Behind The Knife: The Surgery Podcast

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1. Behind the Knife ABSITE 2024 - Pancreas

   8 december 2023 · 45 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

2. Journal Review in Thoracic Surgery: Lobar vs Sublobar Resection for Stage 1A NSCLC – CALGB & JCOG

   7 december 2023 · 48 min

   Afspelen
   In this episode our team reviews the two groundbreaking RCTs which challenged the long-held dogma that a lobectomy is the only acceptable oncologic procedure for NSCLC. Listen as we compare and contrast the North American CALGB trial and Japanese JCOG trial which were both designed to investigate survival and recurrence outcomes by randomizing stage 1A patients to lobectomy versus a sublobar resection. Lees meer

   Learning Objectives:
   -Compare and contrast the patient characteristics of the CALGB and JCOG trials
   -Understand the methodology each trial and be able to explain their nuanced differences
   -Analyze the results of the CALGB and JCOG trials and how they apply to patients today

   Hosts:
   Kelly Daus MD, Peter White MD, Eric Vallieres, MD and Brian Louie MD

   Referenced Material
   https://pubmed.ncbi.nlm.nih.gov/36780674/
   Altorki N, et al. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083. PMID: 36780674; PMCID: PMC10036605.

   https://pubmed.ncbi.nlm.nih.gov/35461558/’
   Saji H, et al. West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3. PMID: 35461558.

   https://pubmed.ncbi.nlm.nih.gov/37473998/
   Altorki N, et al. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2023 Jul 18:S0022-5223(23)00612-8. doi: 10.1016/j.jtcvs.2023.07.008. Epub ahead of print. PMID: 37473998.

   Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

   If you liked this episode, check out our other Cardiothoracic episodes: https://behindtheknife.org/podcast-categ…

3. Behind the Knife ABSITE 2024 - Adrenal

   6 december 2023 · 26 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

4. Behind the Knife ABSITE 2024 - Hepatobiliary

   5 december 2023 · 45 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

5. Behind the Knife ABSITE 2024 - Spleen

   4 december 2023 · 19 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

6. Behind the Knife ABSITE 2024 - Stomach

   1 december 2023 · 52 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

7. Behind the Knife ABSITE 2024 - Esophagus

   30 november 2023 · 38 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

8. Behind the Knife ABSITE 2024 - Parathyroid

   29 november 2023 · 18 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

9. Behind the Knife ABSITE 2024 - Thyroid

   28 november 2023 · 18 min

   Afspelen
   Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

   Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

   Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

   If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

10. Behind the Knife ABSITE 2024 - Head and Neck

    27 november 2023 · 21 min

    Afspelen
    Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Lees meer

    Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet

    Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series. Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife. Learn more at https://www.medtronic.com/

    If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.

    Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

11. Clinical Challenges in Endocrine Surgery: Autofluorescence in Endocrine Surgery

    23 november 2023 · 31 min

    Afspelen
    Making a discovery that changes how we practice is one of the most exciting things about the fields of medicine and surgery. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Samantha Ruff from The Ohio State University. Hear Dr. Phay tell the story of how parathyroid autofluorescence was discovered and the work that has gone on since that day. The group discusses several articles focusing on intraoperative adjuncts used to identify parathyroid tissue during thyroid and parathyroid surgery. Lees meer

    Hosts: Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, John Phay, MD, Clinical Professor of Surgery, Priya H. Dedhia, MD, PhD, Assistant Professor of Surgery, Samantha Ruff, MD, Surgical Oncology Fellow, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

    Twitter handles:
    Barbra Miller - @OSUEndosurgBSM
    John Phay – @JohnPhayMD
    Priya Dedhia – @priyaknows
    Samantha Ruff - @SamRuff_MD

    Learning objectives:
    1) Understand the background of the discovery of parathyroid autofluorescence
    2) Describe various intraoperative adjuncts utilized to identify parathyroid tissue
    3) Compare and contrast the advantages and disadvantages of using autofluorescence versus indocyanine green for identification of parathyroid tissue
    4) Recognize the impact of use of intraoperative imaging adjuncts on postoperative hypocalcemia (short and long-term)
    5) Understand the general safety issues for the parathyroid imaging techniques discussed

    References:
    1. Benmiloud, F., G. Godiris-Petit, R. Gras, et al., Association of Autofluorescence-Based Detection of the Parathyroid Glands During Total Thyroidectomy With Postoperative Hypocalcemia Risk: Results of the PARAFLUO Multicenter Randomized Clinical Trial. JAMA Surg, 2020. 155(2): p. 106-12 DOI: 10.1001/jamasurg.2019.4613. https://pubmed.ncbi.nlm.nih.gov/31693081/

    2. Kahramangil, B. and E. Berber, Comparison of…

12. Journal Review in Vascular Surgery: Chronic Limb Threatening Ischemia: BEST-CLI and BASIL-2 Trials

    20 november 2023 · 26 min

    Afspelen
    What is the best surgical treatment for a vasculopathy with critical limb threatening ischemia? In this episode of Behind the Knife the vascular surgery subspecialty team discusses two pivotal trials (BEST-CLI and BASIL-2) and how the findings of these trials can help answer this question. In this episode, we will discuss the age old question: open bypass versus best endovascular treatment. Lees meer

    Hosts:

    Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan

    Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan

    Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan

    Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan

    Learning Objectives

    Review the definition, prevalence, and prognosis of critical limb threatening ischemia

    Review basic treatment options for patients with critical limb threatening ischemia

    Understand the methodology, findings, limitations, and clinical applications of the BEST-CLI trial

    Understand the methodology, findings, limitations, and clinical applications of the BASIL-2 trial

    Compare open bypass and best endovascular therapy for patients with critical limb threatening ischemia

    References

    Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. N Engl J Med. 2022 Dec 22;387(25):2305-2316. doi: 10.1056/NEJMoa2207899. Epub 2022 Nov 7. PMID: 36342173. https://pubmed.ncbi.nl…

13. Clinical Challenges in Minimally Invasive Surgery: MIS in the Pregnant Patient

    16 november 2023 · 40 min

    Afspelen
    If you operate for long enough, chances are you will come across the unique, and potentially daunting scenario of operating on a pregnant patient. If, and when, you do, would you know what to do? Join University of Washington and MIS faculty Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and residents Drs. Ben Vierra and Paul Herman as they discuss non-obstetric surgery in the pregnant patient so that you will be better informed when the challenge arises. Lees meer

    Hosts:
    1. Andrew Wright, UW Medical Center—Montlake and Northwest, @andrewswright
    2. Nick Cetrulo, UW Medical Center—Northwest, @Trules25
    3. Nicole White, UW Medical Center—Northwest, @NicoleWhiteTho1
    4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm
    5. Ben Vierra, UW General Surgery Resident PGY-2

    Learning Objectives
    1. Describe important physiologic changes in pregnancy that are relevant for the surgeon to know.
    2. Review the epidemiology of non-obstetric general surgery in the pregnant patient.
    3. Discuss specific imaging considerations in the pregnant patient.
    4. Become more familiar with the technical aspects of approaching a typical surgical case in a pregnant patient.

    References
    1. Pearl, J.P., Price, R.R., Tonkin, A.E. et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc 31, 3767–3782 (2017). https://doi.org/10.1007/s00464-017-5637-3
    2. Vasileiou G, Eid AI, Qian S, Pust GD, Rattan R, Namias N, Larentzakis A, Kaafarani HMA, Yeh DD; EAST Appendicitis Study Group. Appendicitis in Pregnancy: A Post-Hoc Analysis of an EAST Multicenter Study. Surg Infect (Larchmt). 2020 Apr;21(3):205-211. https://pubmed.ncbi.nlm.nih.gov/31687887/
    3. Dongarwar D, Taylor J, Ajewole V, Anene N, Omoyele O, Ogba C, Oluwatoba A, Giger D, Thuy A, Argueta E, Naik E, Salemi JL, Spooner K, Olaleye O, Salihu HM. Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal-Fetal Mortality. World J Surg. 2020 Dec;44(12):3999-4005. https://pubmed.ncbi.nlm.nih.gov/327375…

14. Journal Review in Hernia Surgery: Artificial Intelligence and Hernia Outcome Prediction

    13 november 2023 · 26 min

    Afspelen
    Join the Hernia Team from Carolinas Medical Center as they discuss applications of artificial intelligence in predicting outcomes for patients undergoing abdominal wall reconstruction. Emerging technologies are allowing us to understand hernia patients who are at risk for increased surgical complexity and postoperative complications – find out more in this Journal Review episode. Lees meer

    Hosts:

    Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD

    Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford

    Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein

    Dr. Monica Polcz, Attending Surgeon, Baptist Health (FL)

    Learning Objectives:

    Provide and introduction to artificial intelligence

    Develop an understanding of the applications of artificial intelligence in surgical outcome prediction for patients undergoing hernia repair

    Learn how risk stratification of hernia patients can affect their care

    References:

    Elhage et al, Development and Validation of Image-Based Deep Learning Models to Predict Surgical Complexity and Complications in Abdominal Wall Reconstruction, JAMA Surgery, 2021

    https://pubmed.ncbi.nlm.nih.gov/34232255/

    Ayuso et al, Predicting Rare Outcomes in Abdominal Wall Reconstruction Using Image-Based Deep Learning Models, Surgery, 2023

    https://pubmed.ncbi.nlm.nih.gov/36229252/

    Hassan et al, Novel Machine Learning Approach for Prediction of Hernia Recurrence, Surgical Complication, and 30-Day Readmission after Abdominal Wall Reconstruction, JACS, 2022

    https://pubmed.ncbi.nlm.nih.gov/35426406/

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out more Behind the Knife hernia episodes: https://behindtheknife.org/podcast-category/hernia/

15. Medical Student Mentorship – Leveraging mentorship into scholarship

    9 november 2023 · 31 min

    Afspelen
    We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? And how do you leverage those relationships into getting research experience and lines on your CV? Lees meer

    Hosts:
    Nina Clark, MD
    Jessica Millar, MD
    Jon Williams, MD

    Guests:
    Michael Englesbe, MD, University of Michigan
    Erika Bisgaard, MD, University of Washington

    Some tips from the episode:
    Get involved

    Even if you’re not destined for an academic career, getting involved in research early on can help you to participate with the scientific literature, understand data, and incorporate new research into your practice.

    Realistically, research is an important component of your ERAS application and your CV. It’s also a great opportunity to learn new skills and develop strong relationships with mentors.

    Remember why you’re in medical school

    You came to medical school to become a doctor first – don’t forget that or let research take away from it. Your mentors have been through it and understand that things get busy.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our Medical Student Intern Survival Guide Series: https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

16. Medical Student Mentorship – Who they are, what they do.

    6 november 2023 · 34 min

    Afspelen
    We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? In this episode, our surgical education fellows and two expert mentors talk through the ins and outs of mentors – who are they, what can they do for you, how do you find one, and what do you do once you have one. Lees meer

    Hosts:
    Nina Clark, MD
    Jessica Millar, MD
    Jon Williams, MD

    Guests:
    Michael Englesbe, MD, University of Michigan
    Erika Bisgaard, MD, University of Washington

    Some tips from the episode:

    Mentorship teams: think about 4-5 people who can help you in different ways.

    Research mentor who can help you find opportunities and be productive

    1-2 people who support you in all things (these might be residents!)

    1-2 higher level sponsors who facilitate opportunities and pay for things

    Discipline and accountability

    RESPOND TO EMAILS. If you get an indication that a potential mentor would like to meet with you, take them up on the offer and be prompt with your replies! Nobody likes to be ghosted.

    Meet with your mentors at some regular cadence (every 2 weeks is a good place to start)

    Think of mentorship as a game of tennis – if your mentor gives you something to work on, the next meeting you should bring it back completed. This is a relationship, and back and forth accountability can establish trust.

    Change over time

    As you grow, you’ll change, and so will your relationships with mentors. This is one of the most rewarding aspects of these relationships and something you should aim to maintain over time.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our Medical Student Intern Survival Guide Series: https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/

17. Clinical Challenges in Surgical Education: Ob/Gyn ResidencyCAS - Creation of a New Independent Residency Application System

    2 november 2023 · 29 min

    Afspelen
    Challenges continue to plague the residency application process, with programs receiving increased application volume that makes holistic review difficult, and medical student applicants burdened with application costs and uncertainty about what programs best align with their values. As a specialty, Ob/Gyn is facing these problems head on, and have united within their field to create a new independent residency application system, ResidencyCAS. While substantial changes to an already stressful process can be intimidating, the new platform offers many advantages that hope to improve the residency application experience for applicants, programs, and the Ob/Gyn community as a whole. We’re joined by Dr. Maya Hammoud and Dr. AnnaMarie Connolly, two of the leaders in this effort, to break down the creation of ResidencyCAS, plans for its implementation starting in the 2024-2025 application cycle, and the reaction of the Ob/Gyn and medical education communities to this change. Lees meer

    Learning Objectives
    1. Listeners will describe current challenges to applicants and programs in the residency application process.
    2. Listeners will identify the coming changes to the Ob/Gyn residency application process, with awareness of the planned design and use of the ResidencyCAS system.
    3. Listeners will describe the value of potential changes to the residency application process.
    4. Listeners will explain the barriers and efforts required to coordinate large-scale changes within medical education like the creation and implementation of ResidencyCAS.
    5. Listeners will consider how changes to the residency application process could affect and improve their own field, program, or application.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our other Surgical Education Episodes: https://behindtheknife.org/podcast-category/surgical-education/

18. Journal Review in Trauma Surgery: Direct Peritoneal Resuscitation

    30 oktober 2023 · 33 min

    Afspelen
    Direct Peritoneal Resuscitation! We’re not just dumping fluids into the open abdomen. What is DPR? Why do it? Who should get it? Does it work? Come try and stay awake for some basic science talk before then learning all about why you should consider adopting DPR into your Trauma/EGS practice? Join Drs. Cobler-Lichter, Kwon, Meizoso, Urréchaga, and Rattan as they guide you through all this and more! Lees meer

    Hosts:
    Michael Cobler-Lichter, MD, PGY2:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @mdcobler (twitter)

    Eva Urrechaga, MD, PGY6/R4:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @urrechisme (twitter)

    Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center

    Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 3 years in practice
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @jpmeizoso (twitter)

    Rishi Rattan, MD, Attending Surgeon in Trauma/Critical Care, 7 years in practice
    Legacy Emanuel Medical Center
    @DrRishiRattan (twitter)

    Learning Objectives:
    - State the proposed benefits of DPR
    - Identify who can benefit from DPR
    - Demonstrate the proper way to set up a DPR circuit
    - Discuss the proposed basic science mechanism for DPR’s efficacy

    Quick Hits:
    1. Consider DPR in all your open abdomens in EGS/Trauma. You never know when you’re going to be able to close some of these patients.
    2. The principal of DPR is to allow the fluid to dwell in the abdomen as long as possible. Keep the catheter deep and don’t put holes in your dressing.
    3. DPR is ideal for patients with packing, who are in discontinuity, and for fresh anastomoses. These will only benefit from DPR, not be harmed by it.
    4. Make sure these patients are receiving hourly I/Os. Nursing by-in is huge for this procedure.
    5. DPR is associated with higher rates of fascial closure, reduces inflammation, and improves blood flow to the abdomen.

    References

    Ribeiro-Junior MAF, Cássia Tie…

19. Pelvic Exenteration Surgery Series Episode 2: Anterior compartment tumors

    26 oktober 2023 · 27 min

    Afspelen
    Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes that we learn during surgical training, and into all compartments of the pelvis. Lees meer

    Episode 2 outlines the radical technical approaches to anteriorly invasive tumours, including en bloc cystectomy, perineal urethrectomy, inter-labial vaginectomy and radical pubic bone resections.

    Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Paul Sutton from The Christie Hospital, Manchester, UK.

    Technical videos:
    Solomon MJ, Däster S, Loizides S, Sutton P, Brown KGM, Austin KKS, Lee PJ. Access to the anterior pelvic compartment in pelvic exenteration in women-the interlabial approach: video vignette. Br J Surg. 2021 Aug 19;108(8):e268-e269. doi: 10.1093/bjs/znab127.

    Solomon MJ, Alahmadi R, Lee PJ, Austin KKS. En bloc partial pubic bone excision with complete soft tissue pelvic exenteration. Br J Surg. 2022 Jun 14;109(7):640-641. doi: 10.1093/bjs/znac122. PMID: 35485605.

    References:
    Solomon MJ, Austin KK, Masya L, Lee P. Pubic Bone Excision and Perineal Urethrectomy for Radical Anterior Compartment Excision During Pelvic Exenteration. Dis Colon Rectum. 2015 Nov;58(11):1114-9. doi: 10.1097/DCR.0000000000000479.

    Check our more high-yield colorectal surgery content from Behind the Knife.

20. Pelvic Exenteration Surgery Series Episode 1: Principles of Patient Selection and Surgery

    23 oktober 2023 · 29 min

    Afspelen
    Join Professor Michael Solomon, Dr Kilian Brown and Dr Jacob Waller from Royal Prince Alfred Hospital in Sydney, Australia, for this special four part series on pelvic exenteration surgery for locally advanced and recurrent rectal cancer. Learn about these ultra-radical procedures which go beyond the traditional TME planes, that we learn during surgical training, and into all compartments of the pelvis. Lees meer

    Episode 1 provides listeners with an overview of the principles of exenteration surgery and preoperative patient assessment and selection.

    Each episode in this series features a different international guest surgeon. In episode 2, the RPA team are joined by Dr Elaine Burns from St Mark's Hospital, London, UK.

    References and further reading:
    -Burns EM, Quyn A; Lexicon Collaboration of UKPEN and the ACPGBI Advanced Cancer subcommittee. The 'Pelvic exenteration lexicon': Creating a common language for complex pelvic cancer surgery. Colorectal Dis. 2023 May;25(5):888-896. doi: 10.1111/codi.16476.
    -Brown KGM, Solomon MJ. Decision making, treatment planning and technical considerations in patients undergoing surgery for locally recurrent rectal cancer. Seminars in Colon and Rectal Surgery. 2020;31(3):100764
    -van Kessel CS, Solomon MJ. Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking. Cancers. 2022 Oct 15;14(20):5058. doi: 10.3390/cancers14205058
    -PelvEx Collaborative. Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative. Cancers (Basel). 2022 Feb 24;14(5):1161. doi: 10.3390/cancers14051161

    Check out more high-yield colorectal surgery content from Behind the Knife: https://behindtheknife.org/podcast-category/colorectal/

21. Association of Out Surgeons & Allies (AOSA) – Episode 2: The Medical Student and Resident Perspective

    19 oktober 2023 · 31 min

    Afspelen
    This week, we discuss the experiences of residents and medical students in surgery who identify as LGBTQIA+. We discuss the question of disclosure during interviews, how to identify programs that are welcoming to diverse identities, and how AOSA has grown the community of trainees and faculty mentors and hopes to continue to support them in the future. Lees meer

    Hosts:

    Jason Bingham, MD

    Nina Clark, MD

    Guests:

    Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center

    Christina Georgeades, MD, R4 General Surgery at Medical College of Wisconsin cgeorgeades@mcw.edu, Twitter/X: @CGeorgeades

    Cameron Smith, MS3 at Kansas City University Cameron.smith@kansascity.edu, Instagram: @cameron_smith_1996, Twitter/X: @cafe_aficionad0

    Jillian Wothe, MD, R1 General Surgery at Brigham & Women’s Hospital jillian.wothe@gmail.com, Twitter/X: @JillianWothe

    Learn more and get involved with AOSA:
    https://www.outsurgeons.org
    Twitter/X: @OutSurgeons

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out episode one in this series: https://behindtheknife.org/podcast/association-of-out-surgeons-allies-aosa-episode-1/

22. BIG T Trauma Series Ep. 18 – Rib Plating Update

    16 oktober 2023 · 29 min

    Afspelen
    Has the pendulum swung too far? Is it time to put the drill down?? Or, drill, baby, drill! While the number of rib plating cases has exploded the data supporting the practice is less-than-stellar. On this episode of the BIG T Trauma series Drs. Patrick Georgoff, Teddy Puzio, and Jason Brill bring you up to speed on rib plating. Lees meer

    If you haven’t already, we recommend you listen to Behind the Knife episode 298, published in May 2020. (https://behindtheknife.org/podcast/big-t-trauma-series-ep-10-rib-fractures/) This episode covers comprehensive management of rib fractures, including multimodal pain control, regional blocks, pulmonary toilet, BiPAP, etc.

    REFERENCES:
    GUIDELINES
    EAST PMG Rib Plating (2017): https://www.east.org/education-resources/practice-management-guidelines/details/rib-fractures-open-reduction-and-internal-fixation-of-update-in-process
    EAST PMG Rib Fracture Non-Surgical Management (2022): https://www.east.org/education-resources/practice-management-guidelines/details/nonsurgical-management-and-analgesia-strategies-for-older-adults-with-multiple-rib-fractures-a-systematic-review-metaanalysis
    Chest Wall Injury Society Guidelines (2020): https://cwisociety.org/wp-content/uploads/2020/05/CWIS-SSRF-Guideline-01102020.pdf

    FLAIL/UNSTABLE CHEST
    Operative vs Nonoperative Treatment of Acute Unstable Chest Wall Injuries: A Randomized Clinical Trial, JAMA 2022: https://jamanetwork.com/journals/jamasurgery/fullarticle/2796556
    Prospective randomized controlled trial of operative rib fixation in traumatic flail chest, JACS 2013: https://pubmed.ncbi.nlm.nih.gov/23415550/
    Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status, Interact Cardiovasc Thoracic Surg 2005: https://pubmed.ncbi.nlm.nih.gov/17670487/
    Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients, J Trauma 2002: https://pubmed.ncbi.nlm.nih.gov/11956391/
    Surgical Rib Fixation of Multiple …

23. Clinical Challenges in Colorectal Surgery: Management of Horseshoe Abscess

    12 oktober 2023 · 36 min

    Afspelen
    You have a young patient with a horseshoe abscess. How should you address the abscess initially? What is the best approach to drain it? Now that it is drained, what do I do with all the drains? Tune in to figure out how to best approach the most challenging of perianal abscesses. Lees meer

    Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Julia Saraidaridis as they discuss the management of horseshoe abscess and complicated perianal fistula.

    Learning Objectives
    1. Describe the evaluation for perianal abscesses and fistula.
    2. Discuss the different surgical options in managing horseshoe abscesses and post operative care to definitive management
    3. Explain the rationale behind use of different fistula surgeries in complex perianal fistulas

    Link to episode video: https://behindtheknife.org/video/clinical-challenges-in-colorectal-surgery-management-of-horseshoe-abscess/

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal Surgeons. Learn more here: https://behindtheknife.org/premium

24. Journal Review in Bariatric Surgery: Mesenteric Defect Closure and Internal Hernia Evaluation/Management

    9 oktober 2023 · 29 min

    Afspelen
    To close or not to close - that is the question! Internal hernias following bariatric surgery can be a vexing source of delayed postoperative morbidity. Join Drs. Matthew Martin, Kunoor Jain-Spangler, Adrian Dan, and Vincent Cheng for this EXCELLENT Journal Review in Bariatric Surgery. Lees meer

    Article #1: Stenberg 2023 - Long-term Safety and Efficacy of Closure of Mesenteric Defects in Laparoscopic Gastric Bypass Surgery

    Two mesenteric defects are created during Roux-en-Y gastric bypass (RNYGB)

    Petersen’s Defect

    Jejuno-jejunostomy mesenteric defect

    Consensus does not exist regarding the standard of care for mesenteric defect closure (e.g., closure of one or both defects, material used for closure).

    Risks of leaving defects open: internal herniation with or without bowel ischemia

    Risks of closing defects

    Kinking the bowel (especially near the jejunojejunostomy) leading to obstruction

    Chronic abdominal pain

    This article discusses a randomized controlled trial of obese patients undergoing bariatric RNYGB

    Randomized into two groups: a closure group and a non-closure group

    Followed patients for 10 years with 95-96% follow up rate

    Results analyzed using a Cox proportional hazards regression that included risk factors like BMI, total weight loss at 1 year after surgery, and the other

    Highlighted outcomes

    Within the first 30 postop days, there was a higher rate of SBO in the closure group (1.3%) compared to the non-closure group (0.2%). This was attributed to kinking of the jejunojejunostomy

    After 30 postop days and up to 10 years, reoperation rates for SBO were higher in the non-closure group (14.9%) compared to the closure group (7.8%). This trend was consistent regarding each site of mesenteric defect.

    No significant differences between the two groups regarding chronic opioid use as a metric of chronic abdominal pain.

    Article #2: Nawas 2022 - The Diagnostic Accuracy of Abdominal Computed Tomography in Diagnosing Internal Herniation Following Roux-en-Y Gastric …

25. Association of Out Surgeons & Allies (AOSA) - Episode 1

    5 oktober 2023 · 25 min

    Afspelen
    This week we sat down with the Association of Out Surgeons & Allies (AOSA) leadership in the first installment of a BTK/AOSA collaboration addressing issues important to LGBTQ+ surgeons, patients, and allies. We are joined by Guest Host Dr. Andrew Schlussel, BTK Members Drs. Nina Clark and Jason Bingham, and AOSA Leaders Drs. Nicole Goulet, Alexis Moren, and Courtney Collins. More information about AOSA and how to get involved can be found at https://www.outsurgeons.org. Lees meer

    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/

26. Clinical Challenges in Surgical Oncology: Gastrointestinal Stromal Tumors (GISTs)

    2 oktober 2023 · 33 min

    Afspelen
    Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Lees meer

    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 and current HPB fellow at MD Anderson

    Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University.

    Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center

    Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center

    Learning Objectives:

    In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management. We discuss key concepts including the genetic background of these tumors and high-yield targeted therapies that are relevant both in direct patient care and board exams.

    Reference:
    Gold JS, Gönen M, Gutiérrez A, Broto JM, García-del-Muro X, Smyrk TC, Maki RG, Singer S, Brennan MF, Antonescu CR, Donohue JH, DeMatteo RP. Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol. 2009 Nov;10(11):1045-52. doi: 10.1016/S1470-2045(09)70242-6. Epub 2009 Sep 28. PMID: 19793678; PMCID: PMC3175638.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our surgical oncology oral board exam review here: https://behindtheknife.org/premium/

27. Journal Review in Hernia Surgery: Smoking in Elective Open Ventral Hernia Repair

    28 september 2023 · 27 min

    Afspelen
    How do you counsel the patient with a large painful hernia who still smokes a pack of cigarettes every day? Join Drs. Michael Rosen, Clayton Petro, Sara Maskal, and Ryan Ellis as they discuss some of the highlights in the literature on smoking and its impact on postoperative outcomes in elective, clean open ventral hernia repairs. Lees meer

    Hosts:
    - Michael Rosen, Cleveland Clinic
    - Clayton Petro, Cleveland Clinic
    - Sara Maskal, Cleveland Clinic
    - Ryan Ellis, Cleveland Clinic, @ryanellismd

    Learning objectives:
    - Evaluate historical data on smoking in surgery
    - Compare with newer literature specific to contemporary ventral hernia repairs
    - Understand how the historical and new data can be applied in clinical practice

    References:
    Møller AM, Villebro N, Pedersen T, Tønnesen H. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002 Jan 12;359(9301):114-7. doi: 10.1016/S0140-6736(02)07369-5. PMID: 11809253.

    Kubasiak JC, Landin M, Schimpke S, Poirier J, Myers JA, Millikan KW, Luu MB. The effect of tobacco use on outcomes of laparoscopic and open ventral hernia repairs: a review of the NSQIP dataset. Surgical Endoscopy. 2017 Jun;31:2661-6.

    DeLancey JO, Blay Jr E, Hewitt DB, Engelhardt K, Bilimoria KY, Holl JL, Odell DD, Yang AD, Stulberg JJ. The effect of smoking on 30-day outcomes in elective hernia repair. The American Journal of Surgery. 2018 Sep 1;216(3):471-4.

    Sørensen LT. Wound healing and infection in surgery: the clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Archives of surgery. 2012 Apr 1;147(4):373-83.

    Petro CC, Haskins IN, Tastaldi L, Tu C, Krpata DM, Rosen MJ, Prabhu AS. Does active smoking really matter before ventral hernia repair? An AHSQC analysis. Surgery. 2019 Feb;165(2):406-411. doi: 10.1016/j.surg.2018.07.039. Epub 2018 Sep 13. PMID: 30220485.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and m…

28. Clinical Challenges in Surgical Palliative Care: “When the horse is out of the barn: Skills to avoid offering surgical overtreatment at the end of life"

    25 september 2023 · 22 min

    Afspelen
    Surgeons are trained to, well…do surgery, but is that always the right treatment for the patient? Not offering surgery can be a challenge, especially when you’re consulted about a sick patient in the middle of the night and the clinical momentum is moving toward the OR. Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington as we discuss how to recognize when a surgery is potentially not beneficial and communicate serious news with the patient and consulting team. Lees meer

    Hosts:
    Dr. Katie O’Connell (@katmo15) is an assistant professor of surgery at the University of Washington. She is a trauma surgeon, palliative care physician, director of surgical palliative care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA.

    Dr. Ali Haruta is a PGY7 current palliative care fellow at the University of Washington, formerly a UW general surgery resident and Parkland trauma/critical care fellow.

    Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 general surgery resident and current surgical oncology fellow at the University of Washington.

    Dr. Virginia Wang is a PGY2 general surgery resident at the University of Washington.

    Learning Objectives:

    Identify when a patient’s disease course is unlikely reversible by surgery

    Learn to avoid defaulting to offering potentially non-beneficial surgical treatment for patients at the end-of-life

    Learn to recommend comfort-focused treatments for patients at the end-of-life

    Develop the communication skill of delivering serious news

    References:

    1. Cooper Z, Courtwright A, Karlage A, Gawande A, Block S. Pitfalls in communication that lead to nonbeneficial emergency surgery in elderly patients with serious illness: description of the problem and elements of a solution. Ann Surg. Dec 2014;260(6):949-57. doi:10.1097/SLA.0000000000000721

    2. VitalTalk. One page Guides. https://www.vitaltalk.org/guides/

    3. VitalTalk. Using Ask-Tell-Ask to Mak…

29. Clinical Challenges in Burn Surgery: Electrical Burns - Part 2 of 2

    21 september 2023 · 26 min

    Afspelen
    While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries. Lees meer

    Hosts:
    - Dr. Tam Pham: UW Medicine Regional Burn Center
    - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center
    - Dr. Alex Morzycki: UW Medicine Regional Burn Center
    - Dr. Jamie Oh: UW Medicine Regional Burn Center

    Learning Objectives:
    - Review the epidemiology and common mechanisms for electrical injuries
    - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems
    - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release
    - Recognize possible long-term complications of electrical injuries and their subsequent management

    References:
    1. Daskal Y, Beicker A, Dudkiewicz M, Kessel B. [HIGH VOLTAGE ELECTRIC INJURY: MECHANISM OF INJURY, CLINICAL FEATURES AND INITIAL EVALUATION.]. Harefuah. 2019 Jan;158(1):65-69. Hebrew. PMID: 30663297.

    2. Pawlik AM, Lampart A, Stephan FP, Bingisser R, Ummenhofer W, Nickel CH. Outcomes of electrical injuries in the emergency department: a 10-year retrospective study. Eur J Emerg Med. 2016 Dec;23(6):448-454. doi: 10.1097/MEJ.0000000000000283. PMID: 25969345.

    3. Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T; Wilderness Medical Society. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med. 2014 Dec;25(4 Suppl):S86-95. doi: 10.1016/j.wem.2014.08.011. PMID: 25498265.

    4. Zemaitis MR, Foris LA, Lopez RA, et al. Electrical Injuries. [Updated 2023 Apr 9]. In: StatPearl…

30. Clinical Challenges in Burn Surgery: Electrical Burns - Part 1 of 2

    18 september 2023 · 20 min

    Afspelen
    While on your burn rotation, the emergency department calls due to a patient who may have been injured at his job site, coming in contact with a high-voltage line. Join Drs. Tam Pham, Clifford Sheckter, Alex Morzycki and Jamie Oh as they discuss the work-up, management, resuscitation, and subsequent complications and reconstruction for electrical injuries.
    Hosts:
    - Dr. Tam Pham: UW Medicine Regional Burn Center
    - Dr. Clifford Sheckter: Stanford Medicine, Santa Clara Valley Medical Center
    - Dr. Alex Morzycki: UW Medicine Regional Burn Center
    - Dr. Jamie Oh: UW Medicine Regional Burn Center Lees meer

    Learning Objectives:
    - Review the epidemiology and common mechanisms for electrical injuries
    - Understand the impact of electrical injuries on different organ systems, including skin, musculoskeletal, cardiac, neurologic, and renal systems
    - Be able to guide initial work-up and resuscitation of acute electrical injuries including upper extremity compartment evaluation and release
    - Recognize possible long-term complications of electrical injuries and their subsequent management

    References:
    1. Daskal Y, Beicker A, Dudkiewicz M, Kessel B. [HIGH VOLTAGE ELECTRIC INJURY: MECHANISM OF INJURY, CLINICAL FEATURES AND INITIAL EVALUATION.]. Harefuah. 2019 Jan;158(1):65-69. Hebrew. PMID: 30663297.

    2. Pawlik AM, Lampart A, Stephan FP, Bingisser R, Ummenhofer W, Nickel CH. Outcomes of electrical injuries in the emergency department: a 10-year retrospective study. Eur J Emerg Med. 2016 Dec;23(6):448-454. doi: 10.1097/MEJ.0000000000000283. PMID: 25969345.

    3. Davis C, Engeln A, Johnson EL, McIntosh SE, Zafren K, Islas AA, McStay C, Smith WR, Cushing T; Wilderness Medical Society. Wilderness Medical Society practice guidelines for the prevention and treatment of lightning injuries: 2014 update. Wilderness Environ Med. 2014 Dec;25(4 Suppl):S86-95. doi: 10.1016/j.wem.2014.08.011. PMID: 25498265.

    4. Zemaitis MR, Foris LA, Lopez RA, et al. Electrical Injuries. [Updated 2023 Apr 9]. In: StatPearls…

31. Clinical Challenges in Surgical Education: Thriving as a Surgical Intern

    14 september 2023 · 30 min

    Afspelen
    Surgical residency is hard. In some ways, intern year may be the hardest. We’ve been there. We’re a group of surgical residents formally known as the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional organization of surgical education research fellows working together to foster peer mentorship, networking, and scholarly collaboration. We’ve collectively reflected on our experiences as surgical interns across the country. Join Drs. Ananya Anand, Joe L’Huillier, and Rebecca Moreci as they discuss three tips for thriving as a surgical intern. Lees meer

    Hosts:
    –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD
    –Dr. Joseph L’Huillier, University at Buffalo, @JoeLHuillier101
    –Dr. Rebecca Moreci, Louisiana State University, @md_moreci
    –COSEF: @surgedfellows

    Learning Objectives:
    Listeners will:
    – List CoSEF’s three tips for thriving as a surgical intern
    – Challenge their definition of patient ownership
    – Recall the “Golden Rule” of treating others how you want to be treated
    – Appreciate the importance of self-care in surgical residency

    References:
    L’Huillier, Joseph C. MD; Lund, Sarah MD; Anand, Ananya MD; Jensen, Rachel M. MD; Williamson, Andrea J.H. MD; Clanahan, Julie M. MD, MHPE; Moreci, Rebecca MD; Gates, Rebecca S. MD, MMHPE. Thriving as a Surgical Intern: Three Tips From the Collaboration of Surgical Education Fellows (CoSEF). Annals of Surgery Open 4(3):p e306, September 2023. | DOI: 10.1097/AS9.0000000000000306

    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/

    Ad referenced in episode: https://jomi.com/

32. Journal Review in Hepatobiliary Surgery: Advances in Liver Venous Deprivation and Hypertrophy

    11 september 2023 · 33 min

    Afspelen
    For patients with insufficient future liver remnant (FLR) volume, adequate hypertrophy after Portal Venous Embolization (PVE) is associated with reduced likelihood of post-operative hepatic insufficiency. But what happens when PVE isn’t enough to obtain adequate volume prior to surgery? In this episode from the HPB team at Behind the Knife, listen in on the discussion about advances in venous deprivation techniques that can potentially increase resection rates and hypertrophy Lees meer

    Hosts
    Anish J. Jain MD (@anishjayjain) is a T32 Research Fellow at the University of Texas MD Anderson Cancer Center within the Department of Surgical Oncology.
    Timothy E. Newhook MD, FACS (@timnewhook19) is an Assistant Professor within the Department of Surgical Oncology. He is also the associate program director of the HPB fellowship at the University of Texas MD Anderson Cancer Center.
    Jean-Nicolas Vauthey MD, FACS (@VautheyMD) is Professor of Surgery and Chief of the HPB Section, as well as 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 Portal Venous Embolization (PVE)
    - Develop an understanding of Sequential Hepatic Venous Embolization (HVE)
    - Develop an understanding of Radiological Simultaneous Porto-hepatic Venous Embolization (RASPE)
    - Develop an understanding of the traditional two-stage hepatectomy with PVE
    - Develop an understanding of the Fast Track Two-Stage Hepatectomy

    Papers Referenced (in the order they were mentioned in the episode):

    1) Niekamp AS, Huang SY, Mahvash A, Odisio BC, Ahrar K, Tzeng CD, Vauthey JN. Hepatic vein embolization after portal vein embolization to induce additional liver hypertrophy in patients with metastatic colorectal carcinoma. Eur Radiol. 2020 Jul;30(7):3862-3868. doi: 10.1007/s00330-020-06746-4. Epub 2020 Mar 7. PMID: 32144462.
    2) Laurent C, Fernandez B, Marichez A, Adam JP, Papadopoulos P…

33. BTK Surgical Oncology Oral Board Review - Sample Episode 2 - Pancreatic Adenocarcinoma

    7 september 2023 · 29 min

    Afspelen
    Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons. Lees meer

    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 surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.

    Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

34. BTK Surgical Oncology Oral Board Review - Sample Episode 1 - Ductal Carcinoma In Situ

    4 september 2023 · 16 min

    Afspelen
    Our Surgical Oncology Oral Board Audio Review includes 46 high-yield scenarios that cover all of the SCORE CGSO topics designed for Surgical Oncology Surgeons by Surgical Oncology Surgeons. Lees meer

    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 surgical oncology surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.

    Learn more about the course and see all the episode topics here: https://behindtheknife.teachable.com/p/btk-surgical-oncology-oral-board-review-course

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

35. Clinical Challenges in Cardiac Surgery: Common Post-Op Cardiac Surgery Problems

    31 augustus 2023 · 33 min

    Afspelen
    We know cardiac surgery can seem a bit daunting on the surface. However, most surgeons will come across cardiac surgery patients at some point whether in the OR, ICU, ED, etc. As the FIRST cardiac surgery specialty team for Behind the Knife, we are excited to bring you episodes focused on high-yield topics to help you navigate common cardiac surgery challenges, discuss relevant literature to help you in practice, and help our listeners feel more comfortable around cardiac surgery patients. Lees meer

    In this episode we’ll discuss common cardiac surgery post-op problems. Whether you're on a cardiac surgery rotation or just covering an ICU with cardiac surgery patients for the night, these common post-op problems are bound to occur.

    Hosts:
    - Jessica Millar, MD- PGY-5 General Surgery Resident, University of Michigan, @Jess_Millar15
    - Aaron William, MD- Cardiothoracic Surgery Fellow, Duke University, @AMWilliamsMD
    - Nick Teman, MD- Assistant Profressor of Thorasis and Cardiovascular Surgery, University of Virginia, @nickteman

    Learning objectives:
    - Understand the workup and management strategies for post-operative bleeding in the post-cardiac surgery patient.
    - Understand how to recognize and manage post-cardiotomy cardiogenic shock in the post-cardiac surgery patient.
    - Understand the workup, short-term, and long-term management for post-cardiac surgery atrial fibrillation.

    Helpful Resources:
    - 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665
    - 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures, Executive summary: https://www.jtcvs.org/article/S0022-5223(14)00835-6/fulltext

    For episode ideas/suggestions/feedback feel free to email Jessica Millar at: millarje@med.umich.edu

    Please visit https://behindtheknife.org to access other high-yield surgical education…

36. Continuing Medical Education (CME) - What? When? How?

    28 augustus 2023 · 30 min

    Afspelen
    CME - What is it? Why do I need it? How do I get it? How much do I need? How do I keep track of credits? Lees meer

    Listen to BTK's Dr. Kevin Kniery's interview with the CEO of ACCME, Dr. Graham McMahon, to learn about the nuts and bolts of CME as well as recent changes to the program.

    Helpful Links:
    Behind the Knife's FREE CME: https://behindtheknife.org/cme/
    CME Passport: CMEpassport.org
    CME Passport/Behind the Knife: https://www.cmepassport.org/activity/search?specialty=behind%20the%20knife

    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/

37. Innovations in Surgery: PEG Tube

    24 augustus 2023 · 34 min

    Afspelen
    In the fifth episode of the “Innovation in Surgery” series, Dan Scheese sits down with Dr. Jeffrey Ponsky to discuss his innovation, the PEG tube. Dr. Ponsky shares many stories about his work with endoscopy in the late 1970s and how the idea for the PEG tube originated. Lees meer

    “The Development of PEG: How it was” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136860/

    “Following the light: A history of the percutaneous endoscopic gastrostomy tube” https://www.facs.org/media/cyrndd5u/07_gastrostomy_tube.pdf

    Dr. Ponsky completed his surgical training at University Hospitals of Cleveland in 1976. In 1979, he became the Director of the Department of Surgery at The Mount Sinai Medical Center in Cleveland, where he remained through 1997. In 1997, Dr Ponsky joined The Cleveland Clinic as the Director of Endoscopic Surgery and Executive Director of the Minimally Invasive Surgery Center. In 2005, he assumed the Oliver H. Payne Professorship and Chair of the Department of Surgery at Case Western University School of Medicine. He returned to The Cleveland Clinic as Director of Developmental Endoscopy in 2014. Dr Ponsky has served as president of many organizations including the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American Society for Gastrointestinal Endoscopy (ASGE). Additionally, Dr. Ponsky has received numerous awards and has published over 300 original articles and book chapters.

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out other innovation episodes here: https://behindtheknife.org/podcast-series/innovations-in-surgery/

38. Clinical Challenges in Colorectal Surgery: Let’s Talk Ostomies!

    21 augustus 2023 · 32 min

    Afspelen
    Have you ever struggled choosing which type of stoma to mature in an anatomically or medically challenging patient? What about wrestled with the associated postoperative complications? Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss ostomy creation and management of stoma complications. Lees meer

    Hosts:
    - Susan Galandiuk MD, University of Louisville, Louisville, Kentucky, @DCREdInChief
    - Vladimir Bolshinsky MD, Peninsula Health, Victoria, Australia, @bolshinskyv
    - Sandy Kavalukas MD, University of Louisville, Louisville, Kentucky, @sandykava
    - Hillary Simon DO, University of Louisville, Louisville, Kentucky, @HillaryLSimon

    Producer:
    - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12

    Learning objectives:
    - Review pre-operative stoma marking and ostomy education.
    - Understand “bail-out” ostomy creation options in medically and anatomically challenging patients.
    - Discuss common postoperative ostomy complications and management.
    - Review common peristomal skin pathology and treatment options.

    Video References:
    - Colwell, Janice C. A.P.R.N., C.W.O.C.N.1; Williams, Toyia M.S.N., R.N.2. Management of the Patient With a Prolapsed Ileostomy. Diseases of the Colon & Rectum 65(12):p e1073, December 2022. | DOI: 10.1097/DCR.0000000000002605 https://www.youtube.com/watch?v=Wx83CpRLkqk
    Non-operative management of stoma prolapse/reduction

    - Colwell, Janice C. A.P.R.N.. Management of the Patient With a Retracted Loop Ileostomy Located in a Crease. Diseases of the Colon & Rectum 65(3):p e182-e183, March 2022. | DOI: 10.1097/DCR.0000000000002367 https://www.youtube.com/watch?v=mc6o7nG1fsQ
    Management of a retracted stoma, in a crease, with peristomal skin breakdown

    - Watanabe, Kazuhiro M.D., Ph.D.; Kohyama, Atsushi M.D., Ph.D.; Suzuki, Hideyuki M.D., Ph.D.; Kajiwara, Taiki M.D., Ph.D.; Karasawa, Hideaki M.D., Ph.D.; Ohnuma, Shinobu M.D., Ph.D.; Kamei, Takashi M.D., Ph.D.; Unno, Michiaki M.D., Ph.D.. Slug Method: A Technique for S…

39. Clinical Challenges in Thoracic Surgery: Complex Pleural Effusions & Empyema - Part 2 of 2

    17 augustus 2023 · 23 min

    Afspelen
    In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Lees meer

    Part 1: https://behindtheknife.org/podcast/clinical-challenges-in-thoracic-surgery-complex-pleural-effusions-empyema-part-1-of-2/

    Learning Objectives:

    -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions
    -Review the evidence for fibrinolytic therapy for management of complex pleural effusions
    -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window
    -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion

    Hosts:

    Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD

    Referenced Material

    https://pubmed.ncbi.nlm.nih.gov/15745977/
    Maskell NA, et al. First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med. 2005 Mar 3;352(9):865-74. doi: 10.1056/NEJMoa042473. Erratum in: N Engl J Med. 2005 May 19;352(20):2146. PMID: 15745977.

    https://pubmed.ncbi.nlm.nih.gov/21830966/
    Rahman NM, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011 Aug 11;365(6):518-26. doi: 10.1056/NEJMoa1012740. PMID: 21830966.

    https://pubmed.ncbi.nlm.nih.gov/35830586/
    Wilshire CL, et al. Comparing Initial Surgery versus Fibrinolytics for Pleural Space Infections: A Retrospective Multicenter Cohort Study. Ann Am Thorac Soc. 2022 Nov;19(11):1827-1833. doi: 10.1513/AnnalsATS.202108-964OC. PMID: 35830586.

    https://pubmed.ncbi.nlm.nih.gov/37043201/
    Wilshire CL, et al. Effect of Intrapleural Fibrinolytic Therapy vs Surgery for Complicated Pleural Infections: A Randomized Clinical Tri…

40. Clinical Challenges in Thoracic Surgery: Complex Pleural Effusions & Empyema - Part 1 of 2

    14 augustus 2023 · 28 min

    Afspelen
    In this two-part episode our team debates management of complex pleural effusions and empyema. Our surgical team is joined by Dr. Jed Gorden, an interventional pulmonologist, as we explore the nuances of deciding on fibrinolytic therapy (part 1) versus surgical management (part 2). Lees meer

    Learning Objectives:

    -Discuss the pros and cons of small bore versus large bore chest tubes for complex pleural effusions
    -Review the evidence for fibrinolytic therapy for management of complex pleural effusions
    -Describe the surgical management of a complex pleural effusion including VATS, open thoracotomy, empyema tube, Eloesser flap, and Clagett window
    -Create a framework for shared-decision making with patients regarding management of a complex pleural effusion

    Hosts:

    Kelly Daus MD, Peter White MD, Jed Gorden, MD and Brian Louie MD

    Referenced Material

    https://pubmed.ncbi.nlm.nih.gov/15745977/
    Maskell NA, et al. First Multicenter Intrapleural Sepsis Trial (MIST1) Group. U.K. Controlled trial of intrapleural streptokinase for pleural infection. N Engl J Med. 2005 Mar 3;352(9):865-74. doi: 10.1056/NEJMoa042473. Erratum in: N Engl J Med. 2005 May 19;352(20):2146. PMID: 15745977.

    https://pubmed.ncbi.nlm.nih.gov/21830966/
    Rahman NM, et al. Intrapleural use of tissue plasminogen activator and DNase in pleural infection. N Engl J Med. 2011 Aug 11;365(6):518-26. doi: 10.1056/NEJMoa1012740. PMID: 21830966.

    https://pubmed.ncbi.nlm.nih.gov/35830586/
    Wilshire CL, et al. Comparing Initial Surgery versus Fibrinolytics for Pleural Space Infections: A Retrospective Multicenter Cohort Study. Ann Am Thorac Soc. 2022 Nov;19(11):1827-1833. doi: 10.1513/AnnalsATS.202108-964OC. PMID: 35830586.

    https://pubmed.ncbi.nlm.nih.gov/37043201/
    Wilshire CL, et al. Effect of Intrapleural Fibrinolytic Therapy vs Surgery for Complicated Pleural Infections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Apr 3;6(4):e237799. doi: 10.1001/jamanetworkopen.2023.7799. PMID: 37043201; PMCID: PMC10098968.

    Please vi…

41. Entrustable Professional Activities (EPAs)- They’re Here, Now What

    10 augustus 2023 · 50 min

    Afspelen
    Entrustable Professional Activities, or EPAs, is a term you may have heard…or maybe not. EPAs represent a tectonic shift in surgical training and how residents will be evaluated. So, what are EPAs? How will they affect you? And what do you need to know? We sat down with Dr. George Sarosi, previous member of the ABS EPA Advisory Council and current General Surgery Residency Program Director at the University of Florida, to answer all of our questions now that EPAs are here. Lees meer

    Guests:
    George Sarosi, MD- Professor of Surgery and General Surgery Residency Program Director- University of Florida
    Patrick Georgoff, MD- Trauma Surgery and Surgical Critical Care- WakeMed Hospital; Co-director and Host of Behind the Knife
    Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife
    Daniel Scheese, MD- General Surgery Resident- Virginia Commonwealth University; Education Fellow- Behind the Knife

    Helpful Websites:
    Resources Page
    - ABS EPA resources page for Programs and Trainees: https://www.absurgery.org/default.jsp?eparesources
    - FAQs about EPAs and the ABS EPA Project (continuously updated so be sure to check back periodically): https://www.absurgery.org/xfer/epaprogfaqs.pdf
    - ABS EPA Program Timeline for program engagement (includes webinars, suggestions for activities for programs to consider, and an expected timeframe for the distribution of additional implementation resources): https://www.absurgery.org/xfer/absepaprogtimeline.pdf
    - Checklists for Program directors/Residency administrators/Faculty (https://www.absurgery.org/xfer/epaimplementationchecklist_programs.pdf) and for Residents (https://www.absurgery.org/xfer/epaimplementationchecklist_residents.pdf) to guide and sequence implementation priorities and timing

    If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen/

42. Journal Review in Emergency General Surgery: Clostridium Difficile Infection

    7 augustus 2023 · 23 min

    Afspelen
    An ever-present spectre looming over the hearts of general surgeons everywhere! Please join our Emergency General Surgery team for a journal review about Clostridium difficile (C. diff) infection. Dr. Ashlie Nadler and Dr. Jordan Nantais are joined by guest Dr. Marika Sevigny, recent graduate of trauma and acute care surgery at the University of Toronto, as Dr. Graham Skelhorne-Gross prepares for his upcoming fellowship at Harborview. Lees meer

    Paper 1: Ahmed et al. Risk factors of surgical mortality in patients with Clostridium difficile colitis. A novel scoring system. Eur J Trauma Emerg Surg. 2022 Jun.
    - Risk score development study using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP)
    - 525 adult (18-89) patients undergoing colectomy between 2012 and 2016
    - Split data into training (80%) and testing (20%) datasets
    - Identified mortality risk factors to create and validate a scoring system
    - Scores ranged from 0 to 37 with the highest score predicting an 83.9% risk of mortality
    - This scoring system appears relatively straight-forward and methodically sound but the lack of a currently available calculator limits use to some degree

    Paper 2: McKechnie et al. Total Abdominal Colectomy Versus Diverting Loop Ileostomy and Antegrade Colonic Lavage for Fulminant Clostridioides Colitis: Analysis of the National Inpatient Sample 2016-2019. J Gastrointest Surg. 2023 Apr 20.
    - Retrospective cohort study of adults (18+) in the National Inpatient Sample (NIS) admitted between Jan 2016 and Dec 2019 for C. difficile colitis, undergoing either a total abdominal colectomy (TAC) or diverting loop ileostomy (DLI) with antegrade vancomycin enemas
    - Focus on not only mortality and complications but also admission cost and length of stay
    - 886 TAC and 409 DLI patients were identified
    - Multivariable logistic regression analysis showed no difference in mortality or overall complications
    - TAC patients had shorter admissions (mean difference 4.0…

43. Dominate the Match – Episode 5: "Meet the Match-2024”

    3 augustus 2023 · 28 min

    Afspelen
    It’s that time of year (again!)- when medical students across the country are preparing their residency applications. The process can be a bit daunting, and there have been a number of changes to process for the 2024 application cycle. Join our education fellow, Dr. Jessica Millar, and Dr. David Hughes as they review the “nuts and bolts” of this year’s residency application cycle. Lees meer

    Guests:
    David Hughes, MD- Clinical Associate Professor of Endocrine Surgery, General Surgery Residency Program Director- University of Michigan

    Important Dates:
    - June 7, 2023: ERAS application opens at 9 a.m. ET.
    - September 6, 2023: Residency applicants may begin submitting MyERAS applications to programs at 9 a.m. ET.
    - September 15, 2023: Registration for the NRMP Match Opens
    - September 27, 2023: Residency programs may begin reviewing MyERAS applications, MSPEs, and supplemental ERAS application data (if applicable) at 9 a.m. ET.
    - October 26-31, 2023: Common Interview Release Window
    - January 31, 2024: Registration for the NRMP Match Closes

    Previous DOMINATE the Match Episodes:
    Episode 2- “Choose Me” (Personal Statements and Letters of Recommendations)
    https://behindtheknife.org/podcast/dominate-the-match-episode-2-choose-me/

    Episode 3- “The Interview”
    https://behindtheknife.org/podcast/dominate-the-match-episode-3-the-interview/

    Episode 4- “Rank and Match”
    https://behindtheknife.org/podcast/dominate-the-match-episode-4-rank-and-match/

    Residency Program Lists:
    - FREIDA Residency and Fellowship Database: https://freida.ama-assn.org/
    - Doximity: https://www.doximity.com/residency/?utm_campaign=marketing_resnav_competitor_broad_20210520&utm_source=google&utm_medium=cpc&gclid=CjwKCAjwt52mBhB5EiwA05YKo1J47BLAtTPtsJBmVvXGP2pDXLLqgDIwM0pgkSYjoBhFUOO1ktXDYRoC2bkQAvD_BwE

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our intern bootcamp series here: https://behindtheknife.org/podcas…

44. BTK Throw Down: Trauma Vascular Access

    31 juli 2023 · 1 uur

    Afspelen
    The first BTK THROW DOWN! A spicy debate…a war of words…a battle of ideas! This fiery episode features leaders in the field of trauma surgery discussing the optimal approach to vascular access in trauma patients. A recent study titled “Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video review” concluded that intraosseous access should be considered a first line therapy in hypotensive trauma patients. Is this appropriate? Crazy? Just so crazy it might work? Let’s get ready to ruuuummmmbbbbbbllllllleeeee! Lees meer

    Hosts:
    Patrick Georgoff, MD (@georgoff)
    Nina Clark, MD (@clarkninam)

    Guests:
    Ryan Dumas, MD – UT Southwestern (@RPDumasMD)
    Michael Vella, MD, MBA – University of Rochester (@MichaelVella32)
    Bellal Joseph, MD – University of Arizona (@TopKnife_B)

    Moving the Needle on Time to Resuscitation: An EAST Prospective multicenter study of vascular access in hypotensive injured patients using trauma video review.
    - Dumas RP, Vella MA, Maiga AW, Erickson CR, Dennis BM, da Luz LT, Pannell D, Quigley E, Velopulos CG, Hendzlik P, Marinica A, Bruce N, Margolick J, Butler DF, Estroff J, Zebley JA, Alexander A, Mitchell S, Grossman Verner HM, Truitt M, Berry S, Middlekauff J, Luce S, Leshikar D, Krowsoski L, Bukur M, Polite NM, McMann AH, Staszak R, Armen SB, Horrigan T, Moore FO, Bjordahl P, Guido J, Mathew S, Diaz BF, Mooney J, Hebeler K, Holena DN. Moving the needle on time to resuscitation: An EAST prospective multicenter study of vascular access in hypotensive injured patients using trauma video review. J Trauma Acute Care Surg. 2023 Jul 1;95(1):87-93. doi: 10.1097/TA.0000000000003958. Epub 2023 Apr 4. PMID: 37012624.

    Time to early resuscitative intervention association with mortality in trauma patients at risk for hemorrhage.
    - Deeb AP, Guyette FX, Daley BJ, Miller RS, Harbrecht BG, Claridge JA, Phelan HA, Eastridge BJ, Joseph B, Nirula R, Vercruysse GA, Sperry JL, Brown JB.…

45. Journal Review in Endocrine Surgery: AAES Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism - Part 2 of 2

    27 juli 2023 · 42 min

    Afspelen
    In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Lees meer

    Hosts:
    - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM
    - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD,
    - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin
    - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen

    Learning objectives:
    - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism
    - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations
    - Define the indications for surgical intervention
    - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation
    - Detail methods for safe and effective perio…

46. Journal Review in Endocrine Surgery: AAES Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism - Part 1 of 2

    24 juli 2023 · 33 min

    Afspelen
    In this two-part series, we come to you LIVE! from the 2023 Annual meeting of the American Association of Endocrine Surgeons in Birmingham, Alabama. If you think evaluating and managing patients with primary hyperparathyroidism is difficult, patients with secondary and tertiary hyperparathyroidism can be even more difficult to evaluate and manage. Join Drs. Barb Miller, Sophie Dream, Jessica Liu McMullin, and Herb Chen as they break down the controversies and complexities associated with evaluation and management of these patients and discuss the recently published AAES guidelines on the definitive surgical management of patients with secondary and tertiary renal hyperparathyroidism. Part 1 focuses on the impetus for creation of these guidelines, the differences in evaluation and indication for surgery when seeing patients with renally mediated hyperparathyroidism, and preoperative planning. Part 2 focuses on intraoperative and postoperative management, parathyroid autotransplantation, and renal transplant recipients. Lees meer

    Hosts:
    - Barbra S. Miller, MD (Moderator), Clinical Professor of Surgery, The Ohio State University, @OSUEndosurgBSM
    - Sophie Dream, MD, Assistant Professor of Surgery, Medical College of Wisconsin, @SDreamMD,
    - Jessica Liu McMullin, MD, Endocrine Surgery Fellow, University of Alabama – Birmingham, @jess_mcmullin
    - Herbert Chen, MD, Professor and Chair of Surgery, University of Alabama – Birmingham, @herbchen

    Learning objectives:
    - Understand the epidemiology and pathogenesis of kidney-related parathyroid disease and how these entities differ from primary hyperparathyroidism
    - Describe the diagnosis of kidney-related hyperparathyroidism and its different presentations
    - Define the indications for surgical intervention
    - Recognize the different approaches and extents of surgery for treating the different types of renally mediated hyperparathyroidism including thymectomy and parathyroid autotransplantation
    - Detail methods for safe and effective perio…

47. Clinical Challenges in Trauma Surgery: Approach to Stab Wounds of the Torso

    20 juli 2023 · 32 min

    Afspelen
    The anterior abdominal stab wound! Who gets explored? When do you get imaging? Who gets serial abdominal exams? How does this change depending on the location of injury? Join Drs. Cobler-Lichter, Kwon, Meizoso, and Urréchaga in their first episode as the new Miami Trauma team - as they discuss how to navigate the nuances of stab wounds to the torso! Lees meer

    Hosts:
    - Michael Cobler-Lichter, MD, PGY2:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @mdcobler (twitter)
    - Eva Urrechaga, MD, PGY6/R4:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @urrechisme (twitter)
    - Eugenia Kwon, MD, Trauma/Surgical Critical Care Fellow:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @jpmeizoso (twitter)

    Learning Objectives:
    - Identify the differences in management of abdominal/thoracoabdominal stab wounds depending on location of injury
    - Identify who needs immediate operative intervention and who can undergo further evaluation
    - Define the management pathways for patients with abdominal stab wounds without an immediate indication for the OR
    - Define thoracoabdominal stab wound and when to evaluate for thoracic injuries
    - Discuss the role of diagnostic imaging when evaluating a patient with a stab to the torso

    Quick Hits:
    1. Don’t forget about the blunt trauma that may be associated with an assault!
    2. Don't miss injuries- always start with the ABCs and do a thorough head to toe exam
    3. For stab wounds to the torso- hemodynamic instability, evisceration, peritonitis, impalement, or gross blood should go to the OR.
    4. The three general clinical pathways for patients without a clear indication for the OR, include serial abdominal exams, local wound exploration, or diagnostic imaging.
    5. Serial abdominal exams require frequent monitoring ideally by the same team member every time to detect changes early.
    6. Loc…

48. Innovations in Surgery: LifeFlow

    17 juli 2023 · 41 min

    Afspelen
    In the fourth episode of the “Innovation in Surgery” series, Drs. Patrick Georgoff and Dan Scheese sit down with Dr. Mark Piehl to discuss his innovation, LifeFlow. Additionally, Dr. Piehl covers multiple other topics in this episode, including circulation-first resuscitation and the process of innovation from the physician’s perspective. Lees meer

    410 Medical Website: https://410medical.com

    Reel Emergency trauma podcast: https://www.youtube.com/watch?v=unog3YkFSOE

    Prehospital emergency care case report from the episode: https://pubmed.ncbi.nlm.nih.gov/36703273/

    Dr. Piehl’s Resuscitation review article: https://link.springer.com/content/pdf/10.1007/s40138-021-00237-6.pdf

    Dr. Piehl’s Shock article on circulation-first resuscitation in trauma: https://pubmed.ncbi.nlm.nih.gov/36703273/

    Preliminary data on prehospital trauma resuscitation with LifeFlow (Larger version of this with historical controls to be presented at AAST): https://410medical.com/app/uploads/2023/04/ESO-Poster-Presentation-April-2023.pdf

    “Unraveling the Fluid Confusion in Sepsis” webinar: https://www.youtube.com/watch?v=yip3AhEezA0

    Dr. Mark Piehl is a pediatric critical care physician at WakeMed in Raleigh, NC, and a Medical Director with the WakeMed Mobile Critical Care transport team. Mark is also Founder and Chief Medical Officer of 410 Medical, a company focused on improving resuscitation in shock, sepsis, and trauma. He previously served as Medical Director of the WakeMed Children's Hospital and Director of Pediatrics at WakeMed. He has numerous Department of Defense grants funding the development of technology to improve trauma care. Mark is also Founder of the Samaritan Health Center, a clinic for the homeless and uninsured in Durham, NC.

    Suture Kit:
    Purchase on suturekit.com
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    How-to Video Series

    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out other innovation episodes here…

49. Clinical Challenges in Vascular Surgery: Aortic Graft Infections

    13 juli 2023 · 28 min

    Afspelen
    In this episode of Behind the Knife the vascular surgery subspecialty team discusses a case of an infected endovascular aortic graft. Although rare, aortic graft infections remain a devastating complication. What options do you have to fix this problem? In this episode, we will cover the who is at risk of this, how they present, and what options you have to fix it.
    Hosts:
    Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan
    Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan
    Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan
    Dr. Drew Braet is a PGY-3 Integrated Vascular Surgery Resident at the University of Michigan Lees meer

    Learning Objectives
    · Understand the incidence of and the relevant risk factors for aortic graft infections
    · Review the spectrum of presenting symptoms and relevant workup for aortic graft infections
    · Understand surgical treatment options including options for in-situ bypass and extra-anatomic bypass
    · Review the different conduits that can be used for in-situ and extra-anatomic reconstruction
    · Discuss relevant post-operative considerations for patients undergoing operative intervention for aortic graft infection

    References

    · Chiesa R, Astore D, Frigerio S, Garriboli L, Piccolo G, Castellano R, Scalamogna M, Odero A, Pirrelli S, Biasi G, Mingazzini P, Biglioli P, Polvani G, Guarino A, Agrifoglio G, Tori A, Spina G. Vascular prosthetic graft infection: epidemiology, bacteriology, pathogenesis and treatment. Acta Chir Belg. 2002 Aug;102(4):238-47. doi: 10.1080/00015458.2002.11679305. PMID: 12244902.
    · Bisdas T, Bredt M, Pichlmaier M, Aper T, Wilhelmi M, Bisdas S, Haverich A, Teebken OE. Eight-year experience with cryopreserved arterial homografts for the in situ reconstruction of abdominal aortic infections. J Vasc Surg. 2010 Aug;52(2):323-30. doi: 10.1016/j.jvs.2010.02.277. Epub 2010 Jun 8. PMID: 20570473.
    · PereraG. B.FujitaniR. M.Kubaska…

50. Journal Review in Minimally Invasive Surgery: Robotic Emergency General Surgery

    10 juli 2023 · 36 min

    Afspelen
    Have you transitioned a portion of your practice to the robot, but would be hesitant to book an urgent/call case on the robot? Have you wondered if the robot might be useful in your emergency or acute care surgery practice? Join University of Washington MIS Surgeons, Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and Resident Drs. Ben Vierra and Paul Herman as they discuss the growing use of the robot for acute cases and provide tips on appropriate case selection. Lees meer

    Hosts:
    1. Andrew Wright, UW Medical Center – Montlake and Northwest, @andrewswright
    2. Nick Cetrulo, UW Medical Center - Northwest, @Trules25
    3. Nicole White, UW Medical Center - Northwest
    4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm
    5. Ben Vierra, UW General Surgery Resident PGY-2

    Learning objectives:
    - Describe the importance of the MIS approach in EGS
    - Review 3 articles on robotic EGS outcomes
    1) Robotic surgery in emergency setting: 2021 WSES position paper
    2) Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients
    3) Urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable periop outcomes to laparoscopic surgery
    - Discuss factors influencing appropriate case selection for urgent/emergent robotic cases
    - Discuss value as it pertains to robotic EGS

    References
    1. Havens JM, Peetz AB, Do WS, Cooper Z, Kelly E, Askari R, Reznor G, Salim A. The excess morbidity and mortality of emergency general surgery. J Trauma Acute Care Surg. 2015 Feb;78(2):306-11. doi: 10.1097/TA.0000000000000517. PMID: 25757115.
    2. Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of National Burden to Define Operative Emergency General Surgery. JAMA Surg. 2016 Jun 15;151(6):e160480. doi: 10.1001/jamasurg.2016.0480. Epub 2016 Jun 15. PMID: 27120712.
    3. Arnold M, Elhage S, Schiffern L, Lauren Paton B, Ross SW, Matthews BD, Reinke CE. Use of minimally invasive surgery in emergency…