Behind The Knife: The Surgery Podcast

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1. Clinical Informatics for Surgeons, Episode 2: Legal Discovery and Cybersecurity When a Case Goes Wrong

   5 november 2026 · 33 min

   Afspelen
   A case goes wrong. There is a complication, maybe a lawsuit, and suddenly the question is not just what happened in the room. It is what got recorded, who owns it, what a plaintiff's attorney can pull into discovery, and whether that same pile of data is a target for people who want to steal it. Join Drs. Scott Steele, Mason Pearce, and Teodor Grantcharov, the surgeon who built the OR Black Box, as they walk through what an instrumented operating room actually captures, why peer review privilege protects the review and not the facts, how AI outputs create a new evidentiary layer, and why cybersecurity is a patient safety issue. The surprising part: governed recording more often protects surgeons than exposes them. Lees meer

   Hosts:

   Scott Steele, MD, MBA, Colon and Rectal Surgeon; President, Cleveland Clinic Main Campus

   Mason Pearce, MD, General Surgery Resident and Clinical Informatics Fellow, University of South Florida; Behind the Knife Education Fellow

   Teodor Grantcharov, MD, PhD, Professor of Surgery, Stanford University; Associate Chief Quality Officer for Innovation and Safety, Stanford Health Care; Founder, Aimbient (formerly Surgical Safety Technologies), the company behind the OR Black Box

   Linkedin: https://www.linkedin.com/in/teodorgrantcharov/?isSelfProfile=true

   Aimbient’s: https://www.linkedin.com/company/aimbient/

   Disclosure: Dr. Grantcharov is the founder of Aimbient (formerly Surgical Safety Technologies). Platform figures discussed on air (hours of data, number of sites and rooms, data volume per OR-hour, retention period, security record, publication count) are company-reported.

   Learning objectives:

   Describe the data an instrumented operating room generates (field and room video, audio, device telemetry, EHR timestamps) and how ownership is layered across the institution, the patient's right of access, and the vendor.

   Distinguish material that is routinely discoverable (the medical record, operative and anesthesia notes, device logs) from contested …

2. Clinical Informatics for Surgeons, Episode 1: What Is Clinical Informatics, and Why Should Surgeons Care?

   2 november 2026 · 29 min

   Afspelen
   You click an order set and ten seconds later the labs, imaging and meds are in. A drug interaction alert fires, and you override it without reading. A sepsis score in the corner of the chart flags your post-op patient. Who built those defaults, who set that alert threshold, and was that score ever validated on surgical patients? Join Drs. Kevin Kniery, Mason Pearce, and Genevieve Melton-Meaux, a practicing colorectal surgeon and the American College of Surgeons' first Chief Health Informatics Officer, as they kick off the Clinical Informatics for Surgeons series. They explain what clinical informatics actually is (hint: not the help desk), how it is already running your operative day, and the few habits that let any surgeon shape the tools everyone else is stuck with. Lees meer

   Hosts:

   Genevieve Melton-Meaux, MD, PhD, Colon and Rectal Surgeon; Senior Associate Dean for Health Informatics and Data Science, University of Minnesota; Chief Health Informatics Officer, American College of Surgeons; Chair, AMIA Board of Directors

   Kevin Kniery, MD, FACS, Vascular Surgeon, Brooke Army Medical Center

   Mason Pearce, MD, General Surgery Resident and Clinical Informatics Fellow, University of South Florida; Behind the Knife Education Fellow

   Learning objectives:

   Define clinical informatics, distinguish it from information technology, and describe how physicians train and certify in the subspecialty (ACGME-accredited fellowship, ABPM/ABPath board exam).

   Identify four everyday systems that shape surgical care (order set defaults, medication alerts, embedded risk scores, OR scheduling logic) and recognize them as clinical design decisions.

   Explain alert fatigue as a patient safety problem and why independent external validation of predictive models matters, using the Epic Sepsis Model as an example.

   Describe the three core areas of the surgeon informatician: clinical decision-making and care process improvement; health information systems, data and analytics; and leadership and change…

3. USA vs. UK: ASGBI Ep. 11 - Surgeons Are Human Too - Breaking the Silence on Mental Health

   29 oktober 2026 · 43 min

   Afspelen
   How do we care for ourselves while caring for others? Lees meer

   Surgery is a demanding profession that requires resilience, sacrifice, and the ability to navigate high-stakes decisions. However, depression, anxiety, burnout, and the emotional consequences of complications are realities that many surgeons face but often struggle to discuss openly.

   In this episode of the Behind the Knife/Association of Surgeons of Great Britain and Ireland (ASGBI) collaborative series, our guests share their personal experiences navigating mental health challenges throughout their careers, confronting stigma, finding support, and learning that being a successful surgeon does not require being perfect.

   Hosts

   Dr. Agnes Premkumar — Behind the Knife Surgical Education Fellow, General Surgery resident (US)

   Dr. Gita Lingham — President, Moynihan Academy, trainee association within the Association of Surgeons of Great Britain and Ireland (ASGBI) (UK)

   Dr. Elizabeth McLennan — Vice President, Moynihan Academy, trainee association within the Association of Surgeons of Great Britain and Ireland (ASGBI) (UK)

   Guests

   Dr. Luke Elms — Board-certified general surgeon specializing in abdominal wall reconstruction and hernia surgery; host of The Hernia Gods podcast.

   Dr. Elizabeth “Liz” Miller — Former neurosurgical trainee and current occupational health physician, mental health advocate, and author of Mood Mapping.

   Resources Mentioned
   Mood Mapping — Dr. Elizabeth “Liz” Miller
   A practical guide to understanding and managing emotional well-being through mood awareness, self-reflection, and strategies such as exercise, music, spending time outdoors, and connecting with others.

   The Hernia Gods Podcast — Dr. Luke Elms
   A podcast exploring the humanity behind surgery, including imposter syndrome, complications, professional identity, self-doubt, and the shared experiences of surgeons at every career stage.
   Available on Apple Podcasts, Spotify, and YouTube.

   Doctors' Support Network
   https://www.dsn.org.uk/. …

4. Demystifying Topical Hemostatic Agents: A Mental Model for Surgeons

   26 oktober 2026 · 42 min

   Afspelen
   The scrub tech holds up two boxes, “SURGICEL or EVARREST?”, and you realize nobody ever taught you the difference. Patrick Georgoff, MD, John McClellan, MD, Kevin Kniery, MD, and Nick Teman, MD, break down topical hemostatic agents, one of the most used and least taught tools in the OR. You’ll get a simple two-question model for picking the right product: can your patient make their own clot, and can a patch reach the bleeding? Through trauma, vascular, and cardiac cases, the team covers when these agents earn their keep and when two minutes of pressure (no peeking!) will do the job. Bottom line: hemostatic agents speed up hemostasis, but they’re a targeted adjunct to good surgical technique, not a substitute for it! Lees meer

   Hosts:

   Patrick Georgoff, MD, Duke

   Nick Teman, MD, University of Colorado

   John McCllelan, MD, UNC

   Kevin Kniery, MD, Madigan Army Medical Center

   Topical Hemostatic Agent PDF link: https://drive.google.com/file/d/1Qv9V_0l20CTXKQ_83newveIahmxzlpcb/view?usp=sharing

   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
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   Vascular Surgery Oral Board Review Course: https://behindtheknife.o…

5. Journal Review in Surgical Oncology: Gastric Cancer

   22 oktober 2026 · 28 min

   Afspelen
   Join the Behind the Knife Surgical Oncology Team as we discuss the MATTERHORN trial and the addition of perioperative immunotherapy to FLOT for resectable gastric and gastroesophageal junction adenocarcinoma! Lees meer

   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 an Associate Professor of Surgery and Surgical Oncologist at the University of Tennessee Health Science Center, Chattanooga.

   Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncologist at Brooke Army Medical Center.

   Joe (Joseph) Broderick, MD, MA (@joebrod5) is a General Surgery research resident between his second and third year at Brooke Army Medical Center.

   Galen Gist, MD (@gistgalen) is a third-year General Surgery resident at Brooke Army Medical Center.

   Learning Objectives:
   In this episode, we review the evolution of perioperative therapy for resectable gastric and gastroesophageal junction adenocarcinoma, from the MAGIC and FLOT4 trials to the MATTERHORN trial, a phase III randomized controlled trial investigating the addition of perioperative durvalumab to FLOT. We discuss the mechanism of checkpoint inhibition, the trial design, the event-free and overall survival results, the pathologic and nodal response data, and the open questions this trial raises for surgeons.

   References used in the making of this episode:

   Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. doi:10.1056/NEJMoa055531

   Al-Batran SE, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomi…

6. Building a Career in Global Surgery - Purpose, Mentorship, and Impact

   19 oktober 2026 · 28 min

   Afspelen
   In this episode of the Behind the Knife Global Surgery Series, we explore what it actually takes to build a meaningful career in global surgery. Global surgery is not a single specialty or job title—it is a broad field that intersects with clinical care, education, research, policy, advocacy, implementation science, and health-system strengthening. So how do trainees and early-career surgeons find their place in it? Lees meer

   Host Mike M. Mallah is joined by Dr. Barnabas Alayande and Dr. Lacey LaGrone for a candid discussion about the personal and professional paths that brought them into global surgery. Dr. Alayande shares how experiences with limited access to healthcare in Nigeria shaped his decision to pursue medicine and ultimately global surgery, while Dr. LaGrone discusses her focus on translating evidence into clinical practice and building scalable approaches to knowledge dissemination.

   Together, they discuss why purpose matters, why global surgery should be viewed as a field rather than a job title, and why aspiring global surgeons should first become excellent at something that allows them to add real value. The conversation also examines mentorship, the difference between visibility and impact, the importance of integrity in partnerships, and the personal sacrifices that can accompany a career devoted to this work.

   For medical students, residents, fellows, and junior faculty interested in global surgery, this episode offers practical advice: develop meaningful expertise, seek mentors who are genuinely invested in your growth, focus less on recognition and more on impact, and keep doing the next right thing—excellently.

   Hosts/Guests:
   Mike M. Mallah, MD, FACS, FICS
   Director of Global Surgery, Medical University of South Carolina
   @MikeMMallahMD
   @MUSCGlobalSurg
   mallahm@musc.edu

   Barnabas Alayande, MD
   Chair, Center for Equity and Global Surgery
   University of Global Health Equity, Rwanda
   General Surgeon, Surgical Educator, and Global Surgery Leader
   @DrBarnabasAlay
   …

7. Clinical Challenges in Bariatric Surgery: Marginal Ulcers

   15 oktober 2026 · 40 min

   Afspelen
   Open the capsule, quit the cigarettes, and know when to cut: the essentials of managing marginal ulcers after bypass. Lees meer

   Marginal ulcers are among the most common complications after Roux-en-Y gastric bypass, with a pooled prevalence around 4.6%, and they span everything from mild postprandial pain to perforation with peritonitis. In this episode, our expert panel works through three clinical scenarios (an uncomplicated early ulcer, a refractory ulcer with recurrent stricture, and a perforated ulcer with peritonitis) to build a practical framework for prevention, workup, medical therapy, and surgical escalation.

   Hosts

   Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California)

   Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio)

   Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida)

   Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California)

   Learning objectives
   1. Identify the established and debated risk factors for marginal ulcers. Recognize smoking, diabetes, NSAIDs, and larger pouch size as key contributors. Appreciate that the role of H. pylori remains unsettled because of heavy heterogeneity across meta-analyses.

   2. Perform a complete etiologic workup for a new marginal ulcer. Assess NSAID and immunosuppressant use, smoking (including cotinine test), H. pylori status, and visible suture or staple material at the anastomosis, and know that endoscopy, not CT, is the diagnostic tool of choice unless perforation is suspected.

   3. Optimize first-line medical management. Use PPI therapy with instructions to open the capsules for faster healing, understand the limited evidence for adding sucralfate, confirm healing with repeat endoscopy, and individual…

8. Journal Review in Vascular Surgery: Vascular Extremity Trauma

   12 oktober 2026 · 48 min

   Afspelen
   It’s 2 a.m. and a patient with a GSW to the thigh is rolling into the trauma bay. He’s hypotensive, tachycardic, and has a tourniquet in place. Do you get a CTA or go straight to the OR? What do you do with the tourniquet? Lees meer

   Join us as we work through this and two other cases of extremity vascular trauma and break down the literature to answer these questions and discuss how we should approach these challenging injuries.

   Hosts:
   · Christian Hadeed - PGY 5 General Surgery, Brookdale Hospital Medical Center
   · Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center
   · Andrew Harrington – Division Chief, Vascular surgery, Richmond University Medical Center
   · Lucio Flores - Vascular surgery, Brookdale Hospital Medical Center

   Learning Objectives:
   · Apply the X-ABCDE approach to patients with extremity vascular trauma, including the role of early hemorrhage control and tourniquets.
   · Recognize the hard and soft signs of extremity arterial injury and determine when additional vascular imaging is indicated.
   · Describe the role of the ankle-brachial index, CT angiography, and conventional angiography in the evaluation of suspected extremity vascular injury.
   · Discuss the principles of operative management of extremity vascular injuries, including temporary shunting, vascular repair, and restoration of limb perfusion.
   · Briefly discuss mangles extremities and when saving the limb may not be appropritate

   References:
   · American College of Surgeons Committee on Trauma. (2025). Advanced trauma life support (ATLS®) student course manual (11th ed.). American College of Surgeons.
   · Lynch, K., & Johansen, K. (1991). Can Doppler pressure measurement replace “exclusion” arteriography in the diagnosis of occult extremity arterial trauma? Annals of Surgery, 214(6), 737–741. https://doi.org/10.1097/00000658-199112000-00016
   · Inaba, K., Branco, B. C., Reddy, S., Park, J. J., Green, D., Plurad, D., Talving, P., Lam, L., & Demetriades, D. (2011). Prospective evaluatio…

9. Operative Standards for Cancer Surgery Series: Total Mesorectal Excision for Rectal Cancer

   8 oktober 2026 · 48 min

   Afspelen
   This mini-series on Behind the Knife will discuss the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program and Cancer Surgery Standards Program. This episode highlights total mesorectal excision for rectal cancer. Lees meer

   Host:

   Jason Lizalek, MD (@JasonLizalekMD) is a Surgical Oncology fellow at Moffitt Cancer Center in Tampa, FL.

   Guests:

   Sean J Langenfeld, MD, FACS, FASCRS (@seanlangenfeld) is a professor of surgery and the chief of the division of colon and rectal surgery at the University of Nebraska Medical Center in Omaha, NE

   Larissa Temple, MD, FACS, FASCRS is a professor of surgery and the chief of colon and rectal surgery at the University of Rochester in Rochester, NY.

   Learning Objectives:
   - Understand the relevant pelvic anatomy that makes TME challenging.
   - Develop a step-by-step approach to TME that avoids major pitfalls and allows for a sfe low pelvic anastomosis.
   - Learn tips and tricks for exposure and progress in the more difficult cases.

   Links to Papers Referenced in this Episode:

   Operative Standards for Cancer Surgery, Volume 1: Breast, Lung, Pancreas, Colon
   https://www.facs.org/quality-programs/cancer-programs/cancer-surgery-standards-program/operative-standards-for-cancer-surgery/purchase/

   Kindle edition:
   https://www.amazon.com/Operative-Standards-Cancer-Surgery-Section-ebook/dp/B07MWSNFSB

   The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement
   https://pubmed.ncbi.nlm.nih.gov/37647138/

   NCCN Guidelines for Rectal Cancer
   https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1461

   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
   Behind the Knife Premium: https://behindtheknife.org/premium
   Oral Board Review: https://beh…

10. Journal Review in Emergency General Surgery: STOP-IT - What a Decade of Data Has Taught Us

    5 oktober 2026 · 29 min

    Afspelen
    It’s postoperative day four after surgery for a perforated colon. The source appears controlled, but the patient is still intubated, the white count is eighteen, and nobody feels comfortable stopping piperacillin–tazobactam. Is four days really enough? Does the ICU buy another four—or is it time to ask what we’re missing? Lees meer

    Join Drs. Rushabh Dev, Skye Shultz, Kelly Ray, Desra Fletcher, and Brycen Ratcliffe from the Emergency General Surgery team in Tiger Country at Mizzou as they revisit STOP-IT and examine what more than a decade of evidence has added to the management of complicated intra-abdominal infection.

    In this EGS Journal Review, the team appraises the landmark trial, explores its subgroup analyses and limitations, and puts contemporary SIS, IDSA, AAST, and Surviving Sepsis guidance into context. The discussion moves from source control and antibiotic duration to resistant organisms, cultures, de-escalation, ICU dosing, and the role of procalcitonin.

    For most complicated intra-abdominal infections, approximately four days after adequate source control remains the default. Persistent illness should prompt a search for failed source control, ineffective therapy, or another diagnosis before simply extending the stop date.

    Hosts

    Dr. Rushabh Dev, MD, FACS – Moderator and Acute Care Surgeon, University of Missouri

    Dr. Skye Shultz – Surgical Critical Care Fellow, University of Missouri

    Dr. Kelly Ray – General Surgery Resident; STOP-IT appraisal and antimicrobial selection

    Dr. Desra Fletcher – General Surgery Resident, University of Missouri; post-STOP-IT evidence and implementation

    Dr. Brycen Ratcliffe – General Surgery Resident; society guidance and microbiology

    Learning Objectives

    By the end of this episode, listeners should be able to:
    · Describe the design, principal results, strengths, and limitations of STOP-IT, including why adequate source control is essential to applying its findings.
    · Apply short-course therapy after adequate operative or perc…

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