Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast
Behind The Knife: The Surgery Podcast

Behind the Knife is the world’s #1 surgery podcast.  From high-yield educational topics to interviews with leaders in the field, Behind the Knife delivers the information you need to know.  Tune in for timely, relevant, and engaging content designed to help you DOMINATE THE DAY! Behind the Knife is more than a podcast.  Visit http://www.behindtheknife.org to learn more.

  1. 2 DAYS AGO

    Motivated by Impact: A Discussion with Dr. Atul Gawande

    In this episode, Dr. Atul Gawande joins Dr. Patrick Georgoff to share his experiences as a surgeon, writer, and global health leader. From his innovative work at Ariadne Labs and Lifebox to his current role as Assistant Administrator for Global Health at USAID, Dr. Gawande discusses the challenges and rewards of creating large-scale impact. He reflects on balancing creativity in writing with precision in surgery, lessons learned from managing teams, and the critical importance of strengthening global health systems.  Enjoy! Dr. Atul Gawande is the Assistant Administrator for Global Health at the U.S. Agency for International Development, where he oversees a bureau that manages more than $4 billion with a footprint of more than 900 staff committed to advancing equitable delivery of public health approaches around the world. The Bureau for Global Health focuses on work that improves lives everywhere--from preventing child and maternal deaths to controlling the HIV/AIDS epidemic, combating infectious diseases, and preparing for future outbreaks. Prior to joining the Biden-Harris Administration, he was a practicing surgeon at Brigham and Women’s Hospital in Boston and a professor at the Harvard Medical School and the Harvard T.H. Chan School of Public Health. He is the founder and was the chair of Ariadne Labs, a joint center for health systems innovation, and of Lifebox, a nonprofit making surgery safer globally. From 2018-2020, he was also the CEO of Haven (an Amazon, Berkshire Hathaway, and JP Morgan Chase healthcare venture). In addition, Atul was a longtime staff writer for The New Yorker magazine and has written four New York Times best-selling books: Complications, Better, The Checklist Manifesto, and Being Mortal. Visit https://www.usaid.gov/organization/atul-gawande to learn more about our special guest.  To learn more about the Global Health Bureau, please visit https://www.usaid.gov/global-health.  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

    44 min
  2. 6 DAYS AGO

    Clinical Challenges in Vascular Surgery: Intermittent Claudication

    A 67 year old woman with a history of hypertension, hyperlipidemia, diabetes, and a 25 pack year smoking history is referred your clinic and is referred for evaluation of her peripheral arterial disease. She reports pain with walking that has limited her doing some daily activities. How can you optimally manage this patient? Does she need an operation? In this episode, we will cover the basics of peripheral arterial disease, discuss the specifics of optimal medical management and dive into the nuances of when (or if) you should offer these patients an operation.  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. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the definition, prevalence, and risk factors for peripheral arterial disease - Understand the specifics of optimal medical management of patients with peripheral arterial disease  - Discuss the controversy regarding operative management of patients with claudication and review indications for an operation in patients with peripheral arterial disease - Review the appropriate anti-platelet and anti-coagulation strategies after interventions in patients with peripheral arterial disease References 1.    Woo K, Siracuse JJ, Klingbeil K, Kraiss LW, Osborne NH, Singh N, Tan TW, Arya S, Banerjee S, Bonaca MP, Brothers T, Conte MS, Dawson DL, Erben Y, Lerner BM, Lin JC, Mills JL Sr, Mittleider D, Nair DG, O'Banion LA, Patterson RB, Scheidt MJ, Simons JP; Society for Vascular Surgery Appropriateness Committee. Society for Vascular Surgery appropriate use criteria for management of intermittent claudication. J Vasc Surg. 2022 Jul;76(1):3-22.e1. doi: 10.1016/j.jvs.2022.04.012. Epub 2022 Apr 22. PMID: 35470016. https://pubmed.ncbi.nlm.nih.gov/35470016/ 2.    Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. Eur J Vasc Endovasc Surg. 2024 Jan;67(1):9-96. doi: 10.1016/j.ejvs.2023.08.067. Epub 2023 Nov 10. PMID: 37949800. https://pubmed.ncbi.nlm.nih.gov/37949800/ 3.    Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, Chandra V, Drachman DE, Eaves JM, Ehrman JK, Evans JN, Getchius TSD, Gutiérrez JA, Hawkins BM, Hess CN, Ho KJ, Jones WS, Kim ESH, Kinlay S, Kirksey L, Kohlman-Trigoboff D, Long CA, Pollak AW, Sabri SS, Sadwin LB, Secemsky EA, Serhal M, Shishehbor MH, Treat-Jacobson D, Wilkins LR. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jun 11;149(24):e1313-e1410. doi: 10.1161/CIR.0000000000001251. Epub 2024 May 14. PMID: 38743805. https://pubmed.ncbi.nlm.nih.gov/38743805/ 4.    Belch JJ, Dormandy J; CASPAR Writing Committee; Biasi GM, Cairols M, Diehm C, Eikelboom B, Golledge J, Jawien A, Lepäntalo M, Norgren L, Hiatt WR, Becquemin JP, Bergqvist D, Clement D, Baumgartner I, Minar E, Stonebridge P, Vermassen F, Matyas L, Leizorovicz A. Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for per

    32 min
  3. 14 NOV

    Clinical Challenges in Hepatobiliary Surgery: Pancreatic Anastomoses in Whipples

    The pancreatic anastomosis is often regarded as the “Achilles Heel” of the Whipple operation, as technical failure and leakage is a significant source of perioperative morbidity and mortality. In this episode from the HPB team at Behind the Knife listen in as we discuss the standard techniques for the anastomosis, alternative techniques for the pancreatic anastomosis in patients with aberrant anatomy and/or physiology, key factors to consider when selecting the ideal approach/technique for the anastomosis, and mitigation strategies for leaks.  Hosts Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center. Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He previously completed his general surgery residency at Massachusetts General Hospital, and will be returning to MGH as faculty at the conclusion of his fellowship.    Monica M. Dua (@MonicaDuaMD) is a Clinical Professor of Surgery and the Associate Program Director of the HPB Surgery Fellowship at Stanford University. She also serves as also serves as the regional HPB Surgeon at the VA Palo Alto Health Care System. Learning Objectives · Develop an understanding of the standard technical approaches to the pancreatic anastomosis during a Whipple (pancreatoduodenectomy) operation · Develop an understanding of the alternative technical approaches to the pancreatic anastomosis during the Whipple when the standard approaches may not be feasible · Develop an understanding of the key anatomic and physiologic factors in the decision making when selecting the optimal approach for the pancreatic anastomosis · Develop an understanding of possible mitigation strategies in the event of a pancreatic anastomotic leak. Suggested Reading Jon Harrison, Monica M. Dua, William V. Kastrinakis, Peter J. Fagenholz, Carlos Fernandez-del Castillo, Keith D. Lillemoe, George A. Poultsides, Brendan C. Visser, Motaz Qadan. “Duct tape:” Management strategies for the pancreatic anastomosis during pancreatoduodenectomy. Surgery. Volume 176, Issue 4, 2024, Pages 1308-1311, https://pubmed.ncbi.nlm.nih.gov/38796390/ 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

    21 min
  4. 11 NOV

    USA vs. UK: ASGBI Ep. 2 - Surgical Careers

    We’re excited to bring you the second episode in our BTK/ASGBI collaborative series, where we compare and contrast various aspects of surgery in the US and the UK, debating who does it better. In today’s episode, BTK fellow Jon Williams and ASGBI hosts Kellie Bateman and Jared Wohlgemut welcome the Christian Macutkiewicz from the UK and Scott Steele to discuss surgeon careers--from getting your first faculty job to broadening your impact to compensation structures.  Dr. Macutkiewicz is the President-Elect of the Association of Surgeons of Great Britain and Ireland. He is a General and HPB Surgeon in Manchester, England. He completed a Bachelor of Science in Biochemistry at the University of Birmingham, before studying medicine at the University of Manchester, and received an MD doctorate at the University of Manchester for research into sepsis. He underwent surgical training in North West Deanery, before completing an HPB and Liver Transplant Fellowship in Leeds. He has been a consultant surgeon in Nottingham, Leeds and most recently in Manchester since 2018. He also works privately at Spire Manchester Hospital.  Dr. Steele needs no introduction as a founder of BTK, but otherwise he is president of the Cleveland Clinic main campus and chair of the department of colorectal surgery. After graduating from West Point, Dr. Steele received his medical degree from University of Wisconsin. He then underwent general surgery residency training at Madigan Army Medical Center in Tacoma, WA followed by colorectal surgery fellowship training at University of Minnesota Medical Center. Dr. Steele then served in the military as an active duty surgeon until 2015, including several deployments and further faculty time at Madigan where he additionally served as Associate Program Director for general surgery. He then served as Division Chief of colorectal surgery at University Hospitals in Cleveland and associate director of surgical services at the Digestive Health Institute, prior to being named Chair of the department of colorectal surgery at the Cleveland Clinic in 2016, a position that he continues to hold today.  So, which country would you rather work in to carry out your illustrious surgical career? Give this episode a listen and decide for yourself! 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

    50 min
  5. 7 NOV

    Clinical Challenges in Trauma Surgery: Traumatic Esophageal Injury

    The dreaded esophageal injury.  Do you still have nightmares about mock oral board scenarios torturing you with the ins and outs of how to manage traumatic esophageal injury?  Think you remember all the nuances?  Whether you do or you don’t, this episode should serve as a good refresher for all levels while offering some pearls for management of this tricky scenario. Hosts: - Michael Cobler-Lichter, MD, PGY4/R2: University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @mdcobler (X/twitter) - Dylan Tanzer, MD, 2nd-year Trauma/Surgical Critical Care Fellow University of Miami/Jackson Memorial Hospital/Ryder Trauma Center - Eugenia Kwon, MD, Trauma/Surgical Critical Care Attending: Loma Linda University Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center Trauma/CC Fellowship - Jonathan Meizoso, MD, MSPH Assistant Professor of Surgery, 5 years in practice University of Miami/Jackson Memorial Hospital/Ryder Trauma Center @jpmeizoso (twitter) Learning Objectives: - Describe the diagnostic workup of a suspected traumatic esophageal injury - Identify when someone with suspected esophageal injury needs immediate surgical management - Describe appropriate surgical techniques for repair of both cervical and thoracic esophageal injuries Quick Hits: 1.     Don’t forget the primary survey.  Unstable patients should be in the OR, as should patients with hard signs of vascular or aerodigestive injury 2.     If there is concern for esophageal injury but no immediate indication for the OR, this should be further investigated with CTA of the affected area.  Clinical exam has poor sensitivity. 3.     The esophagus should be primarily repaired if the defect is able to come together without tension after debridement.  Don’t forget a well-vascularized buttress 4.     If you cannot perform a primary repair, your procedure of choice should be lateral esophagostomy with feeding jejunostomy and gastrostomy for decompression.  Repair over T-tube can be considered for injuries with small amounts of tissue loss References 1.     Biffl WL, Moore EE, Feliciano DV, Albrecht RA, Croce M, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Diagnosis and Management of Esophageal Injuries. J Trauma Acute Care Surg 2015;79(6):1089-95. https://pubmed.ncbi.nlm.nih.gov/26680145/ 2.     Sperry JL, Moore EE, Coimbra R, Croce M, Davis JW, Karmy-Jones R, et al. Western Trauma Association Critical Decisions in Trauma: Penetrating Neck Trauma. J Trauma Acute Care Surg 2013;75(6):936-40. https://pubmed.ncbi.nlm.nih.gov/24256663/ 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

    27 min

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Behind the Knife is the world’s #1 surgery podcast.  From high-yield educational topics to interviews with leaders in the field, Behind the Knife delivers the information you need to know.  Tune in for timely, relevant, and engaging content designed to help you DOMINATE THE DAY! Behind the Knife is more than a podcast.  Visit http://www.behindtheknife.org to learn more.

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