Behind The Knife: The Surgery Podcast

In this episode our team dives into the diagnosis, workup and management of malignant pleural mesothelioma. Listen as we debate the pros and cons of surgical management of this disease with extrapleural pneumonectomy versus pleural decortication and discuss the nuances of choosing the right approach for the right patient. Learning Objectives - Describe the workup and staging of a patient with malignant pleural mesothelioma - List the subtypes of malignant pleural mesothelioma, characteristics of resectable disease, and patient factors which impact surgical candidacy  - Describe the approach to an extrapleural pneumonectomy and pleural decortication - Analyze which surgical approach is best for various subsets of patients - Describe the adjuvant treatment for malignant pleural mesothelioma Hosts Kelly Daus MD, Adam Bograd MD, Peter White MD, Brian Louie MD Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out

Can appendicitis wait until the morning? Join Drs. Ashlie Nadler, Jordan Nantais, Graham Skelhorne-Gross, and Marika Sevigny from our Emergency General Surgery Team as they discuss the role of deferring appendectomies from overnight to the next morning. Paper 1: Patel SV, Zhang L, Mir ZM, Lemke M, Leeper WR, Allen LJ, Walser E, Vogt K. Delayed Versus Early Laparoscopic Appendectomy for Adult Patients With Acute Appendicitis: A Randomized Controlled Trial. Ann Surg. 2024 Jan 1;279(1):88-93. https://pubmed.ncbi.nlm.nih.gov/37436871/ -Non-inferiority randomized controlled trial comparing delayed appendectomy group with surgery taking place after 0600 the morning following a decision to operate versus the immediate appendectomy group with surgery taking place between 8pm and 4am and within 6 hours of a decision to operate -A priori non-inferiority margin of 15% for 30-day complications -Intention-to-treat analysis with risk difference -12% in favor of the delayed group (p < 0.001) -Superiority as on per p

Before 1952, open heart surgery was considered science fiction. The heart was off limits to surgeons despite more than half a million Americans dying annually from heart disease. Doing nothing was the strategy. However, the status quo would soon change thanks to a few brave and imaginative surgeons who dared to break the most rigid of medical taboos: Do not touch the human heart. We sat down with Dr. Gerald Imber, author of the new book “Cardiac Cowboys: The Heroic Invention of Heart Surgery” to discuss how five men raced to invent an entirely new field of surgery.  Guests: Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Nick Teman, MD- Associate Professor of Cardiac Surgery and Critical Care- University of Virginia  Gerald Imber- Assistant Clinical Professor of Plastic surgery at the Weill-Cornell Medical Center, Attending Surgeon at New York-Presbyterian Hospital, and Director of a private clinic in New York City, NY; Author of “Wendell Black, MD”,

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss Management of Advanced and Malignant Polyps.  Come with us as we navigate through sessile serrated lesions, pathology reports, and rectal polyp nuances.  Hosts:  - Susan Galandiuk, University of Louisville, Louisville, Kentucky, @DCREdInChief - Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv - Sandy Kavalukas, University of Louisville, Louisville, Kentucky, @sandykava - Hillary Simon, University of Louisville, Louisville, Kentucky, @HillaryLSimon Producer:  - Manasa Sunkara MS3, University of Louisville, Louisville, Kentucky, @manasasunkara12 Learning objectives:  - Review colorectal cancer screening for the average risk patient. - Understand what a malignant polyp is defined as and management strategies.  - Discuss the pathology review and re-review processes.  References:  - Church J, et al. Keeping the Cecum Clean: A Randomized, Prospective, Placebo-Controlled Trial of Loperamide as Part of Preparation for Co

Join for the third episodes in the Association of Out Surgeons & Allies (AOSA) series for a discussion on LGBTQIA+ healthcare providers and their patients.   Host:  Nina Clark, MD  Guests:  - Andrew Schlussel, DO, Colorectal and General Surgeon, Charlie Norwood VA Medical Center - Dr. James Taylor, Assistant Professor of Colorectal Surgery at Montefiore Medical Center - Dr. Alex Bonte, General Surgery PGY4 at Hackensack University Medical Center in Hackensack NJ.  - Dr. Paige Tannhauser, General Surgery PGY3 (completed) at Allegheny General Hospital in Pittsburgh PA, and currently finishing up a post-doctoral research fellowship at the University of Virginia. Learn more and get involved with AOSA: https://www.outsurgeons.org Twitter/X: @OutSurgeons Resources Mentioned This Episode:  "Gender Unicorn" schema for terminology: https://transstudent.org/gender/ LGBTQ Healthcare Directory: https://lgbtqhealthcaredirectory.org/ CDC Recommendations in LGBTQ Health: https://www.cdc.gov/lgbthealth/index.htm

Listen to another episode by the Hernia Team from Carolinas Medical Center as they discuss their approach to open preperitoneal ventral hernia repair. Although uncommonly performed, a preperitoneal approach offers several advantages including the ability to achieve large mesh overlap without the need for myofascial release. The team discusses their tips and tricks for utilizing the preperitoneal space in even the most challenging hernia cases.  Hosts: - Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD (Twitter) - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford (Twitter) - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein (Twitter) - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL)  Learning Objectives: - Review standard methods of herniorraphy in open abdominal wall reconstruction - Introduce the concept of open preperitoneal ventral hernia repair - Discuss the advantages as well as the standard

Eat when you can, sleep when you can, and don’t F with the pancreas!  What happens when that third rule goes wrong, and why do people say pancreas injuries are like eating crawfish?  Whether you love the pancreas or just the mention of the P-word strikes fear in your heart, or if you just want the answer to the aforementioned questions, join Drs. Cobler-Lichter, Kwon, and Meizoso, as they guide you through all this and more!  Hosts: - Michael Cobler-Lichter, MD, PGY3, University of Miami/Jackson Memorial Hospital/Ryder Trauma Center, @mdcobler (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, 4 years in practice, University of Miami/Jackson Memorial Hospital/Ryder Trauma Center, @jpmeizoso (twitter) Learning Objectives: - Describe the AAST grading system for pancreatic injuries - Come up with a treatment plan for each grade of pancreatic injury - Identify commonly a

Join us for another episode of our Global Surgery series, where we have a special focus on trauma care in resource-limited settings.  Traumatic injury remains one of the largest burdens of disease and causes of mortality internationally. The WHO estimates that 4.4 million lives are lost to traumatic injuries per year, accounting for approximately 8% of all deaths. Notably, traumatic injuries are the top killer of children, adolescents, and young adults, compounding the patient-years lost. Trauma is ubiquitous–accidents and injuries happen all over the globe, and thus differences in trauma incidence and mortality is often a function of health systems and infrastructure.  Jon Williams is joined by Dr. Anthony Charles. Dr. Charles is a trauma surgeon at University of North Carolina, Chapel Hill. Additionally, he holds professorships in the medical school and school of public health at UNC, as well as serving as the director of the adult ECMO program and the director of global surgery at the UNC Institute of Gl

Join us for a new edition of our global surgery series! On this episode, Dr. Jon Williams is joined by Dr. Sudha Jayaraman and Dr. Justina Seyi-Olajide to discuss how we define global surgery today and how health infrastructure interacts with global surgical care.  Dr. Jayaraman is a trauma and acute care surgeon at University of Utah, and the director of the Center for Global Surgery. After attending UC Davis for medical school, Dr. Jayaraman completed general surgery residency at UCSF, during which time she obtained a masters in public health in developing countries from the London School of Hygiene and Tropical Medicine. During this time, her efforts were dedicated to researching and implementing trauma systems development in Uganda. After residency she then completed a trauma and critical care fellowship at Brigham and Women’s, during which she received the Harvard Medical School Health Disparities Fellowship to continue her trauma systems work in Rwanda. Her ongoing work investigating injury burden and

With the increasing popularity of artificial intelligence, its uses are quickly becoming not only a part of everyday life, but also training in surgery. Those of us without much understanding of the technology might be intimidated by this nebulous topic, or worry that we won’t be able to comprehend the advancements to come to the field. Luckily, we’re joined by a leading expert in the use of AI in surgery, Dr. Dan Hashimoto. He breaks down some examples of how AI is being used in surgical education, the role surgeons should play in these advancements, and some tips for how we can critically appraise work in the field of AI if we don’t understand the technology ourselves. Join hosts Nicole Brooks, MD, Judith French, PhD and Jeremy Lipman, MD, MHPE for this exciting conversation.  Learning Objectives 1.     Listeners will describe how AI is being applied to surgical education. 2.     Listeners will identify the roles surgeons without training in AI can play in developing the use of AI in surgery.  3.     List

The Fellowship of the Snow kept it interesting this year…both on and off the slopes!  On this episode, Patrick Georgoff discusses the Western Trauma Association’s updated resuscitative thoracotomy algorithm with Ron Tesoriero, the results of a WTA multicenter trial exploring chest tube irrigation for the prevention of retained hemothorax with Thomas Carver, and prehospital blood administration with Juan Duchesne.   ** Algorithms and papers are pending final review and are therefore not available to link to this episode.   Ron Tesoriero, MD: Associate Professor of Surgery, Director of the Acute Care Surgery Fellowship, and Co-Director of the SICU at UCSF. Thomas Carver, MD: Associate Professor of Surgery, Director of the Acute Care Surgery Fellowship, and Senior Medical Director of Critical Care Services at the Medical College of Wisconsin.   Juan Duchesne, MD: Professor of Surgery and Chief of Trauma and Acute Care Surgery at Tulane university.    Resuscitative Thoracotomy: The Who (Episode 475): https://

In this episode of Behind the Knife the vascular surgery subspecialty team discusses a few case scenarios of patients with dialysis associated hand ischemia (or steal syndrome). Although a rare, steal syndrome can be detrimental to patients with end stage renal disease and result in not only risk of losing dialysis access but even their limb.  What options do you have to fix this problem? In this episode, we will cover the who is at risk of this, and what options you have to fix it. Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. David Schectman 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 high-yield topics regarding hemodialysis access - Understand the incid

Join BTK eduction fellows, Drs. Nina Clark and Jon Williams along with guests Drs. Sharmila Dissanaike and Paula Ferrada for a discussion on whether it’s time for a paradigm shift toward a circulation-first approach to trauma resuscitation. Hosts: Nina Clark, MD and Jon Williams, MD Guests: Sharmila Dissanaike, MD - Texas Tech University Health Sciences Center, Lubbock, TX Paula Ferrada, MD - Inova, Fairfax, VA References: Ferrada P, Dissanaike S. Circulation First for the Rapidly Bleeding Trauma Patient-It Is Time to Reconsider the ABCs ofTrauma Care. JAMA Surg. 2023 Aug 1;158(8):884-885. doi: 10.1001/jamasurg.2022.8436. PMID: 37195675. https://pubmed.ncbi.nlm.nih.gov/37195675/ Ferrada P, Ferrada R, Jacobs L, Duchesne J, Ghio M, Joseph B, Taghavi S, Qasim ZA, Zakrison T, Brenner M,Dissanaike S, Feliciano D. Prioritizing Circulation to Improve Outcomes for Patients with Exsanguinating Injury: ALiterature Review and Techniques to Help Clinicians Achieve Bleeding Control. J Am Coll Surg. 2024 Jan 1;238(1):

Join the Behind the Knife Surgical Oncology Team as we discuss “One versus Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal Tumor: A Randomized Trial,” the randomized trial guiding duration of imatinib treatment for gastrointestinal stromal tumors (GIST). 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 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 discuss the article “One versus Three Years of Adjuvant Imatinib for Ope

Though relatively rare, lateral abdominal wall hernias present a unique challenge to surgeons. Join Drs. Ajita Prabhu, Lucas Beffa, Sara Maskal and Ryan Ellis as they talk through their approach to these difficult cases.   Hosts:   · Ajita Prabhu, MD, Cleveland Clinic, @aprabhumd1  · Lucas Beffa, MD, Cleveland Clinic, @BeffaLukeMD  · Ryan Ellis, MD, Cleveland Clinic, @EllisMD2020  · Sara Maskal, MD, Cleveland Clinic  Learning Objectives:   · Review anatomy of lateral abdominal wall hernias  · Review pitfalls of operating in the retroperitoneum  · Review surgical approaches to repair defects based on algorithmic assessment   References:  · Montelione KC, Petro CC, Krpata DM, Lau B, Shukla P, Olson MA, Tamer R, Rosenblatt S, Rosen MJ, Prabhu AS. Open Retromuscular Lateral Abdominal Wall Hernia Repair: Algorithmic Approach and Long-Term Outcomes at a Single Center. J Am Coll Surg. 2023 Jan 1;236(1):220-234. doi: 10.1097/XCS.0000000000000419. Epub 2022 Dec 15. PMID: 36106747.  https://pubmed.ncbi.nlm.nih.gov/3

Do the words “Is there a doctor on board” fill you with anxiety? For Dr. Thomas Doyle, responding to in flight medical events is just another day at the office. As the medical director for STAT-MD, him and his team provide on the ground consultation for passengers experiencing medical events at 35,000 feet. In this episode we talk about what events are most common, what equipment is on board, what are the rules/regulations around providing medical assistance, and what ground consultation services like STAT-MD can help offer to you so you’re never alone if you hear that phrase “Is there a doctor on board?” Guests: Thomas J. Doyle, MD, MPH- Clinical Associate Professor of Emergency Medicine- University of Pittsburgh Medical Center; Medical Director, STAT-MD Jessica Millar, MD- General Surgery Resident- University of Michigan; Education Fellow- Behind the Knife Major John McClellan, MD- Acute Care and Trauma Surgeon- University of North Carolina Chapel Hill  Want to learn more from Dr. Doyle about in-flight m

You have a patient referred to you for a history of anal dysplasia and found to have an anal lesion on colonoscopy. How do you evaluate this? What are the risk factors? How will you perform surveillance afterwards? Does everyone need HRA? Tune in to find out! Join Drs. Peter Marcello, Jonathan Abelson, Tess Aulet and special guest Dr. Lisa Breen as they discuss high yield papers discussing Anal Dysplasia.  Learning Objectives 1. Describe the different types of anal dysplasia and pathologic categorization 2. Describe high risk populations for development of anal squamous cell cancer 3. Discuss the different options and recommendations for surveillance and treatment of anal dysplasia Video Link: https://www.youtube.com/watch?v=YdOjV1Gcqvk **Introducing Behind the Knife's Trauma Surgery Video Atlas - https://app.behindtheknife.org/premium/trauma-surgery-video-atlas/show-content The Trauma Surgery Video Atlas contains 24 scenarios that include never-before-seen high-definition operative footage, rich, orig

You get called to see a consult in the middle of the night. It is a middle-aged woman with a bariatric history, and she says her stomach is smaller but doesn’t know the name of the operation. She developed worsening abdominal pain after dinner and it’s been getting worse. She’s not peritonitic, but she’s clearly in discomfort. Is it cholecystitis, diverticulitis, pancreatitis, marginal ulcer, or an internal hernia? What do you do? Join Drs. Matthew Martin, Adrian Dan, and Paul Wisniowski on a discussion about initial evaluation and management of bariatric patients with internal hernias.  Show Hosts: Matthew Martin Adrian Dan Paul Wisniowski Video companion: https://app.behindtheknife.org/video/clinical-challenges-in-bariatric-surgery-internal-hernia Show Notes 1.     Initial Evaluation a.     Focused history and physical, labs, and imaging                                       i.     Presenting symptoms may vary and include: nausea, emesis, and abdominal pain ranging from vague to severe.              

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.  In this episode we’ll discuss mitral valve disease. We’ll review important physiologic differences in patients with mitral valve disease, the most common surgical approaches to address mitral valve disease, and how to work up and address acute mitral regurgitation due to acute papillary muscle rupture.  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 Professor

Our Cardiothoracic Oral Board Audio Review includes 43 high-yield scenarios designed for Cardiothoracic Surgeons by Cardiothoracic Surgeons. 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 cardiothoracic 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://app.behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.