Behind The Knife: The Surgery Podcast
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Clinical Challenges in Hernia Surgery: Mesh Infections - How to Treat and What to Consider
3 november 2025 · 22 min
Mesh infections are dreaded complications in hernia repair. This episode highlights relevant mesh properties, pathogens, and management strategies so you can tackle the next mesh infection with confidence! Lees meer
Hosts:
Dr. Maggie Bosley - @MBosleyMD
Dr. Sean Orenstein - @OrensteinSean
Dr. Amber Sandoval
Dr. Peter Ferrin
Institution: Oregon Health & Science UniversityLearning Objectives
- Compare the long-term weight loss and diabetes remission rates of Gastric Bypass vs. Sleeve Gastrectomy.
- Identify the appropriate revision options (Bypass vs. Sadie) for a patient with a failed sleeve based on the reason for failure (reflux vs. weight regain).
- Recognize that all bariatric operations are superior to untreated obesity, making patient selection paramount.Episode Sponsor Disclosures:
Visit goremedical.com/btk to learn more about GORE® ENFORM Biomaterial.
Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx onlyPlease 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:
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/premium/vascular-surgery-oral-board-audio-review
Colorectal Surgery Oral B… -
Oral Board Simulator: Your Secret Weapon to DOMINATING the Exam
30 oktober 2025 · 23 min
In this episode, Drs. Ali, Georgoff, and Swenson share some big-time updates to our oral board simulator. We've also included a full example test for you to listen to. Whether you are studying for the exam, or for your next rotation, try the Behind the Knife Oral Board Simulator for free: https://behindtheknifeoralboardsimulator.org Lees meer
What's new:
Massive Usage & Feedback: The Beta launch of the AI-powered oral board simulator has been a huge success, thanks to the incredible support and actionable feedback from the surgical community. Your feedback has allowed for advanced fine tuning and a better user experience.Next-Level Feedback: Your readiness score just got a whole lot more honest! The score is now a more accurate reflection of your performance and the number of the 362 testable conditions and procedures you've actually covered.
The Examiner Makeover: Experience a real-world test day with 20 different examiner voices (fast, slow, accented) to prepare you for any personality you might face.
Introducing your new study partners: Get ready for three game-changing features designed to elevate your training:
Coach: The ultimate study buddy! Ask it questions, and it will provide the right answers, identify your weaknesses, and walk you through scenarios (the opposite of the unhelpful examiner!).
OpGuide: Perfect for procedural review. Ask it how to perform a procedure (like a Whipple), and it will provide concise, board-appropriate surgical steps.
Wingman: Practice unfamiliar topics without the stress! It presents a patient stem, and if you're stuck, Wingman will answer for you in the first person, teaching you the topic as it goes.
The future is now!
Specialty Expansion: The simulator is coming soon to Vascular, Colorectal, Surgical Oncology, CT Surgery, Pediatric Surgery, and even OBGYN!
Platform Integration: Look out for a big makeover as the simulator is fully integrated into the Behind the Knife app platform for a seamless and beautiful user experience…
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Optimizing Surgical Care for Older Adults: An Inside Look at the ACS Geriatric Surgery Verification Program
27 oktober 2025 · 23 min
In this episode, we explore practical tips for caring for older adults in the clinical setting through a case-based discussion highlighting common perioperative challenges and strategies for success. We also take a deeper dive into the American College of Surgeons Geriatric Surgery Verification Program, including its goals, impact, and how clinicians can get involved in advancing surgical care for the aging patient population. Lees meer
Take Home Points:
The older adult population is the fastest growing patient population and it is important we focus on patient-centered care for this population, as this is a population that almost all of us will engage with.
If you or your hospital isn’t prepared to get verified yet, there are still small processes that can be implemented that can make an impactful difference on your patients.
Geriatric Surgery Verification is at the cutting edge of quality improvement. Like other verification programs (trauma, bariatric) patients will soon seek out these centers that can best address their personal needs.
Hosts:
Agnes Premkumar, MD - General Surgery Resident at Creighton University, @agnespremkumar
Nicole L. Petcka, MD – General Surgery Resident at Emory University, @npetcka2022
Guests:
Marcia M. Russell, MD - Professor of Surgery and Vice Chair for Quality and Safety at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System
Caroline Smolkin, MD - General Surgery Resident at Northwell and American College of Surgeons Clinical Scholar
Resources:
American College of Surgeons Geriatric Surgery Verification Program: https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/
Katlic MR, Wolf J, Demos SJ, Rosenthal RA. Making a Financial Case for the Geriatric Surgery Verification Program. Ann Surg Open. 2024 May 13;5(2):e439. doi: 10.1097/AS9.0000000000000439. PMID: 38911623; PMCID: PMC11191881.
https://pubmed.ncbi.nlm.nih.gov/38911623/Remer SL, Zhou L,…
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Surgical Endoscopy Series Ep. 3: Per Oral Endoscopic Myotomy
23 oktober 2025 · 31 min
In this episode, the Surgical Endoscopy team reviews applications of per oral endoscopic myotomy (POEM) at different locations in the gastrointestinal tract. Specifically, they discuss esophageal POEM for achalasia, G-POEM for gastroparesis, and Z-POEM for management of a Zenker’s diverticulum. The team describes outcomes for these procedures as well as an overview of the procedural steps and postoperative management. Common pitfalls to POEM are deliberated along with advice on how to mitigate challenging situations when they arise. Lees meer
VIDEO LINK: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-3-per-oral-endoscopic-myotomy
Hosts:
• Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery Fellow, Endeavor Health (Evanston, IL), @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. Michael McCormack, Minimally Invasive Surgeon, Swedish Hospital (Chicago, IL)
Learning Objectives:
• Describe the basic steps of the Peroral Endoscopic Myotomy (POEM) technique.
• Identify the different applications for POEM in the esophagus, stomach, and pharynx.
• Recognize the primary indications and success rates for esophageal, gastric, and Zenker's diverticulum POEM procedures.Surgical Endocsopy Series:
- Surgical Endoscopy Series Ep. 1: An Introduction to Surgical Endoscopy: https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-1-an-introduction-to-surgical-endoscopy
- Surgical Endoscopy Series Ep. 2: Endobariatrics - https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-2-endobariatricsPlease 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:
General Surgery Oral Board Review Course: https://behi… -
Operative Standards for Cancer Surgery: Colon Cancer
20 oktober 2025 · 41 min
This new 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 first episode highlights the colon cancer operative standard. 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 CenterLexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a Surgical Oncology fellow at MD Anderson Cancer Center.
Guest:
George Chang, MD, MS, MHCM, FACS, FASCRS, FSSO is a Professor and the interim Department Chair in the Department of Colon and Rectal Surgery at MD Anderson Cancer Center.Learning Objectives: The extent of colon mobilization and resection depends on tumor location, with high vascular ligation of the tumor-bearing segment to complete adequate regional lymphadenectomy. The technical steps of right colectomy are reviewed, including high ligation of the ileocolic pedicle at the level of the superior mesenteric vein, and the right branch of the middle colic artery if present. Tips and tricks are discussed to identify vascular structures and avoid central vascular injury.
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/B07MWSNFSBShort-term outcomes of complete mesocolic excision versus D2 dissection in patients undergoing laparoscopic colectomy for right colon cancer (RELARC): a randomized, controlled, phase 3, superiority trial
Lancet Oncol. 2021 Mar; 22(3):391-401.
https://pubmed.ncbi.nlm.nih.gov/33587893/Impact of Proximal Vascular Ligation on Survival of Patients with Colon Cancer.
Ann Surg … -
Journal Review in Bariatric Surgery: Sleeve vs Bypass and Revisional Strategies
16 oktober 2025 · 35 min
Sleeve, bypass, or something new – which surgery really dominates the day? This Bariatric Surgery Journal Club dives into the debate over which bariatric operation is best. We compare the outcomes of the gastric bypass, sleeve gastrectomy, and the newer Sadie procedure, exploring how bypass may have an edge in long-term diabetes remission and weight loss. We also discuss revisional options for failed sleeves and the importance of matching the patient to the right operation for their specific needs. 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:
- Contrast the outcomes of Roux-en-Y gastric bypass, sleeve gastrectomy, and revisional options such as the single-anastomosis duodeno-ileal bypass (SADI)
- Article #1: Hauge 2025, Effect of gastric bypass versus sleeve gastrectomy on the remission of type 2 diabetes, weight loss, and cardiovascular risk factors at 5 years (Oseberg): secondary outcomes of a single-centre, triple blind, randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/40185112/
- Describe the design and unique triple-blind methodology of a single-center randomized trial comparing bypass and sleeve in patients with obesity and type 2 diabetes.
- Interpret the clinical relevance of the 5-year outcomes, including 63% diabetes remission with bypass vs 30% with sleeve.
- Examine secondary outcomes such as weight loss and cholesterol reduction, which favored bypass over the sleeve
- Formulate patient-centered strategies for sele… -
Journal Review in Transplant Surgery: Use of Normothermic Machine Perfusion (NMP) in Liver Transplant
13 oktober 2025 · 29 min
Liver transplantation continues to evolve as strategies expand to address organ shortage and optimize outcomes. Normothermic machine perfusion (NMP) offers a novel way to preserve and assess donor livers prior to implantation. In this episode of Behind the Knife, our transplant team at University of Nebraska Medical Center discusses the latest evidence from randomized trials, practical applications in donation after circulatory death (DCD) grafts, and how NMP is shaping clinical decision-making in high-risk transplants. Lees meer
Hosts
- Madeline Cloonan, MD PhD, General Surgery Resident, University of Nebraska Medical Center, @maddie_cloonan
- Jacqueline Dauch, MD, Assistant Professor, University of Nebraska Medical Center
- Shaheed Merani, MD PhD, Associate Professor, University of Nebraska Medical Center
- Alan Langnas, DO, Professor, University of Nebraska Medical CenterLearning Objectives
- Describe the principles of normothermic machine perfusion (NMP) and how it differs from static cold storage.
- Summarize the design and key outcomes of the PROTECT trial and the Chapman et al. trial on NMP in liver transplantation.
- Recognize the clinical scenarios where NMP provides the greatest benefit, particularly in high-risk grafts (e.g., DCD donors, high donor risk index).
- Apply a practical viability assessment framework for livers on NMP, including hemodynamics, bile production, lactate trajectory, and histology when indicated.
- Discuss the implications of NMP for allocation, system logistics, and future adoption trends in transplantation.References
1. Markmann JF, Abouljoud MS, Ghobrial RM, et al. Impact of portable normothermic blood-based machine perfusion on outcomes of liver transplant: the OCS Liver PROTECT randomized clinical trial. JAMA Surg. 2022;157(3):189-198. doi:10.1001/jamasurg.2021.6781. https://pubmed.ncbi.nlm.nih.gov/34985503/
2. Chapman WC, Barbas AS, D’Alessandro AM, et al. Normothermic machine perfusion of donor livers for transplantation in the…
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A Practical Approach to Understanding Global Surgery
9 oktober 2025 · 29 min
In this kickoff episode of the Behind the Knife Global Surgery Series, we dive into what global surgery really means—and why it matters to all of us. Five billion people lack access to safe, timely, and affordable surgical care. Our guest, Dr. Juan Carlos Puyana, shares powerful insights on redefining global surgery, building meaningful collaborations, and why surgeons in high-resource countries should care deeply about this work. If you want to broaden your vision of surgery, challenge assumptions, and hear stories that connect operating rooms from South Carolina to South Africa, this is an episode you won’t want to miss. Lees meer
Hosts/Guest:
Mike M. Mallah, MD, FACS, FICS
Director of Global Surgery at Medical University of South Carolina
@MikeMMallahMD
@MUSCGlobalSurg
mallahm@musc.eduJuan Carlos Puyana, MD, FACS
O’Brian Chair of Global Surgery at the Royal College of Surgeons Ireland
@jcpuyanamd
@RCSI_GlobalSurgLearning objectives:
Define global surgery and explain how its meaning has evolved to highlight disparities in access to safe, timely, and affordable surgical care worldwide.
Recognize the value of global surgery engagement for trainees and surgeons in high-resource settings, including broadening perspectives and fostering humility.
Identify principles of ethical collaboration in global surgery, using real-world examples of partnerships built on trust, mutual respect, and shared goals.
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:
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… -
Journal Review in Hepatobiliary Surgery: Resecting Perihilar Cholangiocarcinoma
6 oktober 2025 · 36 min
Surgical resection of perihilar cholangiocarcinoma (pCCA) is one of the highest-risk elective operations performed. The obstructive jaundice suffered by patients preoperatively, central location of the tumors, and extensive nature of the resection make pCCA one of the most challenging HPB disease processes. In this episode from the HPB team at Behind the Knife, listen in on the discussion about perioperative strategies to improve outcomes for surgical resection of perihilar cholangiocarcinoma. Lees meer
Hosts
Anish J. Jain MD (@anishjayjain) is a current PGY4 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology at the University of Texas MD Anderson Cancer Center. He is also the associate program director of the HPB fellowship.
Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as the Dallas/Fort Worth Living Legend Chair of Cancer Research in the Department of Surgical Oncology at The University of Texas MD Anderson Cancer Center.
Learning Objectives
· Develop an understanding of the three treatment sequences for resection of disease in patients with synchronous liver metastasis from a primary rectal cancer (reverse, combined, and classic approach)
· Develop an understanding of the benefits, risks, and nuances of each of the three treatment sequences
· Develop an understanding of which patient cases each treatment sequence is ideal for as well as which cases they are not suitable for.Papers Referenced:
1) Ribero D, Zimmitti G, Aloia TA, Shindoh J, Fabio F, Amisano M, Passot G, Ferrero A, Vauthey JN. Preoperative Cholangitis and Future Liver Remnant Volume Determine the Risk of Liver Failure in Patients Undergoing Resection for Hilar Cholangiocarcinoma. J Am Coll Surg. 2016 Jul;223(1):87-97. https://pubmed.ncbi.nlm.nih.gov/2… -
Clinical Challenges in Surgical Oncology: Pheochromocytomas
2 oktober 2025 · 28 min
Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas. 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 Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.
Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 2ndYear Surgical Oncology fellow at MD Anderson.
Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a General Surgery physician in the United States Air Force station at RAF Lakenheath.
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 General Surgery research resident between his second and third year at Brooke Army Medical Center.
Learning Objectives:
1) Review the presentation of patients with pheochromocytomas.2) Review the work up of patients with pheochromocytomas.
3) Review the treatment of patients with pheochromocytomas.
4) Review the surveillance of patients with pheochromocytomas.
References used in the making of this episode:
Patel D. Surgical approach to patients with pheochromocytoma. Gland Surg. 2020;9(1):32-42. doi:10.21037/gs.2019.10.20. PMID: 32206597; PMCID:PMC7082266.Eisenhofer G, Lenders JW, Siegert G, et al. Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status. Eur J Cancer. 2012;48(11):1739-1749. doi:10.1016/j.ejca.2011.07.016. PMID:22036874; PMCID: PMC3372624.
Lenders JWM, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet. 2005;366(9486):665-675. doi:10.1016/S0140-6736(05)67139-5.
Vicha A, Musil Z, Pacak K. Genetics of pheochromocytoma and paraganglioma syndromes: new advance…
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Meet your AI Examiner: Introducing Behind the Knife Oral Board Simulator
25 september 2025 · 41 min
Learn more: https://behindtheknifeoralboardsimulator.org/ Lees meer
It has arrived! Introducing Behind the Knife's Oral Board Simulator (beta version):
Unlimited unique oral board scenarios
Available 24/7
Diverse examiners
Natural conversation
Detailed, actionable feedback based on SCORE curriculum and American Board of Surgery grading scheme
Try it for free for a limited time!
Note, this is our FIRST version of the Oral Board Simulator. To make it better, we need your feedback. After using the simulator, please take <1 minute to complete the feedback form. This will help us refine the simulator and improve the user experience.
On this pod, we are thrilled to introduce the newest member of the Behind the Knife team, Dr. Matthew Swenson. Dr. Swenson is a general surgeon and U.S. Air Force veteran. He earned his medical degree from the Uniformed Services University and completed his general surgery residency at the University of Nevada in Las Vegas. After training he was stationed in Anchorage, Alaska for 7 years, where he took part in multiple domestic and overseas military exercises. His practice in Alaska also involved partnerships with the local community, including working with residents and local surgeons at the Alaska Native Medical Center. At the completion of his military service, he was recruited to return to Las Vegas as the Associate Program Direct for the Valley Health System General Surgery residency program. Dr. Swenson's primary passion is ensuring surgical residents are fully prepared for independent practice upon graduation, which has led him to create innovative, AI-powered study tools for oral board exam preparation. Whenever time allows, he enjoys family time and all things outdoors.
Hosts:
Ayman Ali, MD (PGY-4, Duke Hospital)
Patrick Georgoff, MD (Trauma/Critical Care Surgeon, Duke Hospital): @georgoff
Matthew Swenson, MD (General Surgeon, Valley Health System)
Talha Rafeeqi, MD (Foregut Surgeon, The Oregon Clinic)Please visit https://behindth…
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USA vs. UK: ASGBI Ep. 6 - Current Challenges and Hopes for the Future of Surgical Training
18 september 2025 · 37 min
Welcome to the 6th episode of our BTK/ASGBI series! During this series, BTK fellow Agnes Premkumar and ASGBI hosts Jared Wohlgemut and Gita Lingam will compare and contrast various aspects of surgery between the United States and the United Kingdom, debating who does what better. Lees meer
In this episode, we delve into surgical training, current challenges, and hopes for the future of surgical training in the US and the UK. We will be discussing the advent of the EPA curriculum in the US, the current challenge of obtaining a speciality position in the UK, and tips for making the resident to attending/junior faculty transition smoothly. Dr. Jeremy Lipman represents the US while Dr. Phil Pearce represents the UK in this thought-provoking conversation.
Dr. Lipman is a colorectal surgeon at the Cleveland Clinic and the director of graduate medical education for all training programs at the Cleveland Clinic. Additionally, he is an Associate Dean for Graduate Medical Education and Professor of Surgery at Case Western Reserve University. He is passionate about surgical training and holds the James E. Sampliner Endowed Chair in Surgical Education.
Dr. Phil Pearce is a consultant in emergency general surgery in Oxford with interests in trauma, complex biliary disease, and most importantly a passion for training.
Take a listen and let us know what you think- who does surgical education and training better?
References:
Speciality training position in the NHS
https://www.ft.com/content/e4b364c3-6a20-42ee-a9a5-ab9eea441c87?utm_source=chatgpt.com
https://www.theguardian.com/society/2025/jul/02/nhs-in-england-told-to-slash-recruitment-of-overseas-trained-medics?utm_source=chatgpt.comSurgery job market in the US
https://surgpli.com/the-state-of-surgery-as-a-career-in-2025/EPA curriculum
https://www.aamc.org/about-us/mission-areas/medical-education/cbme/core-epasPlease visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you… -
Journal Review in Colorectal Surgery: Management of Acute Uncomplicated Diverticulitis With or Without Antibiotics
15 september 2025 · 30 min
Why are we still treating acute uncomplicated diverticulitis with antibiotics? There is plenty of evidence from several randomized controlled trials demonstrating that symptomatic management alone yields similar results. If we should continue prescribing antibiotics for acute uncomplicated diverticulitis, which patients should undergo treatment and when? Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss the management of uncomplicated diverticulitis while reviewing groundbreaking literature. Lees meer
Hosts:
-Jared Hendren, MD
Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Elissa Dabaghi, 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
Social Media Handle: X/Twitter @joseph_trunzo
- Ajaratu Keshinro, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute,
Cleveland Clinic Foundation, Cleveland, Ohio
Social Media Handle: X/Twitter- @AJKesh
- David Rosen, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute,
Cleveland Clinic Foundation, Cleveland, Ohio
Social Media Handle: X/Twitter- @davidrrosenmdLearning Objectives: By the end of this episode, listeners will be able to:
1. Identify criteria for managing acute uncomplicated diverticulitis without antibiotics based on recent literature
2. Define uncomplicated and complicated diverticulitis
3. Discuss nuanced management decisions of patients with uncomplicated diverticulitis to determine when antibiotics may be appropriate for managementReferences:
1. Azhar, N., Aref, H., Brorsson, A., Lydrup, M.‑L., Jörgren, F., Schultz, J. K., & Buchwald, P. (2022). Management of acute uncomplicated diverticulitis without antibiotics: C… -
Journal Review in Surgical Education: Gossip in Residency
11 september 2025 · 36 min
Psst… wanna hear some tea? Join Drs. Maya Hunt, John Woodward, and Cait Silvestri as they discuss gossip - what it is, what it means, and how it can impact the surgical training environment. Joined by authors of a recent paper deconstructing gossip in surgical residency, Dr. Bobbi Ann Adair White and former CoSEF leader Dr. Joseph L’Huillier, the team examines the ways gossip can be positive and negative, how we can mitigate the harms that come with it, and reflect on some of our own experiences with gossip as trainees. Lees meer
Episode Hosts:
- Dr. Maya Hunt, Indiana University, mayahunt@iu.edu
- Dr. John Woodward, University at Buffalo, @JohnWoodward76, jmwoodwa@buffalo.edu
- Dr. Cait Silvestri, Columbia University, @CaitSilvestri, cs4004@cumc.columbia.edu
- CoSEF: @surgedfellows, cosef.orgGuests:
- Dr. Joseph L’Huillier, University of Buffalo, @JoeLHuillier101, josephlh@buffalo.edu
- Dr. Bobbi Ann Adair White, MGH Institute of Health Professions, @_BAAW_, bwhite2@mghihp.eduLearning Objectives:
- Define gossip in the context of surgical education, distinguishing between its academic definition and common perceptions
- Identify how forms of gossip can be constructive, as well as destructive
- Explore the process model of gossip in surgical residency programs, including what choices recipients have when receiving gossip
- Recognize environmental factors that contribute to gossip in surgical settings
- Apply practical strategies to mitigate harmful gossip in training environmentsReferences:
- L'Huillier JC, Silvestri C, Brian R, et al. The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency. Surgery. 2025;180:109126. doi:10.1016/j.surg.2024.109126 https://pubmed.ncbi.nlm.nih.gov/39862712/
- L'Huillier JC, Woodward JM, Lund S, et al. Is it gossip or feedback? Surgical attendings' perceptions of gossip within residency. J Surg Educ. 2024;81(10):1362-1373. doi:10.1016/j.jsurg.2024.07.004 https://pubmed.ncbi.nlm.nih.gov/39173427/Please visit https:/…
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Clinical Challenges in Breast Surgery: The Management of Ductal Carcinoma In Situ (DCIS)
8 september 2025 · 43 min
Ductal carcinoma in situ (DCIS) represents a clinical crossroads in breast surgery—balancing the risks of over-treatment with the need to prevent invasive cancer. With new data from active monitoring trials, the pressure is on for surgeons to personalize care. Tune in to this essential episode to stay ahead of the curve on DCIS management and to hear expert insights from two leading breast surgical oncologists. 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 DCIS and explain its significance as a precursor to invasive breast cancer.
- Discuss challenges in diagnosing and risk-stratifying DCIS.
- Review current standards for surgical and adjuvant management of DCIS.
- Understand the implications of new research, including the COMET trial, for low-risk DCIS.
- Evaluate patient-centered strategies for managing DCIS and preventing over-treatment.References:
- Worni M, Akushevich I, Greenup R, et al. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ. J Natl Cancer Inst. 2015;107(12):djv263. PubMed
- Francis A, Thomas J, Fallowfield L, et al. Addressing overtreatment of screen detected DCIS; the LORIS trial. Eur J Cancer. 2015 Jan;51(16):2296-303. PubMed
- Elshof LE, Tryfonidis K, Slaets L, et al. Feasibility of a non-surgical management strategy for low-grade DCIS: The LORD study. Eur J Cancer. 2015;51(12):1497–1510. PubMed
- Toss MS, et al. Ductal carcinoma in situ (DCIS): current management and future directions. Cancer Treat Rev. 2020;90:102091. PubMed
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Artificial Intelligence for the Clinician Episode 3: Basics of Machine Learning Statistics
4 september 2025 · 25 min
Welcome back our series on AI for the clinician! In this episode, we go over some basics of machine learning statistics with the goal to help you read and analyze contemporary studies. Some of this will be a review, and parts will be technical, but by the end we hope reading these studies is less daunting. Lees meer
Hosts:
Ayman Ali, MD
Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery.Julie Doberne, MD, PhD: @juliedoberne
Julie Doberne is an Assistant Professor of Surgery, Assistant Professor of Medical Informatics and Clinical Epidemiology, cardiothoracic surgeon, and faculty member of the Surgical Data and Decision Sciences Lab at Oregon Health and Science University.Phillip Jenkins, MD: @PhilJenkinsMD
Phil Jenkins is a general surgery PGY-4 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics.Steven Bedrick, PhD: @stevenbedrick
Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Department of Medical Informatics and Clinical Epidemiology.
Shelby Willis, MD
Shelby Willis is a general surgery PGY-4 at Oregon Health and Science University. She is currently in her research time in the Surgical Data and Decision Sciences lab at OHSU pursuing advanced training in informatics.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
BTK Fan Favorites:
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.o… -
Hot Topics from the Annals of Surgery Ep. 2: Academic Surgery
1 september 2025 · 16 min
In the second episode of this new collaboration between BTK and Annals of surgery, we discuss another hot topic: academic surgery. Specifically, we discuss dedicated research time for residents and how surgical leaders think about building the academic surgery enterprise. This discussion was inspired by a couple of recent papers in Annals of Surgery that stirred up a lot of conversation on social media which can be found below. Lees meer
Host: Cody Mullens, MD MPH — general surgery resident at University of Michigan current BTK Surgery Education Fellow (@Cody_Mullens)
Guest: Justin Dimick, MD MPH — Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of you Michigan and Editor in Chief at Annals of Surgery (@jdimick1)
Papers:
Career Trajectory After General Surgery Residency Do Academic Program Graduates Pursue Academic Surgery?
https://journals.lww.com/annalsofsurgery/abstract/2025/05000/career_trajectory_after_general_surgery_residency_.10.aspxTraining the Surgeon-scientist: Time (and Money) Well Spent?
https://journals.lww.com/annalsofsurgery/citation/9900/training_the_surgeon_scientist__time__and_money_.1318.aspxIntroducing a New Annals of Surgery Section Professional Development for the Contemporary Surgeon
https://journals.lww.com/annalsofsurgery/fulltext/2025/08000/introducing_a_new_annals_of_surgery_section_.8.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
BTK Fan Favorites:
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
Download our App:
Apple App Store: ht… -
I’ve Got 99 Problems, and a G Tube is One
28 augustus 2025 · 26 min
In this episode of Behind the Knife, Dr. Patrick Georgoff sits down with Dr. Keri Seymour and Dr. Joey Lew to tackle the complex world of gastrostomy tubes. What may seem like a routine and straightforward procedure is anything but—full of nuanced patient considerations, timing dilemmas, technical challenges, and potential complications that can turn a “simple” consult into a 2 a.m. call you won’t forget. From who truly needs a G tube and when to managing difficult post-op issues like dislodgement and buried bumper syndrome, this episode breaks down the practical, evidence-based approach every surgeon should know. Whether you’re managing stroke patients, trauma cases, or navigating the tricky administrative obstacles around enteral access, this episode will equip you with the insights and strategies to confidently dominate your G tube consults. Lees meer
Hosts:
· Dr. Patrick Georgoff (Acute Care Surgeon, Duke University)
· Dr. Keri Seymour (Minimally Invasive & Acute Care Surgeon, Duke Regional)
· Dr. Joey Lew (Surgical Resident, BTK MIS Team)Learning Goals:
By the end of this episode, listeners will be able to:
· Understand the nuanced indications for gastrostomy tube (G tube) placement.
· Learn which patients truly benefit from G tubes, and when enteral access is not appropriate or indicated.
· Appreciate the importance of goals of care discussions, assessment of comorbidities, and decision-makers—especially in neurocritical and elderly populations.
· Know evidence-based timing for gastrostomy tube placement in stroke, TBI, and other complex scenarios.
· Understand guideline recommendations and the clinical reasoning behind trial periods of nasogastric feeding versus early G tube placement.
· Describe technical approaches to G tube placement and how to tailor the method to patient anatomy and clinical context.
· Solidify knowledge of when to choose endoscopic, laparoscopic, open, or interventional radiology-guided placement.
· Recognize, manage, and strive to prevent … -
Clinical Challenges in Vascular Surgery: Type B Aortic Dissections (TBAD)
25 augustus 2025 · 30 min
A silent danger lurks within the descending thoracic aorta. While most Type B aortic dissections are managed medically, up to half of these patients will either require life-saving surgery or die within just five years. So how do we separate those who will quietly recover from those on the edge of catastrophe? How do we protect the spinal cord, bowel, and limbs from the devastating consequences of malperfusion? Lees meer
Join the University of Michigan Department of Vascular Surgery as they tackle the high-stakes decisions behind managing this unpredictable disease—where timing is critical, interventions are evolving, and lives hang in the balance.
Hosted by the University of Michigan Department of Vascular Surgery:
· Robert Beaulieu, Program Director
· Frank Davis, Assistant Professor of Surgery
· Luciano Delbono, PGY-5 House Officer
· Andrew Huang, PGY-4 House Officer
· Carolyn Judge, PGY-2 House Officer
Learning Objectives:
1. Discuss general approach to diagnosis and management of TBAD.
2. Identifying high-risk features in uncomplicated TBAD and understanding their role in determining the need for surgical management.
3. Review endovascular techniques for managing malperfusion of the limbs, viscera, and spinal cord and discuss associated decision making.
References:
Authors/Task Force Members, Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., Kim, K. M., Kreibich, M., Lescan, M., Di Marco, L., Martens, A., Mestres, C. A., Milojevic, M., Nienaber, C. A., … Hughes, G. C. (2024). EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. The Annals of Thoracic Surgery, 118(1), 5–115. https://doi.org/10.1016/j.athoracsur.2024.01.021
de Kort, J. F., Hasami, N. A., Been, M., Grassi, V., Lomazzi, C., Heijmen, R. H., Hazenberg, C. E. V. B., van Herwaarden, J. A., & Trimarchi, S. (2025). Trends and Updates in the Management and Outcom…
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Journal Review in Thoracic Surgery: The Prehab Prescription- Evidence, Implementation, and Advocacy
21 augustus 2025 · 22 min
What if we could train patients for surgery the way elite athletes train for game day? Lees meer
In this episode, we review the science, shed light on the disparities, explore real-world challenges, and honor the behind-the-scenes workers that facilitate prehabilitation in thoracic cancer care. Join attending surgeon Doctor Jinny Ha, 3rd year general surgery resident Doctor Kyla Rakoczy, and Community Outreach Patient Navigator, Leslie Ricks Chandler, in discussing prehabilitation in thoracic surgery.
Hosts:
Dr. Jinny Ha, MD, MHS, assistant professor of surgery and thoracic surgeon at Johns Hopkins
Leslie Ricks Chandler, Community Outreach Program Advisor Johns Hopkins Thoracic Surgery
Dr. Kyla Rakoczy, MD, 3rd year general surgery resident at Johns Hopkins LinkedIn: Kyla RakoczyLearning objectives:
After listening to this episode, participants will be able to:Define the role and components of prehabilitation in the context of thoracic oncology and ERAS/ESTS guidelines.
Interpret key findings from recent clinical trials on prehabilitation, including outcomes related to functional capacity and readmission rates.
Identify socioeconomic and structural barriers to prehabilitation participation and discuss strategies to improve equitable access to these interventions.
Apply evidence-based criteria to assess which patients may benefit most from preoperative nutrition and exercise interventions.
Recognize the importance of interdisciplinary collaboration—including social work and patient navigation—in optimizing surgical readiness and long-term outcomes.
References:
Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial - PubMed
https://pmc.ncbi.nlm.nih.gov/articles/PMC12070588/
https://pubmed.ncbi.nlm.nih.gov/39775660/
https://ccts.amegroups.org/article/view/68030/html
https://pubmed.ncbi.nlm.nih.gov/36435646/
https://www.sciencedirect.com/science/article/abs/pii/S1043067918301643?via%…
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Journal Review in Endocrine Surgery: Parathyroidectomy for Fracture Risk
18 augustus 2025 · 29 min
Primary hyperparathyroidism is an underdiagnosed condition which leads to decreased bone mineral density, fracture, renal disease, among other symptoms that can decrease the quality of a patient’s life. Moreover, once diagnosed, only a small fraction of patients with the diease end up being offered surgery. Whether it is because of misunderstood indications and benefits of surgery, non-localization of disease, or various other reasons, we thought it was worthwhile to review relevant literature. Lees meer
Hosts: Dr. Becky Sippel is an endowed professor of surgery at Division Chief of endocrine surgery at University of Wisconsin Madison and she is the most recent past president of the AAES. She is an internationally recognized leader in the field of endocrine surgery. She has over 250 publications. She was the PI for a RCT which studies prophylactic central neck dissections which is a widely read and quoted study in endocrine surgery.
Dr. Amanda Doubleday is a fellowship trained endocrine surgeon in private practice with an affiliation to UW Health. Her primary practice is with Waukesha Surgical Specialists in Waukesha WI.
Dr. Simon Holoubek is a fellowship trained endocrine surgeons affiliated with UW Health. He works for UW Health with privileges at UW Madison and UW Northern Illinois. His clinical interests are aggressive variants of thyroid cancer, parathyroid autofluorescence, and nerve monitoring.
Learning Objectives:
1 Understand the natural history of primary hyperparathyroidism and how the disease process can affect bone mineral density.2 Learn about fracture risk associated with primary hyperparathyroidism.
3 Learn about decreased fracture risk in patients with primary hyperparathyroidism who have parathyroidectomy compared to those who are observed.
References:
1 Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Cli… -
Behind the Knife General Surgery Oral Board Review – Sample Episode 10 - Abdominal Wall Defects - Gastroschisis/Omphalocele
14 augustus 2025 · 19 min
Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Lees meer
Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. 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 face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing.
Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review
**Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.**
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
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Behind the Knife 2025 Brief Update
13 augustus 2025 · 6 min
In this episode, the Behind the Knife team shares exciting updates, including updates to the General Surgery Oral Board Review with 123 expert-commentary scenarios, 10 interactive videos, and 97 operative descriptions. They announce upcoming projects such as an AI-powered oral board simulator, Spanish-language review, a free pediatric surgery resource, and detailed surgical instrument flashcards. The team also introduces Dominate Surgery courses for medical students and advanced practice providers, designed to modernize and elevate surgical education. Lees meer
***Choledocholithiasis wtih Gastric Bypass Video Scenario Link: https://app.behindtheknife.org/video/behindtheknife-general-surgery-oral-board-review-video-sample-choledocholithiasis-w-gastric-bypass
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Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic.Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. 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 face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing.
Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review
**Institutional Discounts Avail…
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Behind the Knife General Surgery Oral Board Review – Sample Episode 9 - Axillary Management of Breast Cancer
12 augustus 2025 · 15 min
Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Lees meer
Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. 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 face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing.
Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review
**Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.**
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
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Behind the Knife General Surgery Oral Board Review – Sample Episode 8 - Trauma Resuscitation and ED Thoracotomy
11 augustus 2025 · 17 min
Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Lees meer
Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. 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 face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing.
Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review
**Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.**
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
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Clinical Challenges in Emergency General Surgery: Open Cholecystectomy - “A Lost Art”
7 augustus 2025 · 34 min
When the gallbladder turns hostile, sometimes you must do more than just pause—you have to call in a senior partner for help. Join the Behind the Knife EGS team at Mizzou as we dive into the art and grit of open cholecystectomy. From fundus-first dissection to navigating the “barrier to happiness,” this episode is packed with surgical pearls, tough love, and the kind of wisdom only scars can teach. Lees meer
Participants:
Dr. Rushabh Dev FACS (Moderator, Surgical Attending) – Assistant Professor of Surgery, Associate PD ACS & SCCM Fellowship, SICU Medical Director, Lieutenant Commander United States Navy Reserve
Dr. Jeffery Coughenour FACS (Surgical Attending) – Professor of Surgery and Emergency Medicine, Trauma Medical Director at the University of Missouri SOM
Dr. Christopher Nelson FACS (Surgical Attending) – Associate Professor of Surgery, Medical Director of Emergency General Surgery at the University of Missouri SOM
Dr. Micah Ancheta (ACS Fellow) – Major, United States Airforce
Dr. Desra Fletcher (3rd year general surgery resident)
Learning Objectives:
· Recognize Indications for Conversion
Identify clinical and intraoperative factors that necessitate conversion from laparoscopic to open cholecystectomy.· Apply Risk Stratification Tools
Utilize grading systems (e.g., Parkland, Tokyo, AAST) to assess cholecystitis severity and predict surgical difficulty.· Implement Safe Cholecystectomy Techniques
Describe the six steps of the SAGES Safe Cholecystectomy Program to minimize bile duct injury.· Understand Bailout Strategies
Differentiate between fenestrating and reconstituting subtotal cholecystectomy techniques and their respective risks.· Master Key Operative Steps
Outline the essential components of open cholecystectomy: positioning, incision, exposure, and dissection.· Navigate High-Risk Anatomy
Recognize “zones of danger” and use the B-SAFE mnemonic to reorient and ensure safe progression.· Develop Intraoperative Judgment
Demonstrate when to procee… -
Journal Review in Burn Surgery: Fluid Resuscitation
4 augustus 2025 · 23 min
You’re on call at a level I trauma center and you get called that you’re receiving a large TBSA burn patient – you’re not working at a burn center! You remember hearing about some controversy surrounding burn resuscitation – was it the parkland formula? Consensus formula? ABSITE asked about the Modified Brooke Formula?!? Join Dr. Kathleen Romanowski, Dr. Laura Johnson, Dr. Victoria Miles, and Dr. Lauren Nosanov to discuss modern burn fluid resuscitation! 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:
· Review the basics of initial burn fluid resuscitation
· Evaluate the literature informing national burn fluid resuscitation guidelines
· Consider the causes of failed burn resuscitation and strategies for identifying these complicationsReferences:
· Pham TN, Cancio LC, Gibran NS. American Burn Association Practice Guidelines Burn Shock Resuscitation. J Burn Care Res. 2008: 257-266. doi:10.1097/jbcr.0b013e31815f3876. https://pubmed.ncbi.nlm.nih.gov/18182930/
· Rizzo JA, Coates EC, Serio-Melvin ML, et al. Higher Initial Formula for Resuscitation After Severe Burn Injury Means Higher 24-Hour Volumes. J Burn Care Res. 2023:1017-1022. doi:10.1093/jbcr/irad065. https://pubmed.ncbi.nlm.nih.gov/37339255/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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Journal Review in Minimally Invasive Surgery: Achalasia
31 juli 2025 · 20 min
Today, we’re diving into a condition that’s as fascinating as it is complex: Achalasia—where the esophagus stops playing nice, and swallowing becomes a daily challenge. Lees meer
We’re breaking down the latest evidence, comparing POEM, pneumatic dilation, and Heller myotomy, and digging into what actually matters when deciding how to treat each achalasia subtype.
Join show hosts Drs. Jake Greenberg, Dana Portenier, Zach Weitzner, and Joey Lew as they discuss the past, present, and future of Achalasia management. Whether you're a medical student or a seasoned attending, this episode will arm you with the tools to think critically about diagnosis, tailor your treatment strategy, and stay ahead of the curve on the future of achalasia care.
Hosts:
· Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University
· Dana Portenier, MD, MIS Fellowship Director, 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:
· Describe the pathophysiology and key diagnostic criteria for achalasia, including the role of manometry, EGD, and esophagram.
· Differentiate between the three subtypes of achalasia based on the Chicago Classification and understand the clinical significance of each.
· Compare treatment options for achalasia—pneumatic dilation, Lap Heller myotomy, and POEM—including indications, efficacy, and long-term outcomes.
· Interpret landmark studies (e.g., European Achalasia Trial, JAMA POEM trial) and their impact on treatment decision-making.
· Recognize patient-specific factors (age, comorbidities, achalasia subtype) that influence the choice of therapy.
· Discuss evolving technologies and future directions in achalasia management, including endoluminal robotics, ARMS, and combined anti-reflux strategies.
· Outline a basic treatment… -
Mattox Conference Pro-Con Debate 2025: Direct to OR Resuscitation
28 juli 2025 · 30 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. Teddy Puzo and Joseph Dubois as they battle it out over the use of a DIRECT TO OR TRAUMA RESUSCITATION STRATEGY. 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
Video Link: https://www.youtube.com/watch?v=-DTTGBaLcHo
TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/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://app.behindtheknife.org/listen
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Mattox Conference Pro-Con Debate 2025: Trauma Video Review
25 juli 2025 · 31 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. Ryan Dumas and Bellal Joseph (@TopKniFe_B) as they battle it out over the use of TRAUMA VIDEO REVIEW. 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
Video Link: https://app.behindtheknife.org/video/mattox-conference-pro-con-debate-2025-trauma-video-review
TRAUMA SURGERY VIDEO ATLAS: https://app.behindtheknife.org/course-details/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://app.behindtheknife.org/listen
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BIG T Trauma Ep. 24 - Trauma Video Review
24 juli 2025 · 40 min
In this episode of the Big T Trauma Series, Dr. Patrick Georgoff (@georgoff) and Dr. Jason Brill dive into the evolving world of Trauma Video Review (TVR) with special guests Dr. Michael Vella and Dr. Ryan Dumas. Together, they explore how TVR is transforming trauma care by offering unprecedented insight into both technical and non-technical performance in the trauma bay. The conversation covers everything from implementation logistics and HIPAA concerns to cultural shifts and emerging AI applications. Whether you're curious about getting started or wondering if TVR should be part of trauma verification, this episode delivers essential insights from two national leaders in the space. Don’t miss it! Lees meer
Dr. Ryan Dumas is an associate professor of surgery at Baylor College of Medicine in Houston Texas where he serves as the Section Chief of Acute Care Surgery. Dr. Dumas conducts and publishes research in trauma surgery and artificial intelligence, with a specific emphasis on video technology to capture and review trauma resuscitations. He has helped develop and run several Trauma Video Review programs across the country and utilizes video review as a tool for quality improvement, education, and research. Dr. Dumas is a consultant for Teleflex and Surgical Safety Technologies.
Dr. Michael Vella is an associate professor of surgery, division of acute care surgery and trauma, at the university of Rochester medical center in Rochester, NY and the trauma medical director of the Kessler Level I trauma center. He currently serves as chair of the New York State Committee on Trauma. He has a clinical and research interest in trauma video review, particularly as it relates to trauma team dynamics and initial resuscitation. Dr. Dumas is a consultant for Teleflex.
This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page.
Please visit https://behindthekn…
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Clinical Challenges in Colorectal Surgery: Early Onset Colorectal Cancer
21 juli 2025 · 39 min
The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. 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. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center
- Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center
- Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center
- Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer CenterLearning objectives:
- Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC.
- Identify age groups and demographics most affected by EOCRC.
- Summarize USPSTF recommendations for colorectal cancer screening.
- Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity.
- Understand treatment approaches for colon and rectal cancer (CRC)
- Understand the role of mismatch repair (MMR) status in guiding treatment.
- Outline the importance of genetic counseling and testing in young patients.
- Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes.
- Describe the impact of cancer treatment on fertility and sexual health.
- Review fertility preservation options.
- Identify the value of integrated care teams for young CRC patients.References:
1. Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109, djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/
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Journal Review in Artificial Intelligence: Four Times Better Than Us
17 juli 2025 · 23 min
You have probably seen recent headlines that Microsoft has developed an AI model that is 4x more accurate than humans at difficult diagnoses. It’s been published everywhere, AI is 80% accurate compared to a measly 20% human rate, and AI was cheaper too! Does this signal the end of the human physician? Is the title nothing more than clickbait? Or is the truth somewhere in-between? Join Behind the Knife fellow Ayman Ali and Dr. Adam Rodman from Beth Israel Deaconess/Harvard Medical School to discuss what this study means for our future. Lees meer
Studies:
Sequential Diagnosis with Large Language Models: https://arxiv.org/abs/2506.22405v1
METR study: https://metr.org/blog/2025-07-10-early-2025-ai-experienced-os-dev-study/Hosts:
Ayman Ali, MD
Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on applications of data science and artificial intelligence to surgery.Adam Rodman, MD, MPH, FACP, @AdamRodmanMD
Dr. Rodman is an Assistant Professor and a practicing hospitalist at Beth Israel Deaconess Medical Center. He’s the Beth Israel Deaconess Medical Center Director of AI Programs. In addition, he’s the co-director of the Beth Israel Deaconess Medical Center iMED Initiative.
Podcast Link: http://bedside-rounds.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://app.behindtheknife.org/listen
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Clinical Challenges in Robotic Bariatric Surgery: The Robot is Here to Stay!
14 juli 2025 · 44 min
Join us as we dissect the use of robotics in bariatric surgery – where precision meets programming, and the scalpel gets a software upgrade. Lees meer
Video Clip Link: https://app.behindtheknife.org/video/clinical-challenges-in-robotic-bariatric-surgery-the-robot-is-here-to-stay
This videos includes:
- Robotic RYGB
- Robotic Sleeve Gastrectomy
- SADI: Single Anastomosis DuodenoileostomyHosts:
- 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:
Strengths of the robot:
Surgical robots are at the forefront of technology and continue to improve with detailed, precision cameras and the ability to remove baseline tremors
Allows for smooth movements, fine dissection, and precise tissue handling
Ergonomics are more advantageous to the surgeon when compared to laparoscopy
Weaknesses of the robot:
The loss of haptic feedback can be challenging for surgeons early in their learning curve
Emphasis on surgical robots means some trainees may be losing exposure to laparoscopic techniques
Longer operative time when working robotically, and more time under anesthesia for the patient
Increased cost for robotic surgery
Outcomes data:
Mixed data from the MBSA QIP database (metabolic and bariatric surgery accreditation and quality improvement program)
The most recent study looked at 824,000 patients from 2015-2022 who had a sleeve gastrectomy or RNY gastric bypass, either laparoscopically (lap sleeve 61%, lap RYGB 24%) or robotically (robo sleeve 11%, robo RYGB 4%).
Rob…
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Clinical Challenges in Vascular Surgery: The Risk & Reality of EVAR Complications
10 juli 2025 · 27 min
It’s 2 a.m. The on-call resident’s voice is shaky.
The CT shows an 18cm abdominal aortic aneurysm with a Type 1B endoleak.
There’s gas in the sac, fluid in the belly, and the patient has a defibrillator on both sides of his chest.
Is it a rupture? A graft infection? An aortoenteric fistula? All of the above?
You’re the vascular surgeon, what do you do? Lees meerThis episode dives deep into decision-making when EVAR fails, when infection strikes, and when the patient might not survive a definitive repair. Let’s talk about what happens when clinical textbooks meet real-world chaos.
Hosts:
· Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center
· Paul Haser -Division chief, Vascular Surgery, Brookdale Hospital Medical Center
· Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center
· Lucio Flores, Vascular surgery, Brookdale Hospital Medical CenterLearning objectives:
· Understand the clinical implications and management of late EVAR complications, including Type 1B endoleak and aortoenteric fistula.
· Explore the decision-making process in critically ill patients with multiple comorbidities and infected aortic grafts.
· Compare endovascular vs open surgical approaches in the setting of infected AAA, and when each is appropriate.
· Recognize the role of multidisciplinary collaboration in complex vascular cases.
· Discuss the ethical considerations and goals-of-care planning in high-risk, potentially terminal vascular patients.
· Highlight the importance of long-term surveillance after EVAR and the consequences of noncompliance.References
· Karl Sörelius et al.Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair.Circulation. 2016;134(22):1822–1832.
PubMed: https://pubmed.ncbi.nlm.nih.gov/27799273/ pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15researchgate.net+15· PARTNERS Trial (OVER Trial).Outcomes Following Endovascular vs Open Repair of Abdominal Aortic Aneurysm: A Ra…
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Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!
7 juli 2025 · 31 min
In the corner of the ICU, on multiple pressors, distended, oliguric, and intubated you’ll find the necrotizing pancreatitis patient. Sounds intimidating, but with the persistence, patience, and the proper care these patients can make it! In this episode from the HPB team at Behind the Knife listen in as we discuss the Step-Up approach, when to surgically intervene, various approaches to pancreatic Necrosectomy, and additional aspects of the multidisciplinary care required for the successful treatment of necrotizing pancreatitis. Lees meer
Hosts
Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He will be joining as faculty at the Massachusetts General Hospital in Boston, MA at the conclusion of his fellowship in July 2024.
Learning Objectives
· Develop an understanding of the severity of necrotizing pancreatitis and the proper indications to surgical intervene on this often-tenuous patients.
· Develop an understanding of the Step-Up approach and key aspects (reimaging, clinical status, physiologic status, etc.) that determine when to “step-up” treatment for patients with necrotizing pancreatitis.
· Develop an understanding of long term sequalae and complications associated with necrotizing pancreatitis and operative management
· Develop an understanding of multidisciplinary care and long-term follow-up necessary for adequate treatment of patients suffering from necrotizing pancreatitis.Suggested Reading
Maurer LR, Fagenholz PJ. Contemporary Surgical Management of Pancreatic Necrosis. JAMA Surg. 2023;158(1):81–88. doi:10.1001/jamasurg.2022.5695 https://pubmed.ncbi.nlm.nih.gov/36383374/
Harrison JM, Day H, Arnow K, Ngongoni RF, Joseph A, Aldridge T, Wheeler KJ, DeLong JC, Bergquist JR, Worth PJ, Dua MM, Friedland S, Park W, Eldika S, Hwang JH, Visser BC. What's Beh…
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Intern Bootcamp: Dominate Intern Year
5 juli 2025 · 13 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year.
Hosts: Shanaz Hossain, Nina Clark
Tips for New Interns:
GENERAL TIPS FOR SUCCESS ON THE WARDS
Spend time with the patient!
Trust, but verify.
Be kind to everyone.
Stay humble.
Be flexible.
Seek and apply feedback.
HOW TO LEARN IN THE OR
Double scrub as many cases as you can.
Write down/record everything after a case.
MAINTAIN YOUR PERSONAL SANITY
Figure out your stress outlets and what brings you joy.
Decompress after work.
Maintain work/life boundaries.
Keep in touch with loved ones.
Vacations are meant for relaxation.
Repeat after me: NO WORK ON VACATION!
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/
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Intern Bootcamp: Scary Pages
4 juli 2025 · 23 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
Today, we’re hitting the wards and tackling some of the scary clinical scenarios you will see as an intern.
Hosts: Shanaz Hossain, Nina Clark
Tips for new interns:
THINGS TO REMEMBER
· BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn’t help anybody.
· See the patient. Getting a bunch of pages? Worried about someone? Confused as to what’s going on? Go see the patient and chat with the bedside team.
· Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients.
· Load the boat. You’ve heard this one from us all week! Loop senior level residents in early.HYPOTENSION
· Differential: measurement error, patient’s baseline, and don’t miss – SHOCK.
- Etiologies of shock: hemorrhagic, hypovolemic,
· On the phone: full set of vitals, accurate I/Os,
· On the way: recent notes, PMH/PSH including from this hospital stay, and vitals/I&Os/studies from earlier in the day
· In the room: ABCDs – rapidly gives you a sense of how high acuity the patient is
· Get more info: labs, consider imaging, work up specific types of shock based on clinical concern.
· Initial management: depends on etiology of hypotension; don’t forget to consider peripheral or central access, foley catheterization for close monitoring of urine output, and level of careHYPOXEMIA
· Differential: atelectasis, baseline pulmonary disease, pneumonia, PE, hemo/pneumothorax, volume overload
· On the phone: full set of vitals, amount of supplemental oxygen required and delivery device, rate of escalation in oxygen requireme… -
Intern Bootcamp: Consults
3 juli 2025 · 15 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
This episode, we’ll talk about how to give and receive consults in the hospital like a pro. We’ll also provide some tips on how to make those long call days a little more manageable.
Hosts: Shanaz Hossain, Nina Clark
Tips for New Interns:
GIVING CONSULTS
Clear and Concise Question!
Develop a script, such as:
“Hi, this is XX with the general surgery team. We’re calling to request an evaluation for a patient presenting with XX. I can give you the MRN whenever you are ready…”
Follow this with a brief H&P.
If you are asking another team to perform a procedure on your patient, be prepared with the following information:
NPO Status
Ability to Consent or Proxy Contact
Blood Thinners
Urgency of Procedure
RECEIVING CONSULTS
Make sure you are clear on what the team is asking of you as a consultant.
Clarify if the patient is expecting to receive a surgery before talking to them about an operation!
Quickly gather information about the patient and their hospital course from the consultant, electronic medical record, and, most importantly, the patient!
Note the callback number on the primary team and call them with the plan after you have staffed the patient with your attending.
If you are asked to perform a procedure as a consultant, clarify the following information:
NPO Status
Ability to Consent or Proxy Contact
Blood Thinners
Urgency of Procedure
Develop a system to stay organized and keep track of your to-do list with consults!
CALL SHIFTS
Bring a survival bag with toothbrush/toothpaste, face wash, deodorant, change of clothes, etc to reset.
Try to nap when you can, but:
PM round to address non-urgent pages ahead of time
Set alarms!
Please visit https://behindtheknife.org to access other high-yield surgic…
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Intern Bootcamp: Medical Students
2 juli 2025 · 17 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
You’ve been a doctor for about 3.5 seconds, and suddenly that bright eyed, bushy-tailed medical student on service is looking to you for advice? Don’t fret, in this episode we’ll give you some tips for how to handle it.
Hosts: Shanaz Hossain, Nina Clark
Tips for new interns:
REMEMBER HOW INTERNS DO AND DO NOT TEACH
- Nobody, not even the med students, expect you to be an expert in everything or give a fully-planned formal lecture
- You WILL however spend a ton of time working with students on your team – and via modeling and teachable moments, you can help them learn how it’s done!MODELING
- Remember how hard everything has been in the few days since you started residency? Think about all the information you’ve picked up, tips and tricks you’re developing for efficiency, and best practices you’re learning in the care of your patients. ALL of these are things you can pass on to students.
- Presentations, case prep, answering questions from senior members of the team are ALL excellent opportunities to teach (and show students how you learn yourself, so they can do it independently).TEACHABLE MOMENTS
- Find small topics that you know or are getting to know well – things like looking at a CXR, CT scan, etc.
- Once you’re getting more comfortable caring for specific disease processes, think about high yield lessons for students:
- Acute trauma evaluation and management (ABCDE’s), appendicitis, diverticulitis, benign biliary disease all make great 5 minute chalk talks that you can have in your back pocketIN THE OR
- Watch students practice skills, and try to give some feedback and tips that you use (you learned knot tying and suturing more recently than ANYONE else in the OR and probably have some tips that you’re still us… -
Intern Bootcamp: Resource Overload
1 juli 2025 · 18 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
This episode, we’ll tackle the resources that you should know about to support your own learning throughout residency.
Hosts: Shanaz Hossain, Nina Clark
Tips for new interns:
STRUCTURE YOUR STUDYING
- 2 things you need to do: (1) develop a knowledge base and (2) answer questions
- Knowledge basePick a level-appropriate textbook, read it (ideally all of it) yearly.
Ideally, lead a little bit every day - 10 pages/day is a good goal to start with and you may need to adjust.
- Questions
Do some questions every week – 50/week is a good goal to startPlan to do more questions closer to ABSITE!
Consider storing everything you learn in one place – either a notebook you carry with you or a cloud-based note app
Share this with others, use it to take notes while reading, doing cases, getting feedback, or gaining experience while taking care of patients every day.
SPECIFIC RESOURCES
- TextbooksSabiston: big book, very dense, with a lot of great information.
Schwartz: shorter chapters, clinically oriented, ideal for junior residents
Cameron: shorter chapters, clinically oriented, ideal for senior residents
- ABSITE review books
Fiser: Classic, packed with facts but can be difficult to read, good for looking things up quickly
BTK ABSITE Companion: https://www.amazon.com/Behind-Knife-ABSITE-Review-Companion-ebook/dp/B0CLBZ273F/ref=sr_1_2?crid=3382SFZ81ZHKA&keywords=absite+review+behind+the+knife&qid=1698106031&sprefix=absite+review+behind+the+knife%2Caps%2C64&sr=8-2
- Question banks
TrueLearn: high quality, can be pricy depending on program
SCORE: written/edited by ABS, free for subscribing programs
LEARN HOW TO OPERATE??
- Carry suture and a needle driver with you and practice basic moves
- Consider a home suture kit … -
Intern Bootcamp: The First Day
30 juni 2025 · 16 min
RE-RELEASE
This was first published in 2023 but it's so good we are running it back! Lees meerBuckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.
First up, the first day of intern year.
Hosts: Shanaz Hossain, Nina Clark
Tips for new interns:
BRING WHAT YOU NEED
Name badge
Scrubs, white coat, and extra clinic clothes
Comfortable shoes - even on clinic days
Pager
Phone
Pen
Bonus stuff that’s good to keep in your bag: Snacks, extras of everything, toothbrusth/toothpaste/deodorant, suture
STAY ORGANIZED
Preround purposefully and systematically
Look at the same things in the same order every day on every patient
Write data in the same physical location on your sheet so you can quickly find information on the fly
Keep track of to-do’s from rounds
Check box system:
Nina’s system: empty = not done, half full = ordered/needs follow up, full = completely done and followed up on
Don’t forget to look at the results of imaging studies, labs, or consults after they are entered!
Prioritize urgent/emergent things first, then consults and discharges, then routine orders, then notes
As you get more efficient, start drafting your notes as you pre-round – it will save you lots of time later in the afternoon!
OWN THE FLOOR
During the day, be ready to shift your priorities as urgent issues arise.
Develop a system for remembering what happened after rounds so you can quickly update seniors
Shanaz’s system: One color for AM rounds, a different color for afternoon events
Load the boat! Your team is there to help you. If you are concerned about someone or have a question, ask. There is truly no better time than as an intern.
Master the art of getting your seniors’ attention in the OR - be conscientious, be clear in what you’re asking, and be prepared to report back about urgent findings!
Please visit https://behindtheknife.org to access other high-yield surgical educ…
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Journal Review in Surgical Education: Resident Autonomy in the Good Ole Days
26 juni 2025 · 40 min
In this surgical education episode, the Cleveland Clinic General Surgery Education Team explores the past, present, and future of resident autonomy in the operating room. With guest colorectal surgeons Dr. Tracy Hull (recently retired) and Dr. David Rosen (early career faculty), we discuss how autonomy was granted in “the good ole days,” how educational culture and institutional pressures shape current practice, and what thoughtful autonomy looks like moving forward. Through candid stories—from emergent cases and missed enterotomies to thumbtacks pulled off the wall to stop bleeding—we get a nuanced look at what surgical independence really means, and how to responsibly develop it. Lees meer
Join hosts Pooja Varman, MD, Judith French, PhD, and Jeremy Lipman, MD, MHPE, for this conversation about what it means to train competent, confident, and independent surgeons.
Learning Objectives
By the end of this episode, listeners will be able to
1. Define operative autonomy and its educational value in surgical training
2. Identify barriers to providing resident autonomy in modern surgical environments
3. Discuss strategies for tailoring autonomy to the skill level and readiness of the trainee
4. Describe approaches to communicating resident involvement to patientsReferences
1. Sehat AJ, Oliver JB, Yu Y, Kunac A, Anjaria DJ. Declining Surgical Resident Operative Autonomy in Acute Care Surgical Cases. J Surg Res. 2023;281(k7b, 0376340):328-334. doi:10.1016/j.jss.2022.08.041 https://pubmed.ncbi.nlm.nih.gov/36240719/2. Teman NR, Gauger PG, Mullan PB, Tarpley JL, Minter RM. Entrustment of General Surgery Residents in the Operating Room: Factors Contributing to Provision of Resident Autonomy. J Am Coll Surg. 2014;219(4):778-787. doi:10.1016/j.jamcollsurg.2014.04.019 https://pubmed.ncbi.nlm.nih.gov/25158911/
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:…
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Journal Review in Surgical Oncology: Neuroendocrine Tumors of the Small Bowel
23 juni 2025 · 31 min
Join the Behind the Knife Surgical Oncology Team as we discuss the two key studies investigating optimal management strategies of neuroendocrine tumors of the small bowel. 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 Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles.
- Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University.
- Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson.
- Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical CenterLearning Objectives:
In this episode we review two important papers that discuss optimal management strategies of neuroendocrine tumors (NET) of the small bowel. The first paper by Singh and colleagues discusses the NETTER-2 trial investigating the role of radioligand therapy for NET as a first-line treatment. The second article by Maxwell et all challenges surgical dogma regarding optimal debulking cutoffs for debulking of NET.Links to Papers Referenced in this Episode:
1. Singh S, Halperin D, Myrehaug S, Herrmann K, Pavel M, Kunz PL, Chasen B, Tafuto S, Lastoria S, Capdevila J, García-Burillo A, Oh DY, Yoo C, Halfdanarson TR, Falk S, Folitar I, Zhang Y, Aimone P, de Herder WW, Ferone D; all the NETTER-2 Trial Investigators. [177Lu]Lu-DOTA-TATE plus long-acting octreotide versus high‑dose long-acting octreotide for the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, gastroenteropancreatic neuroendocrine tumours (NETTER-2): an open-label, randomised, phase 3 study. Lancet. 2024 Jun 29;403(10446):2807-2817. doi: 10.1016/S0140-6736(24)00701-3. Epub 2024 Jun 5. PMID: 38851203. https://pubmed.ncbi.nlm.nih.gov/38851203/2. Maxwell JE, Sherman SK, O'Dorisio TM,…
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Journal Review in Colorectal Surgery: Hand Assist Laparoscopy in Colon and Rectal Surgery
19 juni 2025 · 36 min
You have a patient with complicated diverticulitis s/p IR drain with colo-cutaneous fistula and colo-vaginal fistula. They are scheduled for surgery. How will you do it? What is the role for hand assist? How can hand assist help? Tune in to find out! Lees meer
Join Drs. Peter Marcello, Jonathan Abelson, and Tess Aulet as they discuss high yield papers discussing hand assist laparoscopy in Colon and Rectal surgery.
Learning Objectives
1. Describe the technical considerations and how to do hand assist laparoscopic surgery (HALS)
2. Discuss the indications for use of HALS
3. Review literature supporting use of HALSVideo Link: https://app.behindtheknife.org/video/journal-review-in-colorectal-surgery-hand-assist-laparoscopy-in-colon-and-rectal-surgery
References:
Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, Feingold DL, Lee SW, Mutch MG, Sonoda T, Yan Y, Whelan RL. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum. 2008 Jun;51(6):818-26; discussion 826-8. doi: 10.1007/s10350-008-9269-5. Epub 2008 Apr 17. PMID: 18418653. https://pubmed.ncbi.nlm.nih.gov/18418653/Jacobs C, Read TE. "Peek port": avoiding conversion during laparoscopic colectomy-an update. Surg Endosc. 2020 Sep;34(9):3944-3948. doi: 10.1007/s00464-019-07165-3. Epub 2019 Oct 4. PMID: 31586252. https://pubmed.ncbi.nlm.nih.gov/31586252/
Heneghan HM, Martin ST, Kiran RP, Khoury W, Stocchi L, Remzi FH, Vogel JD. Laparoscopic colorectal surgery for obese patients: decreased conversions with the hand-assisted technique. J Gastrointest Surg. 2013 Mar;17(3):548-54. doi: 10.1007/s11605-012-2089-x. Epub 2012 Nov 27. PMID: 23188222. https://pubmed.ncbi.nlm.nih.gov/23188222/
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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From Cringe to Competent: Surviving Intern Year
16 juni 2025 · 31 min
Intern year: where the learning curve is steep and you’re not sure if the patient is crashing or you are. In this episode of Behind the Knife, our surgical education fellows reflect on what they wish they had known before Day 1—and all the humbling, hilarious, and genuinely formative moments along the way. Lees meer
From getting lost wheeling a critical patient through the hospital, to triple-scrubbing just to be acknowledged, to accidentally spraying TPA into your own eye (yes, really)—this episode is a candid conversation about the highs, lows, and everything in between. Whether you're gearing up to start your intern year or reflecting on how far you've come, this is the episode we all needed.
Hosts:
Elizabeth Maginot, MD – General Surgery Resident, University of Nebraska Medical Center @e_magination95
Nina Clark, MD – General Surgery Resident, University of Washington @clarkninam
Ayman Ali, MD – General Surgery Resident, Duke University
Michelle LaBella, MD – General Surgery Resident, University of North Carolina
Emma Burke, MD – General Surgery Resident, Baylor College of Medicine @emmaburke017
Learning Objectives:
Identify common misconceptions about intern year—and how to manage expectations
Understand how to approach early mistakes with humility and resilience
Recognize the importance of teamwork and asking for help
Reflect on what makes a strong, dependable intern
References
BTK Intern Survival Guide: https://app.behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide
Institutional pharmacists (seriously, call them—they’re the unsung heroes)
Check out our Medical Student and Intern Survival Guide HERE: https://app.behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide
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Hot Topics from the Annals of Surgery Ep. 1: Robotic Surgery
12 juni 2025 · 22 min
This new series will be a collaboration between BTK and Annals of Surgery, where we will be discussing hot topics in surgery research. No, we won’t be getting into the nitty gritty of methods of individual papers but rather will focus on high-level discussions of contemporary topics that are moving our field forward. Lees meer
Hosts:
Cody Mullens, MD is a general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens)
Justin B. Dimick, MD MPH is the Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of Michigan. He also serves as the Editor in Chief at Annals of Surgery. (@jdimick1)
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
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USA vs. UK: ASGBI Ep. 5 - Sustainable Surgical Practices
9 juni 2025 · 43 min
The evidence for climate change is irrefutable. But how does surgical care contribute to global emissions, and is there anything we can do to make surgery more sustainable? Join Jon Williams and our ASGBI partners for the next installment of our BTK/ASGBI collaborative series, where we discuss how to make surgical care greener. Mrs. Cleo Kennington from the UK and Dr. Benjamin Miller from the US are our guest experts, and provide valuable insights into local sustainability efforts you can take home to your hospital, broader concepts of how high-quality care is sustainable, innovations in sustainability, and what the future of sustainable surgery may look like. After listening, you get to decide–Who has more sustainable surgical practices? The UK or US? Lees meer
Mrs. Cleo Kenington is a Consultant Emergency General and Trauma Surgeon at St George’s Hospital, London and was the recent ASGBI Sustainability Lead. She is a big advocate for practicing what she preaches, focusing on how we can reduce the environmental impact at all stages, from cycling to work, preventing complications and unnecessary surgeries, to reducing the use of disposable surgical components.
Dr. Benjamin Miller is a general and minimally invasive surgeon at the Cleveland Clinic, with a clinical focus on complex abdominal wall reconstruction. After earning his MD from University of Minnesota School of Medicine in 2011, Dr. Miller went to Nashville to complete his general surgery residency at Vanderbilt University Medical Center. Following this, he became a MIS/complex ab wall fellow at Cleveland Clinic, after which he joined as faculty in 2023. In addition to his clinical interests, Dr. Miller has a deep passion for sustainability efforts within surgical practice, carrying on the legacy of established sustainability efforts within surgical care at Cleveland Clinic and training the next generation of sustainable surgeons.
If you enjoyed this episode, stay tuned for more upcoming BTK/ASGBI collaborative co…
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Clinical Challenges in Hernia Surgery: Mesh Selection for Hernia Repair
5 juni 2025 · 41 min
Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan Ellis as they review mesh materials used in hernia repair and the general properties surgeons who perform hernia repairs should know. Lees meer
Hosts:
- Sara Maskal, MD, Cleveland Clinic
- Ryan Ellis, MD, Cleveland Clinic
- Benjamin T. Miller, MD, Cleveland Clinic
- Michael Rosen, MD, Cleveland ClinicLearning Objectives:
- Understand common mesh materials
- Review properties of the different mesh materials
- Understand how to apply knowledge of the different mesh properties to different patient scenariosReferences:
- Ellis R, Miller BT. Mesh selection in abdominal wall reconstruction: an update on biomaterials. Surgical Clinics. 2023 Oct 1;103(5):1019-28. https://pubmed.ncbi.nlm.nih.gov/37709387/
- Krpata DM, Petro CC, Prabhu AS, Tastaldi L, Zolin S, Fafaj A, Rosenblatt S, Poulose BK, Pierce RA, Warren JA, Carbonell AM. Effect of hernia mesh weights on postoperative patient-related and clinical outcomes after open ventral hernia repair: a randomized clinical trial. JAMA surgery. 2021 Dec 1;156(12):1085-92. https://pubmed.ncbi.nlm.nih.gov/34524395/
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Artificial Intelligence for the Clinician Ep. 2: Natural Language Processing and Large Language Models
2 juni 2025 · 45 min
Welcome back to our series on AI for the clinician! Large language models, like ChatGPT, have been taking the world by storm, and healthcare is no exception to that rule – your institution may already be using them! In this episode we’ll tackle the fundamentals of how they work and their applications and limitations to keep you up to date on this fast-moving, exciting technology. Lees meer
Hosts:
Ayman Ali, MD
Ayman Ali is a Behind the Knife fellow and general surgery PGY-3 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery.Ruchi Thanawala, MD: @Ruchi_TJ
Ruchi Thanawala is an Assistant Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU.Phillip Jenkins, MD: @PhilJenkinsMD
Phil Jenkins is a general surgery PGY-3 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics.Steven Bedrick, PhD: @stevenbedrick
Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Department of Medical Informatics and Clinical Epidemiology.Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen