Behind The Knife: The Surgery Podcast

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Preoperative Optimization Recurrences and complications following abdominal wall reconstruction and hernia repair are common challenges for the general surgery. In this episode, the Hernia and Abdominal Wall Reconstruction team discusses evidence-based approaches to preoperative optimization and prehabilitation.  We review patient modifiable risk factors and multi-disciplinary strategies for risk, complication, and recurrence reduction. ·       Dr. Vahagn Nikolian is an Assistant Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair.  ·       Dr. Sean Orenstein is an Associate Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. ·       Dr. Emaad Iqbal is a resident in General Surgery at Columbia University Medical Center.  ·       Dr. Shahrose Rahman is a resident in General Surgery at Oregon Health & Science University.  Seminal Papers in Preoperative Optimizatio

Why should a surgeon care about breast cancer chemotherapy trials? Join Drs. Michael Alvarado, Rita Mukhtar, and Alexa Glencer as they discuss the benefits of neoadjuvant chemotherapy over upfront surgery and the role of adjuvant chemotherapy for select patients who harbor residual disease at the time of surgery. Learning objectives: - Understand the benefits conferred by neoadjuvant chemotherapy compared to upfront surgery in certain patients with breast cancer - Learn about the study design and results of the CREATE-X phase 3 randomized controlled trial comparing adjuvant capecitabine to standard therapy in patients with HER2 negative invasive breast cancer with residual disease following cytotoxic neoadjuvant chemotherapy - Describe the specific benefit of adjuvant capecitabine for triple negative breast cancer patients and discuss its evolving role with recent FDA approval of neoadjuvant pembrolizumab in this group - Learn about the study design and results of the KATHERINE phase 3 randomized controlled

Has anyone else ever felt the anxiety of hearing the EMS radio call in a pregnant trauma patient, knowing you will soon be getting two patients in one? How do we prioritize our assessment, diagnostic work up, and treatment options for our patient when we have a second patient growing in her uterus?  Join our Miami Trauma team including Drs. Urréchaga, Neeman, and Rattan as they discuss how to navigate the physiologic changes and management considerations for the pregnant trauma patient!  Learning Objectives:  - Understand the physiology of the pregnant patient and how it changes how we clinically assess them in the trauma bay - Emphasize the basics of the primary and secondary assessment in the pregnant patient  - Identify when radiology adjuncts are appropriate - Identify laboratory and diagnostic adjuncts that are unique to the pregnant patient’s work up - Discuss treatment options for mom and fetus depending on clinical status Quick Hits: 1. Sick mom before sick baby - stick to basics and treat mom like

Welcome to the first Surgical Palliative Care Journal Club, the second of a six-part series focused on the integration of palliative care into the practice of surgery.  Join us as we discuss the first study of how to best integrate palliative medicine principles into the care of trauma ICU patients.  We then tackle the question:  Why are surgeons often unwilling to discontinue life-sustaining treatments in the post-operative period?   We discuss a 2013 study about “surgical buy-in” and review alternatives to making “informal contracts” with patients before surgery.   References: Mosenthal AC, Murphy PA, Barker LK, et al. Changing the culture around end-of-life care in the trauma intensive care unit. J Trauma. 2008;64(6):1587-1593. doi:10.1097/TA.0b013e318174f112. Schwarze ML, Redmann AJ, Alexander GC, Brasel KJ. Surgeons expect patients to buy-in to post-operative life support preoperatively: results of a national survey. Crit Care Med. 2013;41(1):1-8. doi: 10.1097/CCM.0b013e31826a4650. Dr. Red Hoffman (@

5 years of General Surgery residency? Check. Case numbers? Check. Ready for independent practice? Hmmm.   Join Drs. John D. Mellinger, Jeremy Lipman, Judith French, and Amy Han as we discuss the past, present and future of operative assessment. Learning objectives: In this episode, we discuss the current practices of operative assessment in surgical training and the opportunities for improvement. We delve into evidence-based framework for operative performance assessment outlined in “A Proposed Blueprint for Operative Performance Training, Assessment, and Certification.” We explore the distinction between high versus low frequency operations, standards setting, training of assessors, and the role of technology in improving reliability, generalizability, and frequency of operative assessments.     References: Bansal N, Simmons KD, Epstein AJ, Morris JB, Kelz RR. Using Patient Outcomes to Evaluate General Surgery Residency Program Performance. JAMA Surg. 2016;151(2):111–119. doi:10.1001/jamasurg.2015.3637

Cardiac arrhythmias such as atrial fibrillation are common in any ICU. But, adequately addressing additional perioperative considerations is key in the surgical ICU. In this Critical Care episode of Behind the Knife, Drs. Bankhead, Dumas, & Park will address how to approach a critically ill patient who presents with an arrythmia. Hemodynamically stable vs. unstable patients are discussed, as well as the current ACLS guidelines for management of a patient in cardiac arrest.  Referenced Articles and Guidelines: 1. Van Gelder I, Groenveld H, Crijns H, et al. Lenient versus Strict Rate Control in Patients with Atrial Fibrillation. NEJM 2010.  2. Walkey A, Hogarth K, Lip G. Optimizing Atrial Fibrillation Management: From ICU and Beyond. CHEST 2015.  3. AFFIRM Investigators. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NEJM 2002.  4. ACLS Training Center: Tachycardia with a Pulse Algorithm. https://www.acls.net/acls-tachycardia-algorithm 5. ACLS Training Center: Ca

November is Lung Cancer Awareness Month, and what better way is there to spend your time than getting to know the recent advances in adjuvant therapy for early-stage lung adenocarcinoma?  Learning Objectives -        Review work-up and treatment of lung adenocarcinoma -        Review evidence behind Osimertinib as an adjuvant therapy in EGFR mutation positive disease -        Review recent advances in gene expression profiles for targeted application of adjuvant chemotherapy -        Discuss future directions for research -        Discuss additional advancements in diagnosis, monitoring, and immunotherapy Referenced Material -        Wu Y, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med 2020; 383:1711-1723. DOI: 10.1056/NEJMoa2027071  https://www.nejm.org/doi/full/10.1056/NEJMoa2027071 -        Woodard GA, Wang SX, Kratz JR, et al. Adjuvant Chemotherapy Guided by Molecular Profiling and Improved Outcomes in Early Stage, Non-Small-Cell Lung Cancer. Clin

Join Behind the Knife's very own Dr. Scott Steele, Chairman of the Department of Colorectal Surgery at Cleveland Clinic, for a high-level talk on the treatment of T2N0 rectal cancer.  There is an associated video that goes along with this episode.  Check it out at behindtheknife.org or YouTube. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Join Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross as they tackle Cancer Emergencies.   Case 1 - Learning Points: These are complex patients and multidisciplinary care should be provided with input from oncology.  A step-up approach should be used, starting with medical management prior to considering surgery in appropriate patients. Highly selected patients may benefit from surgery, namely those with a high performance status, a prognosis of months if the bowel obstruction was resolved, minimal carcinomatosis, and a single transition point. Diversion, bypass, or resection are all options, but a patient’s capacity to heal related to recent systemic therapy needs to be taken into account.  Consent for surgery should focus on goals of care, quality of life, and achievable outcomes, and highlight the inherent risk in patients with advanced disease and a limited lifespan.  Case 2 - Learning Points: Colorectal malignancy is an exceedingly common cause of general surgical emergency and require

In this episode from the Endocrine Surgery team at BTK we discuss the clinical applications of genetic testing for thyroid cancer. We walk through three cases of thyroid nodules and discuss why and how genetic testing can guide surgical and medical management. As usual we review key points such as imaging criteria for thyroid nodules, the Bethesda system for thyroid cytopathology, and MEN syndromes. We also go into a more nuanced discussion of how progress in genetic testing has led to more variability in management options.               Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established.  Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department  Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department  Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research  Dr. Vivek Sant is

Adjuvant?  Neoadjuvant?  Short course?  Long course?  The treatment of rectal cancer treatment has come a long way.  Tune in to learn more about Total Neoadjuvant Therapy (TNT) and the mysterious HOLY PLANE. Learning Objectives: 1.    Describe the rationale for Total Neoadjuvant Therapy (TNT) for rectal cancer 2.    Review the history of chemo and radiation therapy in treatment of rectal cancer 3.    Describe total mesorectal excision  References Bahadoer RR, Dijkstra EA, van Etten B et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021 Jan;22(1):29-42. doi: 10.1016/S1470-2045(20)30555-6. Epub 2020 Dec 7 https://doi.org/10.1016/S1470-2045(20)30555-6 Fokas E, Allgäuer M, Polat B et al. Randomized Phase II Trial of Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Tot

The American Board of Surgery has a new family leave policy for surgery trainees: https://www.absurgery.org/default.jsp?policygsleave.  What's new?  Is it enough?  And what does competency-based training have to do with it?  Join Drs. Patrick Georgoff and Shanaz Hossain as they discuss the details with ABS president Dr. Jo Buyske.  Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Tick tock tick tock, 5 min is up! There is a plus sign on the testing stick. And you are…. Pregnant! Congratulations??? Join Drs. Erika Rangel, Eugene Kim, Yue-yung Hu, and Debbie Li as they discuss the challenges surgeons and trainees face as they navigate through pregnancy and parenthood.  Learning objectives: In this episode, we learn about the personal experiences including the good, the bad, and the ugly behind pregnancy and parenthood. We discuss about the stigma faced and experienced by many surgeons and trainees, and most importantly, ways we can support our current and future trainees to navigate this deeply personal and should be celebrated occasion in their life.  References Incidence of Infertility and Pregnancy Complications in US Female Surgeons https://doi.org/10.1001/jamasurg.2021.3301 Pregnancy and Motherhood During Surgical Training - https://doi.org/10.1001/jamasurg.2018.0153 Perspectives of US General Surgery Program Directors on Cultural and Fiscal Barriers to Maternity Leave and Postpa

Post-operative pain is a challenging topic most surgeons would prefer not to have to think about, and post-inguinal hernia repair pain can be a particular pain in the…groin. Drs. Mike Weykamp, Andrew Wright, and Nick Cetrulo from the University of Washington provide a framework for approaching these challenging patients to help clarify when and how to best evaluate post-inguinal hernia repair pain and identify the patients who might benefit from surgical intervention. Referenced Articles and Videos:  1.     D Chen. Mapping for inguinal chronic pain: An approach that all surgeons can do. Your Session: Abdominal Wall Hernia - Provocative Questions in the Practice of Hernia Repair held during the 2017 SAGES Annual Meeting in Houston, TX https://www.youtube.com/watch?v=Yx5zSS3CA-U 2.     J Lange, R Kaufmann, A Wijsmuller, J Pierie, R Ploeg, P Amid. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia 2015.  https://pubmed.ncbi.nlm.nih.gov/25138620/ 3.     P Amid. Rad