Behind The Knife: The Surgery Podcast

Latest Episodes:

BTK General Surgery Oral Board Review – Sample Episode 7 - Enteric Feeding Tube Troubles Aug 22, 2024

Show notes

Our oral board review course includes 100 scenarios that meticulously cover 115 SCORE core topics. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test.
All of our premium courses are available via our website and apps (iOS and Android). Users can take notes, pin chapters and download content for offline viewing.
Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium
**Institutional Discounts Available - Please email hello@behindtheknife.org to learn more.**
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Humanitarian Extraordinaire: An Interview with Dr. Ammar Darwish Aug 19, 2024

Show notes

Need a dose of inspiration? You found it here. This interview with Dr. Ammar Darwish will have you in awe. Dr. Darwish is a general and trauma surgery at Manchester University NHS Foundation Trust and Medical Director at The David Nott Foundation (https://davidnottfoundation.com/). Dr. Darwish volunteers for intensely dangerous but highly impactful surgical humanitarian missions in conflict zones around the world. In fact, he has been deployed to over 50 global humanitarian missions in the last 15 years. He is passionate about helping victims of conflict and natural disaster by better equipping and training doctors who care for them.
Want to learn more about the Nott Foundation? Good! You should. Check out their website for more: https://davidnottfoundation.com/
Interview with Dr. David Knott: https://app.behindtheknife.org/podcast/war-doctor-david-nott-on-surgery-in-war-zones
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Clinical Challenges in Emergency General Surgery: Management of Duodenal Emergencies Aug 15, 2024

Show notes

Join our Emergency General Surgery team as we talk about the dreaded difficult duodenum. We discuss two cases on a common disease that has now become a rarity in surgical management. We cover principles of combined assessment and resuscitation, diagnosis and helpful adjuncts, and multidisciplinary and surgical management.
Hosts: Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross
We have come a long way from managing duodenal emergencies with vagotomies since the widespread use of proton pump inhibitors. But surgeons and trainees still need to gain competence in managing duodenal emergencies, despite the dearth of operative interventions often encountered. We discuss the two most common presentations related to duodenal ulcers - bleeding and perforation. We focus on resuscitation, damage-control surgery, and the role of non-surgical management options.
Learning Objectives:
- Learn to investigate and resuscitate patients with upper gastrointestinal bleeding
- Develop an approach to the management of upper gastrointestinal bleeding
- Understand the risks and benefits of various surgical techniques for dealing with perforated duodenal ulcers
References:
Tarasconi, A., Coccolini, F., Biffl, W.L. et al. Perforated and bleeding peptic ulcer: WSES guidelines. World J Emerg Surg 15, 3 (2020). https://doi.org/10.1186/s13017-019-0283-9

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Journal Review in Colorectal Surgery: Management of Splenic Flexure Cancer Aug 12, 2024

Show notes

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon as they discuss the controversial management of colon cancer of the splenic flexure. What procedure do you perform? Does it matter? Tune in to hear the discussion!
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 surgical procedure options for splenic flexure cancer.
- Understand the importance of confirming the location of the tumor with imaging and/or endoscopically, perioperatively.
- Discuss surgical principles of operating in the left upper quadrant.
References:
de’Angelis, et al. Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. Surg Endosc. 2021 (35) :661–672.
https://pubmed.ncbi.nlm.nih.gov/32072288/
Degiuli M, et al. Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group. Dis Colon Rectum. 2020 Oct;63(10):1372-1382.
https://pubmed.ncbi.nlm.nih.gov/32969880/
Manceau G, et al. What Is the Optimal Elective Colectomy for Splenic Flexure Cancer: End of the Debate? A Multicenter Study From the GRECCAR Group With a Propensity Score Analysis. Dis Colon Rectum. 2022 Jan 1;65(1):55-65.
https://pubmed.ncbi.nlm.nih.gov/34882628/
Okazaki T, et al. Two Types of Variational Arteries' Courses From the Superior Mesenteric Artery to Supply the Splenic Flexure: Gross Anatomical Study. Dis Colon Rectum. 2024 Jan 1;67(1):120-128.
https://pubmed.ncbi.nlm.nih.gov/37493262/
Pang AJ, Marinescu D, Morin N, Vasilevsky CA, Boutros M. Segmental resection of splenic flexure colon cancers provides an adequate lymph node harvest and is a safe operative approach - an analysis of the ACS-NSQIP database. Surg Endosc. 2022 Aug;36(8):5652-5659.
https://pubmed.ncbi.nlm.nih.gov/34973078/
Rusli SM, et al. Laparoscopic D3 oncological resection in splenic flexure cancer: Technical details and its impact on long-term survival. Colorectal Dis. 2023 Mar;25(3):431-442.
https://pubmed.ncbi.nlm.nih.gov/36281503/
Sakamoto K, et al. Drainage pattern of the splenic flexure vein and its accompanying arteries using three-dimensional computed tomography angiography: a single-centre study of 600 patients. Colorectal Dis. 2023 Aug;25(8):1679-1685.
https://pubmed.ncbi.nlm.nih.gov/37221647/
Vargas, HD. Gaining Mesenteric Length following Colorectal Resection: Essential Maneuvers to Avoid Anastomotic Tension. Clin Colon Rectal Surg. 2023 Jan 13;36(1):37-46.
https://pubmed.ncbi.nlm.nih.gov/36643828/
Vogel JD, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer. Dis Colon Rectum. 2022 Feb 1;65(2):148-177.
https://pubmed.ncbi.nlm.nih.gov/34775402/
Video References

“Splenic Flexure Cancers.” Lahey Hospital & Medical Center. Disease of the Colon and Rectum Journal Club. February 28, 2022. https://www.youtube.com/watch?v=87HXHQYMxe4&list=PLMBNyGA6TZajQn4UlDyKxrLakFZb7SC_2&index=23

Varela, C. and Yang, S. Laparoscopic-Assisted Colonic Resection for Splenic-Flexure Cancer With D3 Lymphadenectomy, Diseases of the Colon & Rectum 66(6):p e295-e297, June 2023. https://journals.lww.com/dcrjournal/pages/collectiondetails.aspx?TopicalCollectionID=138&ParentCollection=109

***TRUELEARN LINK: https://truelearn.referralrock.com/l/BTKPODCAST/
Discount code: BTKPODCAST
Using the discount code, you can get a discount of $25 off our Residency (General surgery, anesthesiology, OBGYN, Psychiatry, Peds, Neurology, Emergency Medicine, Internal Medicine, and Family Medicine), USMLE, andCOMLEX SmartBank subscriptions of 90-days or more. The code can also be applied for 15% off our allied healthSmartBanks (PA, Nurse Practitioner, Pharmacy, PT, OT, etc.).
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

BTK Colorectal Surgery Oral Board Review- Sample Episode 3 - Ulcerative Colitis Surgery Aug 08, 2024

Show notes

Our Colorectal Surgery Oral Board Audio Review includes 51 high-yield scenarios designed for Colorectal Surgeons by Colorectal 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 colorectal 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 full set of 51 scenarios here: https://behindtheknife.teachable.com/p/btk-colorectal-surgery-oral-board-review-course
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

BTK Surgical Oncology Oral Board Review - Sample Episode 3: Adrenal Mass Aug 05, 2024

Show notes

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.
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://app.behindtheknife.org/premium/surgical-oncology-oral-board-audio-review
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

BTK Vascular Surgery Oral Board Review – Sample Episode 3 - Asymptomatic Carotid Stenosis Aug 01, 2024

Show notes

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular 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 vascular 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 full set of 72 scenarios here: https://app.behindtheknife.org/course-details/vascular-surgery-oral-board-audio-review
Our Vascular Surgery Oral Board Book is available on Amazon here: https://www.amazon.com/dp/B0CZ8ZBF83
Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Journal Review in Endocrine Surgery: Thyroid and Parathyroid Disorders in Pregnancy Jul 29, 2024

Show notes

Pregnancy leads to many physiologic changes, and thyroid and parathyroid disorders alter that physiology even more leading to complex laboratory interpretation and decision-making impacting both mother and fetus. In this episode, join endocrine surgeons Drs. Barb Miller, John Phay, Priya Dedhia, and Surgical Oncology Fellow Dr. Vennila Padmanaban from The Ohio State University. Hear about normal and abnormal thyroid and parathyroid physiology and treatment of patients with thyroid cancer. The group discusses several articles focusing on current guidelines from the American Thyroid Association as well as other key studies.
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, Vennila Padmanaban, 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
Vennila Padmanaban - @vennilapadmanMD
Learning objectives:
1) Understand normal changes in thyroid and parathyroid physiology during pregnancy
2) Describe the impact of thyroid and parathyroid dysregulation on maternal and fetal health
3) Compare and contrast management of thyroid and parathyroid disorders during pregnancy vs. non-pregnancy
4) Recognize the importance of multidisciplinary care of patients with thyroid and parathyroid disorders
References:
1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457. Erratum in: Thyroid. 2017 Sep;27(9):1212. doi: 10.1089/thy.2016.0457.correx. PMID: 28056690
https://pubmed.ncbi.nlm.nih.gov/28056690/
2. Jee SB, Sawal A. Physiological Changes in Pregnant Women Due to Hormonal Changes. Cureus. 2024 Mar 5;16(3):e55544. doi: 10.7759/cureus.55544. PMID: 38576690; PMCID: PMC10993087
https://pubmed.ncbi.nlm.nih.gov/38576690/
3. Patel, Kepal N. MD; Yip, Linwah MD; Lubitz, Carrie C. MD, MPH; Grubbs, Elizabeth G. MD; Miller, Barbra S. MD; Shen, Wen MD; Angelos, Peter MD; Chen, Herbert MD; Doherty, Gerard M. MD; Fahey, Thomas J. III MD; Kebebew, Electron MD; Livolsi, Virginia A. MD; Perrier, Nancy D. MD; Sipos, Jennifer A. MD; Sosa, Julie A. MD; Steward, David MD; Tufano, Ralph P. MD; McHenry, Christopher R. MD; Carty, Sally E. MD. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Annals of Surgery 271(3):p e21-e93, March 2020. DOI: 10.1097/SLA.0000000000003580
https://pubmed.ncbi.nlm.nih.gov/32079830/
4. Appelman-Dijkstra NM, Pilz S. Approach to the Patient: Management of Parathyroid Diseases Across Pregnancy. J Clin Endocrinol Metab. 2023 May 17;108(6):1505-1513. doi: 10.1210/clinem/dgac734. PMID: 36546344; PMCID: PMC10188304
https://pubmed.ncbi.nlm.nih.gov/36546344/
5. Eremkina A, Bibik E, Mirnaya S, Krupinova J, Gorbacheva A, Dobreva E, Mokrysheva N. Different treatment strategies in primary hyperparathyroidism during pregnancy. Endocrine. 2022 Sep;77(3):556-560. doi: 10.1007/s12020-022-03127-3. Epub 2022 Jul 12. PMID: 35821184
https://pubmed.ncbi.nlm.nih.gov/35821184/
TRUELEARN LINK: https://truelearn.referralrock.com/l/BTKPODCAST/
Discount code: BTKPODCAST
Using the discount code, you can get a discount of $25 off our Residency (General surgery, anesthesiology, OBGYN, Psychiatry, Peds, Neurology, Emergency Medicine, Internal Medicine, and Family Medicine), USMLE, andCOMLEX SmartBank subscriptions of 90-days or more. The code can also be applied for 15% off our allied healthSmartBanks (PA, Nurse Practitioner, Pharmacy, PT, OT, etc.).
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Journal Review in Thoracic Surgery: Health Consequences of Thymectomy in Adults Jul 25, 2024

Show notes

Does the adult thymus have a purpose and function? Are there any long-term health effects of thymectomy? Tune in to another Swedish Thoracic surgery journal review where we discuss the recent paper out of the NEJM which reports on the health consequences of thymus removal in adults. This paper has been widely picked up by the media and our patients frequently bring it into the office. Listen as we discuss the study population, methods, and potential applications of this paper.
Learning Objectives:

- Review the purpose and function of the thymus.
- Discuss the population, methods, and results of this trial.
- Discuss the application of this paper and how it may or may not impact clinical practice for thoracic surgeons.
Hosts:

Chloe E. Hanson, MD, PGY-3
Kelly Daus MD, PGY-4
Peter White, MD, Thoracic Surgery Attending
Brian Louie, MD, Thoracic Surgery Attending
Reference Material:

Kooshesh KA, Foy BH, Sykes DB, Gustafsson K, Scadden DT. Health Consequences of Thymus Removal in Adults. N Engl J Med. 2023;389(5):406-417.
https://pubmed.ncbi.nlm.nih.gov/37530823/

Lin TM, Chang YS, Hou TY, et al. Risk of incident autoimmune diseases in patients with thymectomy. Ann Clin Transl Neurol. 2020;7(7):1072-1082.
https://pubmed.ncbi.nlm.nih.gov/32478484/
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Big T Trauma Series Ep. 19 - Multimodal Pain Control Jul 22, 2024

Show notes

Did you know that 13% of trauma patients who go home with an opioid prescription will develop opioid dependence? Multimodal pain regimens not only reduce opioid consumption, but also improve pain control. On this episode of the BIG T TRAUMA series, we explore a multimodal approach to pain management...and tackle some surgical dogma along the way.
Hosts:

Patrick Georgoff, MD, Trauma Surgeon, Duke University, @georgoff
Teddy Puzio, MD, Trauma Surgeon, University of Texas Houston
Gabby Hatton, MD, Trauma Surgery fellow, University of Texas Houston

References:
1. Rate and Risk Factors Associated With Prolonged Opioid Use After Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2020: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767637
2. Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey. Injury Prevention 2017: https://pubmed.ncbi.nlm.nih.gov/27597400/
3. Ketamine For Acute Pain After Trauma (KAPT): A Pragmatic, Randomized Clinical Trial. J Trauma 2024:
https://pubmed.ncbi.nlm.nih.gov/38689402/
4. EAST PMG: Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma (2023): https://www.east.org/education-resources/practice-management-guidelines/details/efficacy-and-safety-of-nonsteroidal-antiinflammatory-drugs-nsaids-for-the-treatment-of-acute-pain-af
5. Systematic Review and Meta-Analysis of the Association Between Non-Steroidal Anti-Inflammatory Drugs and Operative Bleeding in the Perioperative Period. JACS 2021:
https://pubmed.ncbi.nlm.nih.gov/33515678/
6. Is the use of nonsteroidal anti-inflammatories after bowel anastomosis in trauma safe? J Trauma 2023:
https://pubmed.ncbi.nlm.nih.gov/36728125/
7. University of Texas at Houston Multimodal Pain Guideline: https://med.uth.edu/surgery/acute-trauma-pain-multimodal-therapy/
8. ACS TRAUMA QUALITY PROGRAMS BEST PRACTICES GUIDELINES FOR ACUTE PAIN MANAGEMENT IN TRAUMA PATIENTS: https://www.facs.org/media/exob3dwk/acute_pain_guidelines.pdf
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

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