Behind The Knife: The Surgery Podcast
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Clinical Informatics for Surgeons, Episode 2: Legal Discovery and Cybersecurity When a Case Goes Wrong
5 november 2026 · 33 min
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 …
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Clinical Informatics for Surgeons, Episode 1: What Is Clinical Informatics, and Why Should Surgeons Care?
2 november 2026 · 29 min
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…
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USA vs. UK: ASGBI Ep. 11 - Surgeons Are Human Too - Breaking the Silence on Mental Health
29 oktober 2026 · 43 min
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/. … -
Demystifying Topical Hemostatic Agents: A Mental Model for Surgeons
26 oktober 2026 · 42 min
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
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.o… -
Journal Review in Surgical Oncology: Gastric Cancer
22 oktober 2026 · 28 min
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…
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Building a Career in Global Surgery - Purpose, Mentorship, and Impact
19 oktober 2026 · 28 min
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.eduBarnabas Alayande, MD
Chair, Center for Equity and Global Surgery
University of Global Health Equity, Rwanda
General Surgeon, Surgical Educator, and Global Surgery Leader
@DrBarnabasAlay
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Clinical Challenges in Bariatric Surgery: Marginal Ulcers
15 oktober 2026 · 40 min
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…
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Journal Review in Vascular Surgery: Vascular Extremity Trauma
12 oktober 2026 · 48 min
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 CenterLearning 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 appropritateReferences:
· 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… -
Operative Standards for Cancer Surgery Series: Total Mesorectal Excision for Rectal Cancer
8 oktober 2026 · 48 min
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/B07MWSNFSBThe 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=1461Please 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… -
Journal Review in Emergency General Surgery: STOP-IT - What a Decade of Data Has Taught Us
5 oktober 2026 · 29 min
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… -
Behind the Knife en español: repaso para la certificación en cirugía general - Cáncer de Cólon
1 oktober 2026 · 26 min
Enlace del curso: https://behindtheknife.org/premium/repaso-para-el-examen-de-certificaci-n-en-cirug-a-general Lees meer
Behind the Knife es el podcast quirúrgico líder en el mundo y una plataforma de educación quirúrgica. Nuestra misión es crear contenido innovador de educación quirúrgica que sea accesible para todos. Estamos muy emocionados de expandirnos al público hispanohablante y ofrecerles 4 episodios de muestra de nuestro Curso de Repaso para el examen de certificación de Cirugía General.
Hoy, escucharás un caso de muestra de este curso de repaso en audio, que incluye 100 escenarios.
El curso tiene un formato emocionante y completamente único. Cada uno de los 100 caso consta de dos partes. La primera parte es un caso oral perfectamente ejecutado que imita la realidad. Cada caso tiene una duración de cinco a siete minutos e incluye una variedad de tácticas y estilos. Si logras alcanzar este nivel de desempeño en tu preparación, seguramente aprobarás el examen de certificación con éxito.
La segunda parte introduce comentarios de alto rendimiento para cada escenario. Estos comentarios incluyen consejos y trucos para ayudarte a dominar los escenarios más desafiantes, además de una enseñanza práctica y fácil de entender que cubre los temas más confusos que enfrentamos como cirujanos generales. Estamos seguros de que encontrarás este enfoque único de doble formato como una forma altamente efectiva de prepararte para el examen.
Nuestro contenido está disponible en nuestras aplicaciones para iOS y Android y en nuestro sitio web (behindtheknife.org). Por favor, consulta las notas del programa para más información. Nos encantaría escuchar tus comentarios sobre este episodio enviando un correo electrónico a hello@behindtheknife.org y apreciamos tu ayuda para difundir la palabra entre tus colegas si disfrutas del material.
Este contenido incluye 97 descripciones operatorias para todos los procedimientos comunes —y la mayoría de los poco comunes— incluidos en el Currículo d…
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Journal Review in Vascular Surgery: Disrupt PAD III: Intravascular Lithotripsy for Calcified Peripheral Artery Disease
28 september 2026 · 33 min
Calcified peripheral artery disease (PAD) remains one of the most challenging problems in endovascular intervention. Calcium limits vessel expansion, increases the risk of dissection and procedural failure, and can ultimately lead to bailout stenting. The Disrupt PAD III program provided important evidence for a different approach: intravascular lithotripsy (IVL) as a vessel-preparation strategy. In this episode, we examine the randomized Disrupt PAD III trial published by Tepe and colleagues and the large, real-world observational analysis led by Armstrong and colleagues. Together, these studies explore whether IVL can make treatment of heavily calcified lesions more predictable, reduce the need for stenting, and support a “leave-nothing-behind” strategy. Lees meer
Hosts:
Dr. Robert Beaulieu
Dr. Frank Davis
Dr. Luciano Delbono
Dr. Andrew Huang
Dr. Carolyn JudgeLearning Objectives
By the end of this episode, listeners should be able to:Explain the challenges posed by moderate to severe vascular calcification during peripheral endovascular intervention and the rationale for dedicated vessel-preparation strategies.
Describe the design, patient population, endpoints, and primary findings of the randomized Disrupt PAD III trial comparing IVL with conventional PTA.
Interpret the procedural and longer-term outcomes associated with IVL, including residual stenosis, dissection rates, bailout stenting, and primary patency.
Evaluate how the Disrupt PAD III observational study complements the randomized trial by examining IVL in a larger, more complex, real-world population and across multiple vascular beds.
Identify the practical implications, limitations, and remaining unanswered questions surrounding IVL, including its role relative to other calcium-modification strategies such as atherectomy.
References
Tepe G, Brodmann M, Werner M, et al. Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial. JACC Cardio…
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Clinical Challenges in Breast Surgery: Managing Breast Cancer Risk - From Assessment to Interventions
24 september 2026 · 57 min
Breast cancer risk varies widely across patients, and surgeons play a central role in recognizing elevated risk and guiding appropriate management. In this episode, we review the spectrum of breast cancer risk and discuss practical strategies for risk assessment and risk reduction. We’ll cover surveillance, lifestyle interventions, risk-reducing medications, high-risk breast lesions, and prophylactic surgery—with an emphasis on translating the available evidence into individualized clinical care. Lees meer
Hosts:
- Rashmi Kumar, MD, PhD
Resident, University of Michigan General Surgery Residency Program
Twitter/X: @RashmiJKumar
- Melissa Pilewskie, MD
Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine
Twitter/X: @MPilewskie
- Stephanie Downs-Canner, MD
Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program
Twitter/X: @SDownsCannerLearning Objectives:
Identify major modifiable and nonmodifiable breast cancer risk factors, including genetic predisposition, family history, breast density, high-risk lesions, prior chest radiation, and lifestyle factors.
Select and interpret commonly used breast cancer risk-assessment tools—including the Gail, Tyrer-Cuzick, and BCSC models—while recognizing their important limitations.
Recommend appropriate risk-management strategies based on a patient’s risk level, including enhanced surveillance, lifestyle interventions, genetic evaluation, and endocrine risk-reducing therapy.
Explain the indications, benefits, limitations, and tradeoffs of managing high-risk breast lesions and pursuing risk-reducing surgery, including bilateral mastectomy and salpingo-oophorectomy.
References:
Risk-Assessment ToolsNational Cancer Institute. Breast Cancer Risk Assessment Tool.https://bcrisktool.cancer.gov/
National Breast Cancer Foundation. What is the Tyrer-Cuzick mod…
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From Paper to Practice: What Every Surgeon Should Know About Guidelines
21 september 2026 · 27 min
Ever wonder how a mountain of clinical data transforms into a clinical practice guideline, or whether deviating from one puts you at legal risk? Join us as we pull back the curtain on guidelines methodology, decode the fine print, and put the evidence into practice. Lees meer
Hosts:
Scott Steele, MD, MBA – Colon and Rectal Surgeon at Cleveland Clinic
Nicole L. Petcka, MD, MHPE – General Surgery Resident at Emory University
Guests:
Bethany Slater, MD – Pediatric Surgeon at Mount Siani, SAGES Guidelines Committee Chair
Francesco Palazzo, MD – Minimally Invasive Surgeon at Jefferson Health, SAGES Guidelines Committee Co-chair
Elisa Calabrese, MD – General Surgery Resident at UCSF-East Bay, SAGES/RACS Guidelines Fellow
Resources:
Kumar, S. S., Collings, A. T., Wunker, C., Athanasiadis, D. I., DeLong, C. G., Hong, J. S., Ansari, M. T., Abou-Setta, A., Oliver, E., Berghella, V., Alli, V., Hassan, I., Hollands, C., Sylla, P., Slater, B. J., & Palazzo, F. (2024). SAGES guidelines for the use of laparoscopy during pregnancy. Surgical endoscopy, 38(6), 2947–2963. https://doi.org/10.1007/s00464-024-10810-1Please 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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for… -
Beyond the Match, Episode 3: Working Conditions, Resident Mobility, and Accountability
17 september 2026 · 35 min
You stayed late again, the service is still short-staffed, and when you finally say something, the answer is: you just need to be more efficient. More resilient. That's the go-to explanation for almost everything hard about residency — but what if the problem isn't your resilience at all? In the finale of Beyond the Match, Mckenzie Roebuck, Carl Engelke, Michael Brinton, and Omer Hassan of CoSEF look downstream at what happens after residents match: working conditions, culture and mental health, the practical barriers that make transferring so difficult, why residents may not trust existing reporting systems, and what real accountability and resident voice would require. Lees meer
Hosts:
Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org
Dr. Carl Engelke, The Ohio State University, Carl.Engelke@osumc.edu
Dr. Michael Brinton, Medical College of Wisconsin, mbrinton@mcw.edu
Dr. Omer Hassan, University of Calgary/Alberta Children's Hospital, omerh91@gmail.com
CoSEF: X @surgedfellows, cosef.org
Learning objectives:
Summarize the real problems the congressional report identifies in working conditions, mistreatment reporting, and resident mental health
Distinguish necessary difficulty in residency training from preventable system dysfunction, and describe its relationship to resident well-being and reporting
Explain the practical barriers to resident mobility, including position availability, training requirements, funding, visa status, professional risk, and stigma
Describe local and national accountability mechanisms — including program reporting, GMECs, ACGME pathways, and unions — and the limitations of each
Identify strategies to strengthen resident voice, psychological safety, anti-retaliation protections, and institutional accountability rather than relying on individual resilience alone.
References:
House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the Amer…
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Beyond the Match, Episode 2: Application Chaos, Transparency, and the Cost of Uncertainty
15 september 2026 · 35 min
You matched into your dream program... but only after submitting 80 applications, spending thousands of dollars, and losing sleep wondering if anyone was even reading yours. Meanwhile, on the other side of the screen, a program director is staring down a thousand applications for six spots, trying to figure out who's actually serious about coming. Sound familiar? Join Mckenzie Roebuck, Milanie Milan, Sarah Lund, and Bryanna Stukes of CoSEF as they unpack the residency application arms race: why uncertainty drives overapplication, what preference signaling and application caps actually solve, the trade-offs of virtual versus in-person interviews, and how better transparency, advising, holistic review, and even AI might help applicants and programs find the right fit. Lees meer
Hosts:
Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org, insta @mrowemd, X @mrowemd1
Dr. Milanie Milan, Cleveland Clinic, milanie.milan98@gmail.com, insta @m.mdgram
Dr. Sarah Lund, Mayo Clinic, slund@alum.mit.edu, X @DrSarahLund
Dr. Bryanna Stukes, UT Southwestern bryanna.stukes@UTSouthwestern.edu
CoSEF: X @surgedfellows, cosef.org
Learning objectives:
Explain how uncertainty across the residency selection process drives overapplication and distinguish the Match algorithm from the broader application ecosystem
Describe how preference signaling, application caps, and interview format affect applicant and program behavior, including equity trade-offs
Identify ways programs can improve both competitiveness and program-level transparency
Discuss how investment in holistic review and mission-specific selection criteria may improve application review while introducing new challenges.
References:
House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public. Published online March 27, 2026.
National Resident Matching Program. Advance Data Tables: 2026 Main Residency Match. NRMP. Publ…
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Beyond the Match, Episode 1: Pay, Benefits, and Bargaining Power
14 september 2026 · 35 min
What does it say about a training system when childcare can eat up almost half a resident’s monthly salary — and the physicians doing essential clinical work have almost no ability to negotiate their pay or benefits? A recent House Judiciary Committee report argues that the Match suppresses resident compensation and bargaining power. But if the Match disappeared tomorrow, would residents actually get paid more? Join Mckenzie Roebuck, Maya Hunt, Nicole Santucci, and Michael Kabbash of CoSEF as they unpack resident pay and benefits, where GME funding actually goes, why residency is not a normal labor market, and where real leverage for change might come from. Lees meer
Hosts:
Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org, insta @mrowemd, X @mrowemd1
Dr. Maya Hunt, Indiana University, mayahunt@iu.edu
Dr. Nicole Santucci, Washington University in St. Louis, snicole@wustl.edu
Dr. Michael Kabbash, University of Florida, michel.kabbash@surgery.ufl.edu, X @MichaelKabbash
CoSEF: X @surgedfellows, cosef.org
Learning objectives:
Summarize the congressional report’s arguments about resident compensation and bargaining power
Explain how GME funding supports residency and why federal GME dollars do not map directly onto resident salaries
Describe how salary and benefit structures affect residents’ financial well-being, family planning, and quality of life
Identify institutional, policy, and collective strategies to strengthen resident compensation and bargaining power.
References:
House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public. Published online March 27, 2026.
Association of American Medical Colleges. AAMC Survey of Resident/Fellow Stipends and Benefits. https://www.aamc.org/data-reports/students-residents/report/aamc-survey-resident/fellow-stipends-and-benefits.
Centers for Medicare and Medicaid Services. Direct Graduate Medical Education (DG…
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Surgical Critical Care Review: Acute Respiratory Distress Syndrome
11 september 2026 · 59 min
Introducing Behind the Knife Surgical Critical Care Review! Lees meer
DOMINATE THE ICU with our comprehensive course that includes audio + simulator + question bank.
Master the management of the critically ill patient with Behind the Knife's all-new Surgical Critical Care Review. Built for high-yield, real-world application, this comprehensive multimedia program gives residents, fellows, and practicing surgeons everything they need to confidently manage the sickest patients in the hospital.What's included:
38 High-Yield Podcasts — Expert-led discussions spanning the full SCORE curriculum for Surgical Critical Care.
AI Case Simulator — Test your judgment against our one-of-a-kind interactive simulator, built to recreate the pressure of high-stakes clinical scenarios. 110 simulator credits included with purchase.
Comprehensive Question Bank — Rigorous, board-style multiple-choice questions to sharpen your performance on rounds and on exam day.
Get Instant Access Here: https://behindtheknife.org/premium/surgical-critical-care-review
Enjoy this sample episode from the course.
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Surgical Critical Care Review: Traumatic Brain Injury
10 september 2026 · 24 min
Introducing Behind the Knife Surgical Critical Care Review! Lees meer
DOMINATE THE ICU with our comprehensive course that includes audio + simulator + question bank.
Master the management of the critically ill patient with Behind the Knife's all-new Surgical Critical Care Review. Built for high-yield, real-world application, this comprehensive multimedia program gives residents, fellows, and practicing surgeons everything they need to confidently manage the sickest patients in the hospital.What's included:
38 High-Yield Podcasts — Expert-led discussions spanning the full SCORE curriculum for Surgical Critical Care.
AI Case Simulator — Test your judgment against our one-of-a-kind interactive simulator, built to recreate the pressure of high-stakes clinical scenarios. 110 simulator credits included with purchase.
Comprehensive Question Bank — Rigorous, board-style multiple-choice questions to sharpen your performance on rounds and on exam day.
Get Instant Access Here: https://behindtheknife.org/premium/surgical-critical-care-review
Enjoy this sample episode from the course.
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Surgical Critical Care Review: Liver Failure
9 september 2026 · 31 min
Introducing Behind the Knife Surgical Critical Care Review! Lees meer
DOMINATE THE ICU with our comprehensive course that includes audio + simulator + question bank.
Master the management of the critically ill patient with Behind the Knife's all-new Surgical Critical Care Review. Built for high-yield, real-world application, this comprehensive multimedia program gives residents, fellows, and practicing surgeons everything they need to confidently manage the sickest patients in the hospital.What's included:
38 High-Yield Podcasts — Expert-led discussions spanning the full SCORE curriculum for Surgical Critical Care.
AI Case Simulator — Test your judgment against our one-of-a-kind interactive simulator, built to recreate the pressure of high-stakes clinical scenarios. 110 simulator credits included with purchase.
Comprehensive Question Bank — Rigorous, board-style multiple-choice questions to sharpen your performance on rounds and on exam day.
Get Instant Access Here: https://behindtheknife.org/premium/surgical-critical-care-review
Enjoy this sample episode from the course.
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Surgical Critical Care Review: Mechanical Circulatory Support
8 september 2026 · 21 min
Introducing Behind the Knife Surgical Critical Care Review! Lees meer
DOMINATE THE ICU with our comprehensive course that includes audio + simulator + question bank.
Master the management of the critically ill patient with Behind the Knife's all-new Surgical Critical Care Review. Built for high-yield, real-world application, this comprehensive multimedia program gives residents, fellows, and practicing surgeons everything they need to confidently manage the sickest patients in the hospital.What's included:
38 High-Yield Podcasts — Expert-led discussions spanning the full SCORE curriculum for Surgical Critical Care.
AI Case Simulator — Test your judgment against our one-of-a-kind interactive simulator, built to recreate the pressure of high-stakes clinical scenarios. 110 simulator credits included with purchase.
Comprehensive Question Bank — Rigorous, board-style multiple-choice questions to sharpen your performance on rounds and on exam day.
Get Instant Access Here: https://behindtheknife.org/premium/surgical-critical-care-review
Enjoy this sample episode from the course.
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Clinical Challenges in Colorectal Surgery: Managing the Tough Stoma
3 september 2026 · 28 min
This episode offers a practical, case-based approach to one of the most common intraoperative challenges in GI surgery: constructing a stoma that just won't cooperate. The discussion covers preoperative marking and stoma siting in the obese and non-elective patient, technical maneuvers to gain length and reduce tension on the stoma, strategies for the foreshortened small bowel mesentery, and considerations for maturing a stoma in a massively dilated, thick-walled colon. Join Drs. Elissa Dabaghi, Jared Hendren, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss this clinical challenge in colorectal surgery. Lees meer
Hosts:
· Elissa Dabaghi, MD, Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio· Jared Hendren, MD, Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
· Joseph Trunzo, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter @joseph_trunzo
· Ajaratu Keshinro, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter- @AJKesh
· David Rosen, MD, Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, X/Twitter- @davidrrosenmd
Learning Objectives: By the end of this episode, listeners will be able to:
1. Describe preoperative marking strategies and intraoperative technical adaptations for stoma siting and construction in obese and non-elective patients.
2. Apply strategies for managing a foreshortened small bowel mesentery when constructing an end or loop ileostomy.
3. Recognize technical considerations for maturing a stoma in a massively dilated, thick-walled colon and identify associated long-term risksSponsor Disclaimer: Visit https://www.goremedical.com/btkpod to learn m…
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Building the House of Surgical Education: The Legacy of Dr. Ajit Sachdeva
31 augustus 2026 · 39 min
What does it take to build a national surgical education apparatus from scratch? In this episode, we sit down with Dr. Ajit Sachdeva, the former Senior Vice President for Education at the American College of Surgeons—a role he held for 24 years before passing the torch in fall 2025. When Dr. Sachdeva arrived at the ACS in 2001, there was no division, no script, and almost no structure. Over the course of his tenure, he created an ecosystem that now touches surgeons at every stage of their careers, from the first year of medical school to the last year of practice. Lees meer
Dr. Sachdeva reflects on competence, excellence, and the value of surgical educators. He discusses the structural shifts that have shaped modern surgical training, including simulation standards, competency-based curricula, the ACS Accredited Education Institutes, and the Academy of Master Surgeon Educators. He also shares his thoughts on the challenges that remain: resource constraints, the tension between clinical productivity and educational investment, and the gap between national standard-setting and local implementation.
Join hosts Pooja Varman, MD, Judith French, PhD, and Jeremy Lipman, MD, MHPE to reflect on Dr. Sachdeva’s impact on surgical education.
Learning Objectives
By the end of this episode, listeners will be able to
1. Distinguish between competence, proficiency, expertise, and mastery in the context of surgical training and career development.
2. Identify key structural initiatives from the ACS Division of Education and describe their impact on surgical education at the national level.
3. Discuss the challenges of sustaining and funding surgical education infrastructure and articulate strategies for aligning educational goals with institutional priorities.References
1. ACS Accredited Education Institutes: https://www.facs.org/for-medical-professionals/education/programs/accredited-education-institutes/
2. Dr. Ajit Sachdeva Describes a Career of Distinction in Practice and Surgical … -
Clinical Challenges in Trauma Surgery: Organ Retrieval to Trauma Survival - Challenging Trauma Steps Made Familiar
27 augustus 2026 · 54 min
It’s 0300 and you encounter a rapidly expanding zone 1 retroperitoneal haematoma. Time to enter “tiger country”. What can you do to make this a more familiar expedition? Lees meer
• Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated
1. Mr Prashanth Ramaraj. ST5 General Surgery, George Hospital, Western Cape / Southeast Scotland Deanery. @LonTraumaSchool2. Dr Roisin Kelly. Medical Officer, Emergency Medicine, Sydney, Australia.
3. Mr Max Marsden. Consultant Trauma and UGI Surgeon, Royal London Hospital. @maxmarsden83
4. Mr Christopher Johnston. Consultant Liver Transplant Surgeon and Transplant Surgery Fellowship Lead, Edinburgh Transplant Unit. @cjcjohnston
• Learning objectives: Bulleted list of learning objectives.
A) To understand the rationale for thoracic aortic clamping in resuscitative trauma surgery and how this is performed.B) To understand how to access the retroperitoneal structures by means of medial visceral rotation and how this is performed.
C) To understand the haemostatic ladder for liver trauma and considerations in hepatic exclusion.
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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-sur… -
Clinical Challenges in Endocrine Surgery: Adrenal Cases
24 augustus 2026 · 29 min
There are many acceptable approaches to adrenalectomy. Hypercortisolism with adrenal origin is a challenging topic especially in a population where obesity is incredibly common. A thorough biochemical workup involving endocrinologists and endocrine surgeons is key to offering the best surgery. Large adrenal tumors with indeterminate imaging characteristics have historically been removed with an open surgical approach. However, with modern robotic technology, it is possible to remove these successfully using a minimally invasive approach with a high-volume surgeon. Today we will discuss some clinically challenging adrenal cases addressing the above issues, and include tips and tricks from an expert, high-volume robotic adrenal endocrine surgeon. Lees meer
Hosts:
- Amanda Doubleday, DO, MBA, Assistant Professor, Waukesha Surgical Specialists, ProHealth Care. Affiliated with University of Wisconsin School of Medicine and Public Health, Department of Surgery.
- Simon Holoubek, DO, MPH, Assistant Professor, University of Wisconsin School of Medicine and Public Health, Department of Surgery.
- John R. Porterfield, Jr., MD, MSPH, FACS, President of Clarus Surgery, President of Apex PA Surgical Services and Founder & Chief Medical Officer of Informed Surgical
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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guid… -
Operative Standards for Cancer Surgery Series: Liver Resection for Hepatocellular Carcinoma
20 augustus 2026 · 29 min
This mini-series on Behind the Knife will delve into the technical aspects of the Operative Standards for Cancer Surgery, developed through the American College of Surgeons Cancer Research Program. This third episode highlights the Hepato-Pancreato-Biliary cancer operative standard. Lees meer
Hosts:
Eliza W. Beal, MD, FACS (X: @ElizaWBealMD) is a Hepato-Pancreato-Biliary surgeon at the Barbara Ann Karmanos Cancer Institute in Detroit. She is also an associate professor of Oncology and Surgery at Wayne State University School of Medicine.
Morgan Jackson, MD is a general surgery resident at the Detroit Medical Center and Wayne State University in Detroit, MI.
Daniel Nelson, MD, FACS, FSSO (X: @DWNelsonHPB) is a Hepato-Pancreato-Biliary surgeon at the University of Tennessee Health Science Center - Chattanooga.
Hop Sanderson Tran Cao, MD, FACS (X: @HopSTranCao) is a Hepato-Pancreato-Biliary surgeon at MD Anderson Cancer Center.
Guest:
Alice Wei, MD is a Hepato-Pancreato-Biliary surgeon at Memorial Sloan Kettering and associate professor of surgery at Weill Cornell School of Medicine. Dr. Wei contributed to the development of the operative standards for HPB surgery.
Learning Objectives: The goals of this podcast are to provide education about the standards, generate discussion, and offer technical pearls to both oncologic specialists and general surgeons, to all of whom these standards apply. In this podcast we discuss the operative standards for liver resection for hepatocellular carcinoma, which includes that the surgeon should: (1) perform a thorough inspection of the liver and abdomen, either laparoscopically or open, including performing liver ultrasound, and (2) should resect all lesions to macroscopically negative margins, preferably with an anatomic resection. Our guest Dr. Wei also provides technical tips, pearls for improving skills performing and interpreting liver ultrasound, and discusses the role of lymphadenectomy in patients with hepatocellular carcinoma.…
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USA vs. UK: ASGBI Ep. 10 - The Nuanced Approach to Abdominal Wall Reconstruction
17 augustus 2026 · 39 min
In this episode, we discuss all things abdominal wall reconstruction. What is this new developing field, just patching “holes” with meshes or something more? We delve into the impact of the robot in transforming this speciality in new ways. We also explore the reasons that make the field of abdominal wall reconstruction so special (the creativity in surgical planning and the unique patient-provider relationship). Lees meer
Joining BTK fellow Agnes Premkumar and ASGBI hosts Elizabeth McLennan and Gita Lingam are Dr. Conrad Ballecer and Dr. Akash Mehta. Dr. Conrad Ballecer is an internationally renowned minimally invasive surgeon, focused on abdominal wall reconstruction. He currently works at Creighton University in Phoenix with complex hernias and frequently publicizes his surgical videos for education! Mr. Mehta is a consultant colorectal surgeon at St. Mark’s Hospital in London, United Kingdom. He is interested in intestinal failure and rehabilitation surgery. He is also the lead for the region's abdominal wall multidisciplinary team and has successfully established a minimally invasive abdominal wall surgery program.
This episode is dedicated to Professor Neil Smart, a visionary surgeon from the UK who was a lifelong advocate for hernia surgery and patients. His legacy lives on.
Let us know what you think! And be on the lookout for more ASGBI/BTK collaborative episodes.
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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate S… -
Surgical Endoscopy Series Ep. 5: Novel Endosurgical Techniques
13 augustus 2026 · 42 min
In this surgical endoscopy episode, the BTK team introduces endoscopic surgical procedures that are perhaps less well known. They cover primary endoscopic treatments for gastroesophageal reflux, esophageal plication, intestinal resurfacing procedures, and magnet-assisted enteric anastomoses. Endoscopic options may be viable alternatives to surgical treatment, especially in case where the surgical alternatives may significantly increase morbidity. Lees meer
Video: https://behindtheknife.org/watch/surgical-endoscopy-series-ep-5-novel-endosurgical-techniques
Hosts:
· Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgeon, Dell Medical School, University of Texas at Austin (Austin, TX), @SAyusoMD (Twitter)
· Dr. H. Mason Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL),
· Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter)
· Dr. Zachary Callahan, Minimally Invasive Surgeon, The Surgical Clinic (Nashville, TN), @zmcallahan (Twitter)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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
Vascular Surgery Oral Board Review Course:… -
Journal Review in Minimally Invasive Surgery: Digital Surgery
10 augustus 2026 · 29 min
Digital surgery has morphed from buzzword into ubiquitous high-impact technology. In this episode, the BTK MIS team steps into the rapidly evolving ecosystem of cameras, sensors, robotics, and software that are turning surgical operations into structured, analyzable datasets. From AI segmentation to real-time telepresence, don’t miss this opportunity to catch up on what’s new and what’s next, what’s exciting and what’s terrifying, just on the horizon of your surgical career. Lees meer
Hosts:
· James Jung, MD, PhD, Assistant Professor of Surgery, Duke University
· Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University
· Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD
· Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actuallyLearning Goals:
By the end of this episode, listeners will be able to:
· Define “digital surgery” and describe its core components, including video capture, instrumentation, robotics, data analytics, and system connectivity.
· Discuss current and emerging applications of digital surgery in surgical education, including video-based self-assessment, procedural segmentation, and structured feedback models.
· Describe how digital tools can be used to improve OR efficiency and resource utilization, including instrumentation usage, operative time analysis, and workflow optimization.
· Summarize current telepresence and teleproctoring technologies and their clinical use cases, including augmented reality–based collaboration across institutions and geographic boundaries.
· Identify key ethical, legal, and operational challenges in digital and tele-surgery, including credentialing, cross-state licensure, liability, and trust in remote expertise.
· Discuss how digital surgery may reshape surgical training and competency-based assessment, including implications for autonomy, deliberate practice, and feedback frequency.
· Recognize future directions of dig… -
Journal Review in Thoracic Surgery: Empowering IMGs in CT Surgery - the Time to Act is Now
6 augustus 2026 · 26 min
Navigating the path to becoming a surgeon in the US as an International Medical Graduate (IMG) can definitely have its hurdles. In this episode we sit down with Professor of Surgery, Dr. Ourania Preventza about her journey as an IMG, and how to break down the barriers in one of the most competitive surgical subspecialties. Dr. Preventza teaches us why sponsorship is invaluable, and how we as a surgical community can help support this vulnerable group of providers. With years of experience to offer, both as an IMG herself, and now as a fierce advocate and mentor for trainees, this interview with Dr. Preventza is not one to miss. Lees meer
References:
https://www.jtcvsopen.org/article/S2666-2736(25)00059-2/fulltext
The current landscape and challenges facing international medical graduates in cardiothoracic surgery traininghttps://pubmed.ncbi.nlm.nih.gov/39886768/
International Medical Graduates in Academic Cardiothoracic Surgeryhttps://www.clinicalkey.com/#!/content/playContent/1-s2.0-S2666273625002840?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2666273625002840%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
A career in cardiothoracic surgery in the United States: Guidance and resources for international medical graduateshttps://jtd.amegroups.org/article/view/38164/html
US women in Thoracic Surgery: Reflections on the Past and Opportunities for the FuturePlease 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://behindtheknife.org/oral-board
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General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surge… -
Clinical Challenges in Burn Surgery: Have Some Skin (Substitutes) In the Game
3 augustus 2026 · 29 min
Join our burn team as they dive into the complex world of skin substitutes in burn care, breaking down a practical four-axis framework to help clinicians navigate product selection, patient factors, and clinical goals when managing massive burn injuries. Lees meer
Hosts:
- Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento
- Laura Johnson – Grady Memorial Hospital
- Lauren Nosanov – Grady Memorial Hospital
- Victoria Miles – Louisiana State University Health Science Center, University Medical Center New OrleansLearning objectives:
1. Classify skin substitutes along four axes: layer replaced, cellularity, origin, and duration.
2. Integrate wound, patient, phase-of-care, and goal factors to select an appropriate skin substitute or combination strategy.
3. Critically appraise the evidence base for skin substitutes, including industry influence and the distinction between adjunctive tools and definitive autologous coverage.If you would like the table mentioned in the episode, please email hello@behindtheknife.org.
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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation… -
Power, Partnerships, and the Reality of Global Surgery Collaboration
30 juli 2026 · 29 min
In this episode of the Behind the Knife Global Surgery Series, we take a closer look at the real-world complexity of global surgery partnerships between high-income institutions and partners in the Global South. Words like equity, bidirectionality, partnership, and decolonization are used often in global surgery—but what do they actually mean when funding, mobility, research access, publication opportunities, and institutional power are unequally distributed? Lees meer
Host Mike Mallah is joined by Dr. Hugo Stark from George Hospital in South Africa and Dr. Sydney Bertram from Emory for a candid discussion about the benefits and tensions of collaborations in an unequal world. Together, they explore how global surgery partnerships can create meaningful educational and clinical value, how good intentions can still reproduce unequal systems, and how surgeons can build partnerships that are locally useful, honest about power, and ultimately centered on better surgical care for patients.
Hosts/Guests:
- Mike M. Mallah, MD, FACS, FICS
Director of Global Surgery at Medical University of South Carolina
@MikeMMallahMD
@MUSCGlobalSurg
mallahm@musc.edu- Hugo Stark, MD
Head of Department - Surgery, George Hospital, Western Cape, South Africa
Head of Surgical Services, Central Karoo Region
Sydney Bertram, MD
General Surgery Resident, Emory University
Trainee Advisory Council, Consortium of Universities for Global Health
@Sydney_BertramLearning objectives:
• Describe how global surgery partnerships can provide educational, clinical, professional, and research value for both high-income and Global South partners.
• Identify how asymmetries in funding, mobility, publication access, and institutional agenda-setting can create inequity within otherwise well-intentioned global surgery partnerships.
• Discuss practical principles for ethical global surgery engagement, including centering local needs, avoiding extraction, building durable partnerships, and focusing on patient access to su… -
Clinical Challenges in Breast Surgery: The Fundamentals of Cancer Immunotherapy
27 juli 2026 · 38 min
Immune checkpoint inhibitors have rapidly reshaped care for triple-negative breast cancer (TNBC)—but surgical teams increasingly encounter their downstream perioperative consequences. In this episode, we define immunotherapy through the lens of checkpoint biology, review the landmark evidence supporting pembrolizumab in metastatic PD‑L1–positive TNBC (KEYNOTE‑355) and curative-intent stage II–III TNBC (KEYNOTE‑522), and translate immune-related adverse events (irAEs) into practical periop recognition, triage, and timing decisions—especially for endocrine, pulmonary, hepatic, dermatologic, and GI toxicities. Lees meer
Hosts:
- Rashmi Kumar, MD, PhD
Resident, University of Michigan General Surgery Residency Program
Twitter/X: @RashmiJKumar
- Melissa Pilewskie, MD
Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine
Twitter/X: @MPilewskie
- Stephanie Downs-Canner, MD
Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program
Twitter/X: @SDownsCannerLearning Objectives:
Define immunotherapy and immune checkpoint inhibition in breast cancer
Summarize current clinical indications and pivotal evidence for pembrolizumab in TNBC
Equip perioperative clinicians to identify and manage immune-related adverse events (irAEs) or side effects of immunotherapy.
Rationale for Immunotherapy in Breast Cancer Review
Selecting Triple Negative Breast Cancer Patients for Immunotherapy: https://pubmed.ncbi.nlm.nih.gov/37714640/
Landmark Clinical Trials Discussed in this Episode
KEYNOTE-355: https://pubmed.ncbi.nlm.nih.gov/33232653/
KEYNOTE-522: https://pubmed.ncbi.nlm.nih.gov/33232642/
IMpassion130: https://pubmed.ncbi.nlm.nih.gov/30345906/
IMpassion131: https://pubmed.ncbi.nlm.nih.gov/33930478/
Assessment of Surgical Outcomes in patients receiving chemoimmunotherapy
Surgical outcomes after neoadjuvant chemoi…
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Journal Review in Hernia Surgery: What is Bioresorbable Mesh and Is It Worth It?
23 juli 2026 · 29 min
Join our OHSY Hernia team to review the current landscape of bioresorbable meshes and a conversation considering “are they worth it?" Lees meer
Hosts:
Dr. Maggie Bosley - @MBosleyMD
Dr. Sean Orenstein - @OrensteinSean
Dr. Amber Sandoval
Dr. Peter Ferrin
Institution: Oregon Health & Science University
References:
- Long-Term, Prospective, Multicenter Study of Poly-4-Hydroxybutyrate Mesh (Phasix Mesh) for Hernia Repair in Cohort at Risk for Complication: 60-Month Follow-Up
https://pubmed.ncbi.nlm.nih.gov/36102523/
- Multicenter, Prospective, Longitudinal Study of the Recurrence, Surgical Site Infection, and Quality of Life After Contaminated Ventral Hernia Repair Using Biosynthetic Absorbable Mesh: The COBRA Study
https://pubmed.ncbi.nlm.nih.gov/28009747/
- A prospective, multicenter trial of a long-term bioabsorbable mesh with Sepra technology in cohort of challenging laparoscopic ventral or incisional hernia repairs (ATLAS trial)
https://pubmed.ncbi.nlm.nih.gov/34976385/
- Biosynthetic mesh in hernia repair: A systematic review and meta-analysis
https://journals.lww.com/rhaw/fulltext/2024/07020/biosynthetic_mesh_in_hernia_repair__a_systematic.2.aspxPlease 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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: h… -
Journal Review in Colorectal Surgery: ctDNA in Colorectal Cancer and Anal Squamous Cell Cancer
20 juli 2026 · 42 min
Circulating tumor DNA (ctDNA), a minimally invasive blood-based biomarker, has emerged as one of the most promising advances in cancer surveillance. Today, we will explore how ctDNA is transforming the management of colorectal cancer and anal squamous cell cancer across the disease continuum—from risk stratification and adjuvant therapy decision-making to surveillance and early detection of recurrence. Through landmark clinical trials, real-world applications, and emerging research, we will examine how ctDNA is helping move cancer care closer to the goal of truly personalized medicine. Lees meer
Hosts:
· Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center
· Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian
· Dr. Philip Bauer, Assistant Professor of Surgery, Division of Colon and Rectal Surgery, The Ohio State University Wexner Medical Center, Arthur G. James Cancer Hospital
· Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer CenterGuests:
Dr. Paul Romessor
· Director of Colorectal and Anal Cancer, Department of Radiation Oncology
· Associate Attending Radiation Oncologist
Memorial Sloan Kettering Cancer CenterDr. Jeanne Tie
· Medical Oncologist | Lower GI Unit
· Lower GI Research Lead
· Chair | Lower GI Working Party | GI Cancer Trials
Peter MacCallum Cancer CentreDr. Takayuki Yoshino
· Professor, Global Center of Research Excellence for Advanced Medicine (G-CORE),
Keio University School of Medicine
· Executive Advisor to Hospital East Director
· Director, Department of Global Oncology
· Chief, Department of Gastrointestinal Oncology
National Cancer Center Hospital EastLearning Objectives:
· Describe the biological basis and clinical applications of circulating tumor DNA (ctDNA) as a biomarker of minimal residual disease (MRD) in colorectal cancer.
· Interpret the prognostic significance of postoperative and longitudinal ct… -
Mattox Conference Pro-Con Debate 2026: REBOA
17 juli 2026 · 28 min
Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas (https://www.trauma-criticalcare.com/). The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too! A favorite feature is the annual debates. Today, we are featuring a showdown between Drs. Bryan A. Cotton, MD, MPH and Marty A. Schreiber, MD, FACS, FCCM, FCRST (Hon), COL, MC, USAR as they debate REBOA as a Life-Saving Intervention in Hemorrhagic Shock. You can listen on the podcast or watch the debate with accompanying slides on our website or app. Let's get ready to RUMMMBLLLEEEE! Lees meer
TRAUMA SURGERY VIDEO ATLAS: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios.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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate… -
Mattox Conference Pro-Con Debate 2026: Management of Pediatric Pancreatic Injuries
16 juli 2026 · 27 min
Every spring for over 50 years, the Trauma, Critical Care, and Acute Care Surgery conference, best known simply as the MATTOX conference, is held in Las Vegas (https://www.trauma-criticalcare.com/). The conference is unique in that it is entirely focused on practice-changing clinical education. It’s a damn good time too! A favorite feature is the annual debates. Today, we are featuring a showdown between Drs. Carlos V.R. Brown, MD, FACS and Katie W. Russell, MD as they debate WHETHER OR NOT PEDIATRIC PANCREATIC INJURIES CAN BE MANAGED NON-OPERATIVELY. You can listen on the podcast or watch the debate with accompanying slides on our website or app. Let's get ready to RUMMMBLLLEEEE! Lees meer
TRAUMA SURGERY VIDEO ATLAS: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Preparing for the deadliest injuries is challenging, and currently available resources are limited. That is why we created the Behind the Knife Trauma Surgery Video Atlas. Be ready for the most complex injuries, like penetrating trauma to the neck, audible bleeding from the IVC, and pelvic hemorrhage, with 24 scenarios.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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-… -
Wellbeing and Mental Health in Surgeons
13 juli 2026 · 41 min
Join us as we discuss research on mental health and wellbeing in the surgical workforce with Drs. Yang and Collins. The episode explores key findings from recent national surveys showing that nearly one in seven surgeons report suicidal ideation in the past year, with depression, anxiety, and PTSD affecting 15–20% of the surgical population. The conversation highlights protective factors—professional fulfillment, resilience, self-valuation, and connection—while distinguishing between healthy resilience and normalized suffering. Dr. Yang and Dr. Collins discuss systemic barriers including time constraints, out-of-pocket mental health costs, and persistent stigma, alongside actionable institutional interventions: protecting dedicated wellbeing time, establishing peer support and psychological first aid programs, ensuring free mental health access, and expanding research to understand what helps surgeons thrive. The episode emphasizes that self-care is essential to patient safety and invites listeners to become advocates, engage with the literature, and help drive culture change within their institutions. For more information about the AAS wellbeing survey, please email Dr. Yang at CJYANG@MGH.HARVARD.EDU. Lees meer
Host:
Steven Thornton, MD (General Surgery Resident at Duke University)
Agnes Premkumar (General Surgery Resident at Creighton)
Guests:
Jeff Yang, MD (Massachusetts General Hospital)
Reagan Collins, MD (University of Pennsylvania)
Publications Discussed:
Hughes TM, Collins RA, Cunningham CE. Depression and Suicide Among American Surgeons-A Grave Threat to the Surgeon Workforce. JAMA Surg. 2024 Jan 1;159(1):7-8. doi: 10.1001/jamasurg.2023.4658. PMID: 37792380. [https://pubmed.ncbi.nlm.nih.gov/37792380/]
Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CJ, Donelan K, …
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OBGYN Oral Board Review - Sample Episode: Intraoperative and Postoperative Wound
9 juli 2026 · 24 min
INTRODUCING Behind the Knife OBGYN Oral Board Review!
The oral boards aren't just about knowledge—they are about executing under pressure. This course is designed to give you the structure and confidence to command the room. We have curated 98 high-yield scenarios covering the "Big Three" of the exam: Obstetrics, Gynecology, and Office Practice. Whether it’s a surgical emergency or a complex clinic workup, we will walk you through exactly how to articulate your plan, defend your decisions, and pass this exam.
Each scenario includes 2 parts. The first part is a perfectly executed scenario. 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 are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
Please check out the preview episodes below that include Parts A and B, with and without commentary.
This course includes access to our Oral Board Simulator. Step into the hot seat and experience the pressure of the real exam and receive detailed, actionable feedback with the most advanced oral board prep available. Lees meer3-Month Purchase - 10 exams
6-Month Purchase - 22 exams
12-Month Purchase - 46 exams
Learn More: https://behindtheknife.org/premium/obgyn-oral-board-review
DOMINATE THE DAY! -
EPA Playbook: Blunt or Penetrating Trauma
7 juli 2026 · 50 min
Join Drs. Georgoff, Burke, and Premkumar in this episode of the EPA Playbook as they break down a practical, repeatable framework for managing patients in the trauma bay, one of the most high-pressure environments in surgical training. This episode focuses on the critical first minutes of evaluation, anchored in a structured primary survey. We emphasize how to recognize and immediately address life-threatening injuries, while maintaining situational awareness and clear communication with your team. From airway and hemorrhage control to adjuncts like FAST and early imaging, we highlight what matters most when time is critical. Lees meer
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.
BTK Resources:
Trauma Video Playlist (FAST, How to Read a CT, and more!)
https://behindtheknife.org/video-playlists/trauma-videosBig T Trauma Podcasts
https://behindtheknife.org/podcast-series/big-t-traumaTrauma Surgery Video Atlas (Premium)
https://behindtheknife.org/premium/trauma-surgery-video-atlas -
EPA Playbook: Small Bowel Obstruction
6 juli 2026 · 25 min
Join Drs. Georgoff, Burke, and Premkumar in this episode of EPA Playbook, where we tackle the evaluation and management of small bowel obstruction. Through a realistic series of scenarios, we walk step-by-step through how junior residents can approach this diagnosis using an evidence-based approach. Lees meer
We break down the key components of the small bowel obstruction EPA, from rapid initial assessment and focused physical exam to early resuscitation, recognizing when to go straight to the OR, and post-operative care. Along the way, we highlight critical teaching points you’ll actually use on call. Whether you’re a new intern or an early resident looking to build confidence, this episode is designed to help you act decisively and move one step closer to entrustment.
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.
BTK Resources:
Nasogastric Tube (NGT) Management Video
https://behindtheknife.org/video/behind-the-knife-nasogastric-tube-ngt-managementNasogastric Tube (NGT) Placement Video
https://behindtheknife.org/video/behind-the-knife-nasogastric-tube-ngt-placementOstomy Marking Video
https://behindtheknife.org/video/behind-the-knife-ostomy-markingHow to Change an Ostomy Appliance Video
https://behindtheknife.org/video/behind-the-knife-how-to-change-an-ostomy-applianceHow to Manage a Challenging Ostomy Video
https://behindtheknife.org/video/behind-the-knife-how-to-manage-a-challenging-ostomyCited Studies:
National prospective cohort study of the burden of acute small bowel obstruction https://doi.org/10.1002/bjs5.50136
Management and short-term outcomes of patients with small bowel obstruction in Denmark: a multicentre prospective cohort study https://doi.org/10.1007/s00068-022-02171-y
…
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EPA Playbook: Inguinal Hernia
5 juli 2026 · 22 min
In this episode of EPA Playbook, Drs. Jason Bingham, Emma Burke, and Agnes Premkumar discuss the evaluation and management of inguinal hernias through a case-based approach that reinforces key EPA concepts for surgical trainees. We specifically highlight the importance of a thorough history and physical exam, emphasize risk stratification, and indications for surgery versus watchful waiting. We briefly review a few postoperative considerations as well. Lees meer
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.
Cited studies:
Miserez M, et al. "Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients." Hernia. 2014;18(2):151-163. PubMed ID: 24504225
Carrick MA, et al. "Smoking and anaesthesia." BJA Educ. 2019;19(1):1-6. PubMed ID: 33456860
Amid PK, et al. "Local anesthesia for inguinal hernia repair step-by-step procedure." Ann Surg. 1994;220(6):735-737. PubMed ID: 7979603
Huy TC, et al. "Reoperation for chronic postoperative inguinal pain." JAMA Surg. 2025;160(9):984-991. PubMed ID: 39855588
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EPA Playbook: Perioperative Care of Critically Ill Patient
4 juli 2026 · 25 min
In this episode of EPA Playbook, Drs. Kevin Kniery, Emma Burke, and Agnes Premkumar discuss management of critically ill surgical patients, using case-based discussions to reinforce core principles of shock, resuscitation, and ICU care. We first review the four major types of shock. We then discuss two cases centered around managing a patient in septic shock and cardiogenic shock, delving into the nuances on how management differs between the two. Additionally, we underscore a physiology-driven approach to critical care, the importance of multidisciplinary collaboration, and the need to align treatment decisions with patient goals and values. Lees meer
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.
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EPA Playbook: Benign or Malignant Colon
3 juli 2026 · 28 min
Join Drs. Steele, Burke, & Premkumar in this episode of EPA Playbook, where we tackle a core general surgery EPA: the evaluation and management of benign and malignant colon disease. From common presentations like diverticulitis and lower GI bleeding to the diagnosis and workup of colon cancer, this episode provides a structured framework you can use on the wards, in clinic, and on call. Using case-based discussions, we walk through how to distinguishing benign from malignant processes, selecting appropriate imaging and endoscopy, and recognizing when a patient needs urgent intervention versus outpatient workup. We also cover key principles of colon cancer management, including staging, surgical planning, and multidisciplinary care, alongside high-yield management of benign conditions. Lees meer
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.For additional information on EPAs, visit the American Board of Surgery EPA webpage: https://www.absurgery.org/get-certified/epas/.
Cited Studies:
Gustafsson, U.O., Scott, M.J., Hubner, M. et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World J Surg 43, 659–695 (2019). https://doi.org/10.1007/s00268-018-4844-y
BTK Resources:
Ostomy Marking Video
https://behindtheknife.org/video/behind-the-knife-ostomy-markingHow to Change an Ostomy Appliance Video
https://behindtheknife.org/video/behind-the-knife-how-to-change-an-ostomy-applianceHow to Manage a Challenging Ostomy Video
https://behindtheknife.org/video/behind-the-knife-how-to-manage-a-challenging-ostomy -
Are EPAs Actually Working? An Honest Look at Competency-Based Surgical Training
2 juli 2026 · 37 min
Two years into the EPA era — are we actually training surgeons differently, or just checking new boxes? In this episode, Behind the Knife co-director and Duke Trauma Surgeon Dr. Patrick Georgoff and Behind the Knife surgical education fellows Dr. Agnes Premkumar and Dr. Emma Burke sit down with Dr. Ruchi Thanawala, thoracic surgeon at OHSU, informatician, and founder of Firefly Labs, to get an honest look at the state of competency-based surgical education. We dig into why surgery is uniquely hard to assess, what the data are actually showing (spoiler: significant skewing, and we're not ready to make promotion decisions off it yet), and why collecting assessments is only 25% of the work. If you've ever wondered whether EPAs are moving the needle or just adding noise, this one's for you Lees meer
***FREE EPA COURSE: https://behindtheknife.org/premium/epa-playbook
Simply create an account on behindtheknife.org or our app and you the course will automatically show up in your Library.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://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/prem… -
Intraoperative Cholangiography Guidelines: Routine, Selective, or Never?
29 juni 2026 · 34 min
In this episode, we use the recent SAGES guidelines to tackle one of the most common and controversial questions in general surgery. Through a case-based discussion, our experts review the evidence for intraoperative biliary imaging, discuss strategies for difficult anatomy, and compare IOC with other imaging modalities. Join us as we translate the latest recommendations into practical lessons that can be applied in the operating room. Lees meer
Take Home Points:
Routine IOC is supported; however, this remains a conditional recommendation that should be individualized based on anatomy, surgeon experience, and available resources.
Use a selective approach to IOC in special populations, including pediatric and pregnant patients, where risks and benefits may differ.
Alternative imaging modalities including ICG fluorescence and laparoscopic ultrasound have complementary roles.
Routine IOC may help maintain surgeon and team proficiency, and trainees should learn both IOC performance and interpretation
Hosts:
Jason Bingham, MD – General and Bariatric Surgeon
Nicole L. Petcka, MD, MHPE – General Surgery Resident at Emory University
Guests:
Emily Miraflor, MD – General and Colorectal Surgeon at UCSF East Bay, Senior Author on the SAGES Guidelines
Kevin El-Hayek, MD - HPB and Foregut Surgeon at MetroHealth and Professor of Surgery at Case Western Reserve School of Medicine, Chair of the SAGES HPB/Solid Organ Committee
Dena Shehata, MD - SAGES Guideline Fellow, Co-first author on the SAGES Guidelines
Resources:
Kumar, S. K., Shehata, D. G., Cetrulo, L. N., Ignacio, R., Chiu, J., Davis, B. R., McDonald, M., Bloom, M. B., Ayloo, S., Kchaou, A., Orthopoulos, G., Pucher, P. H., Oliphant, U., Hallowell, P. T., Serrot, F., Overby, D., Moreno-Paquentin, E., Slater, B. J., & Miraflor, E. (2025). SAGES guidelines for the use of intraoperative imaging of the common bile duct. Surgical endoscopy, 39(11), 7091–7102. https://doi.org/10.1007/s00464-025-12142-0SAGES Safe Cholecystecto…
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Clinical Challenges in Hernia Surgery: Is Optimization Still Necessary for Hernia Surgery?
25 juni 2026 · 34 min
Join our Hernia Team for a review of the current controversy around preoperative optimization and the practical implications. Lees meer
Hosts:
Dr. Maggie Bosley - @MBosleyMD
Dr. Sean Orenstein - @OrensteinSean
Dr. Amber Sandoval
Dr. Peter Ferrin
Institution: Oregon Health & Science University
References:
Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications
https://pubmed.ncbi.nlm.nih.gov/26206646/Risk factors for postoperative wound infections and prolonged hospitalization after ventral/incisional hernia repair
https://pubmed.ncbi.nlm.nih.gov/24030572/lack of association between glycated hemoglobin and adverse outcomes in diabetic patients undergoing ventral hernia repair: an ACHQC study
https://pubmed.ncbi.nlm.nih.gov/35969297/Impact of preoperative haemoglobin A1c levels on postoperative outcomes in adults undergoing major noncardiac surgery: A systematic review
https://pubmed.ncbi.nlm.nih.gov/38853752/Does active smoking really matter before ventral hernia repair? An AHSQC analysis
https://pubmed.ncbi.nlm.nih.gov/30220485/Abstinence from smoking reduces incisional wound infection: a randomized controlled trial
https://pubmed.ncbi.nlm.nih.gov/12832959/The Association of Nicotine Replacement Therapy With Outcomes Among Smokers Hospitalized for a Major Surgical Procedure
https://pubmed.ncbi.nlm.nih.gov/31790653/Is weight trajectory a better marker of wound complication risk than BMI in hernia patients with obesity?
https://pubmed.ncbi.nlm.nih.gov/38082008/Gender, racial, and socioeconomic disparity of preoperative optimization goals in ventral hernia repair
https://pubmed.ncbi.nlm.nih.gov/37658198/Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?
https://pubmed.ncbi.nlm.nih.gov/39907236/The impact of preoperative optimization for abdominal wall reconstruction on long-term glucose control and smoking cessation
https://pubmed.ncbi.nlm.nih.gov/40739418/Wa…
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Rectal Cancer in the Young and Pregnant: Fertility and Management Considerations
22 juni 2026 · 28 min
As colorectal cancer rates rise among younger adults, surgeons are increasingly caring for patients with rectal cancer who are pregnant or hoping to preserve future fertility. With more individuals delaying childbearing, balancing effective cancer treatment with fertility preservation and maternal–fetal safety has become an important clinical challenge. This timely topic was recently highlighted by Dr. Sharon Suwanabol during a presentation at the American Society of Colon and Rectal Surgeons annual meeting 2026. Lees meer
In this episode, we explore the intersection of rectal cancer, fertility, and pregnancy through a multidisciplinary, case-based discussion. We review how surgery, chemotherapy, and pelvic radiation can affect fertility and sexual function in both men and women, and why early counseling and referral to reproductive endocrinology specialists are essential. The discussion also emphasizes that evaluation and treatment during pregnancy can often be performed safely, with care individualized based on tumor stage, gestational age, and the patient’s goals and values.
Hosts and discussants
· Dr. Betelhem Yohannes, General surgery resident at the University of Washington
· Dr. Griffen Allen, General surgery resident at the University of Washington
· Dr. Raga Siddharthan, Assistant Professor of Surgery in the Section of Colorectal Surgery at the University of Washington
· Dr. Stacey Cohen, Professor in the Division of Hematology and Oncology at the University of Washington and a gastrointestinal medical oncologist at Fred Hutch Cancer Center, specializing in colorectal and other GI cancers.
Learning objectives
· Describe the impact of rectal cancer surgery on fertility, sexual function, and future childbearing potential.
· Review the effects of chemotherapy and pelvic radiation on reproductive health and fertility preservation.
· Discuss available fertility preservation strategies and the importance of early pre-treatment counseling and referral.
· Recognize the dia… -
Journal Review in Bariatric Surgery: Socioeconomic Disparities
18 juni 2026 · 24 min
Why do millions of patients qualify for bariatric surgery, yet only a fraction ever make it to the operating room? Lees meer
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:
This episode explores disparities in access to bariatric surgery through three key studies examining eligibility, referral patterns, and weight stigma.References:
Article #1: Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis (2010, Martin et al.) https://pubmed.ncbi.nlm.nih.gov/19782647/
Analyzed national U.S. datasets to compare patients eligible for bariatric surgery with those who underwent surgery.
Although more than 22 million Americans met criteria for bariatric surgery, only about 0.4% underwent surgery in 2006.
Patients eligible for surgery were more likely to be female, uninsured, lower income, and from racial and ethnic minority groups, while those receiving surgery were disproportionately Caucasian women with private insurance.
This discussion highlights insurance coverage as one of the largest structural barriers to care.
Article #2: Investigating racial disparities in bariatric surgery referrals (2019, Johnson-Mann et al.) https://pubmed.ncbi.nlm.nih.gov/30824334/
This study focused on referral patterns within a primary care network.
Among nearly 4,700 eligible patients, only 5% were referred to bariatric surgery.
Referral disparities were seen across sex, ethnicity, and insurance status.
Hispanic p…
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Whole Blood vs. Components: The Prehospital Debate
15 juni 2026 · 43 min
Prehospital blood is one of the hottest debates in trauma resuscitation — and the evidence just got a lot more interesting. In this episode, Drs. Patrick Georgoff and Ayman Ali sit down with Dr. Ed Barnard, UK defense professor of emergency medicine and author of the landmark SWIFT trial, and Dr. Juan De Chesney, trauma surgeon and pioneer in prehospital blood programs, to break down what we actually know about getting blood to patients before they hit the doors. The SWIFT trial — the largest prehospital whole blood RCT to date — found no superiority of whole blood over component therapy, but the story is far more nuanced than a negative headline suggests. From the logistics of carrying blood on a helicopter to the stark reality that only 1.8% of US ground EMS carries any blood products at all, this conversation exposes both the progress and the enormous gaps that remain. Lees meer
Hosts:
Ayman Ali, MD: Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital.
Patrick Georgoff, MD @georgoff: Patrick Georgoff is faculty in the Department of Surgery at the Duke University School of Medicine where he serves as an Associate Professor of Trauma, Acute, and Critical Care Surgery and Trauma Medical Director. He is a leading educator and creator for Behind the Knife, a premier digital education platform and podcast advancing surgical training through innovative, high-yield multimedia content.
Juan Duchesne, MD: Juan Duchesne is a trauma surgeon and Professor of Surgery serving as the Trauma Medical Director and Division Chief at the University of Mississippi Medical Center. His pioneering contributions to the field—particularly in whole blood and balanced resuscitation practices—have been honored with numerous accolades.
Ed Barnard, PhD FRCEM FIMC RCSEd, @edbarn @DefProfEM: Ed Barnard is an emergency physician and UK Defence Professor of Emergency Medicine, RCEM/NIHR Associate Professor, and Affiliated Assistant Professor at the University of Cambridge.…