course, traditional resusc

Your patient was in a terrible car crash and is currently intubated with multiple traumatic injuries that will need surgery. Family has just arrived and all they’ve heard is that he has a broken leg. How do you share this serious news with family? What do you do when they become angry, cry or bombard you with questions that you don’t have answers to? Join the surgical palliative care team from the University of Washington as we role play a difficult conversation with a standardized patient. We will identify common challenges that arise and discuss key skills to navigate these situations. 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 resid

Circulating tumor DNA, more commonly referred to as ctDNA, has emerged as an attractive and potentially highly sensitive biomarker for patients with colorectal cancer. But what exactly is ctDNA, does it have any prognostic value for patients with colorectal liver metastasis, and how can it be incorporated into the management of said patients? In this episode from the HPB team at Behind the Knife, listen in on the discussion about ctDNA and its role in the perioperative management of colorectal liver metastasis.   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

Taking a lactating patient the OR? Prescribing antibiotics? What about a CT scan with IV contrast? Pump and dump, right? WRONG. It's time to get educated! Today, we review the finer points of caring for our lactating patients.  In this episode Dr. Patrick Georgoff is joined by Dr. Austin Eckhoff, general surgery resident at Duke University, Dr. Annie Dotson, family medicine and breastfeeding medicine physician at Duke University, and Dr. Katrina Mitchell, breast surgeon at Ridley Tree Cancer Center in Santa Barbara, CA.  Resources:  https://www.bfmed.org/ https://www.e-lactancia.org/ https://physicianguidetobreastfeeding.org/ - -  TRASH THE PUMP & DUMP: https://physicianguidetobreastfeeding.org/trash-the-pump-and-dump/trash-pump-dump/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

The American Board of Surgery In-Training Examination will officially be switching from reporting percentile scores by year level to percent of questions correct. What does this change mean for residents? Podcast hosts Dr. Ananya Anand, Dr. Joe L’Huillier, and Dr. Rebecca Moreci are joined by three fellow CoSEF members for this discussion: Dr. Gus Godley, Dr. Colleen McDermott, and Dr. Josh Roshal.  Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, ananya_anand@stanford.edu –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101, josephlh@buffalo.edu –Dr. Rebecca Moreci, Louisiana State University, @md_moreci, morecir@med.umich.edu –COSEF: @surgedfellows Special guests:  -Dr. Gus Godley, University of Chicago, frederick.godley@uchicagomedicine.org, @GusGodley -Dr. Colleen McDermott, University of Utah, colleen.mcdermott@hsc.utah.edu -Dr. Josh Roshal, Brigham and Women’s Hospital, jaroshal@utmb.edu, @Joshua_Roshal Learning Objectives:  Listeners will:  – Understand the changes t

The ABSITE score report is changing… what does it mean? CEO of the American Board of Surgery Dr. Jo Buyske discusses ABSITE and MUCH more.   Hosts: Dr. Scott Steele, Dr. Nina Clark, Dr. Jessica Millar Guest: Dr. Jo Buyske, President/CEO of the American Board of Surgery Resources:  Announcement - ABSITE Percentiles:  https://www.absurgery.org/wp-content/uploads/2024/02/ABSITE-Percentiles.pdf  ABSITE Data Tools: https://sandbox.absurgery.org/default.jsp?publicdata   Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode our team dives into the diagnosis, workup and management of malignant pleural mesothelioma. Listen as we debate the pros and cons of surgical management of this disease with extrapleural pneumonectomy versus pleural decortication and discuss the nuances of choosing the right approach for the right patient. Learning Objectives - Describe the workup and staging of a patient with malignant pleural mesothelioma - List the subtypes of malignant pleural mesothelioma, characteristics of resectable disease, and patient factors which impact surgical candidacy  - Describe the approach to an extrapleural pneumonectomy and pleural decortication - Analyze which surgical approach is best for various subsets of patients - Describe the adjuvant treatment for malignant pleural mesothelioma Hosts Kelly Daus MD, Adam Bograd MD, Peter White MD, Brian Louie MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out

Can appendicitis wait until the morning? Join Drs. Ashlie Nadler, Jordan Nantais, Graham Skelhorne-Gross, and Marika Sevigny from our Emergency General Surgery Team as they discuss the role of deferring appendectomies from overnight to the next morning. Paper 1: Patel SV, Zhang L, Mir ZM, Lemke M, Leeper WR, Allen LJ, Walser E, Vogt K. Delayed Versus Early Laparoscopic Appendectomy for Adult Patients With Acute Appendicitis: A Randomized Controlled Trial. Ann Surg. 2024 Jan 1;279(1):88-93. https://pubmed.ncbi.nlm.nih.gov/37436871/ -Non-inferiority randomized controlled trial comparing delayed appendectomy group with surgery taking place after 0600 the morning following a decision to operate versus the immediate appendectomy group with surgery taking place between 8pm and 4am and within 6 hours of a decision to operate -A priori non-inferiority margin of 15% for 30-day complications -Intention-to-treat analysis with risk difference -12% in favor of the delayed group (p < 0.001) -Superiority as on per p

Before 1952, open heart surgery was considered science fiction. The heart was off limits to surgeons despite more than half a million Americans dying annually from heart disease. Doing nothing was the strategy. However, the status quo would soon change thanks to a few brave and imaginative surgeons who dared to break the most rigid of medical taboos: Do not touch the human heart. We sat down with Dr. Gerald Imber, author of the new book “Cardiac Cowboys: The Heroic Invention of Heart Surgery” to discuss how five men raced to invent an entirely new field of surgery.  Guests: Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Nick Teman, MD- Associate Professor of Cardiac Surgery and Critical Care- University of Virginia  Gerald Imber- Assistant Clinical Professor of Plastic surgery at the Weill-Cornell Medical Center, Attending Surgeon at New York-Presbyterian Hospital, and Director of a private clinic in New York City, NY; Author of “Wendell Black, MD”,

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss Management of Advanced and Malignant Polyps.  Come with us as we navigate through sessile serrated lesions, pathology reports, and rectal polyp nuances.  Hosts:  - Susan Galandiuk, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer:  - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives:  - Review colorectal cancer screening for the average risk patient. - Understand what a malignant polyp is defined as and management strategies.  - Discuss the pathology review and re-review processes.  References:  - Church J, et al. Keeping the Cecum Clean: A Randomized, Prospective, Placebo-Controlled Trial of Loperamide as Part of Preparation for Co

Join for the third episodes in the Association of Out Surgeons & Allies (AOSA) series for a discussion on LGBTQIA+ healthcare providers and their patients.   Host:  Nina Clark, MD  Guests:  - Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center - Dr. James Taylor, Assistant Professor of Colorectal Surgery at Montefiore Medical Center - Dr. Alex Bonte, General Surgery PGY4 at Hackensack University Medical Center in Hackensack NJ.  - Dr. Paige Tannhauser, General Surgery PGY3 (completed) at Allegheny General Hospital in Pittsburgh PA, and currently finishing up a post-doctoral research fellowship at the University of Virginia. Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Resources Mentioned This Episode:  "Gender Unicorn" schema for terminology: https://transstudent.org/gender/ LGBTQ Healthcare Directory: https://lgbtqhealthcaredirectory.org/ CDC Recommendations in LGBTQ Health: https://www.cdc.gov/lgbthealth/index.htm

Listen to another episode by the Hernia Team from Carolinas Medical Center as they discuss their approach to open preperitoneal ventral hernia repair. Although uncommonly performed, a preperitoneal approach offers several advantages including the ability to achieve large mesh overlap without the need for myofascial release. The team discusses their tips and tricks for utilizing the preperitoneal space in even the most challenging hernia cases.  Hosts: - Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD (Twitter) - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford (Twitter) - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein (Twitter) - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL)  Learning Objectives: - Review standard methods of herniorraphy in open abdominal wall reconstruction - Introduce the concept of open preperitoneal ventral hernia repair - Discuss the advantages as well as the standard