Simini Boards Cast

Simini Podcasts

  The Simini Boards-Cast is the go-to audio study tool for small animal surgery residents prepping for board exams.  Each episode simplifies high-yield surgical content from trusted sources  — built to help you pass faster and with less stress.  🎧 Audio-based learning for passive study ✂️ Practical relevance for surgical application 🧠 Flashcard-style recaps + board-style questions 📈 Designed with resident + program director input  Whether you're commuting, walking the dog, or post-op, turn that time into surgical mastery.  Subscribe now and get board-ready — fast. 

  1. 1D AGO

    Chapter 94 - Part D: Anal Sac Disease: Infection, Abscess, and the Surgical Trap

    In this BoardsCast episode, we continue Tobias Chapter 94 — Rectum, Anus, and Perineum by dismantling the most dangerous assumption in “routine” perineal surgery: “Anal sacs are gross… just cut them out.” Anal sac disease is usually not a surgical problem at its core. It’s an inflammatory drainage disorder driven by an obstruction cascade: impaction → inflammation → infection → abscess → rupture. And here’s the trap: rupture doesn’t fix the disease — it destroys your anatomy, so if you operate in the hot, swollen phase, you’re operating blind.  This is where “minor procedure” becomes catastrophe, because the anal sacs sit between the sphincters, millimeters from the caudal rectal nerve and continence system. The biggest surgical disasters here are usually anatomic, not bacterial. You’ll learn: The obstruction cascade and why abscess rupture is a false finish lineWhy acute inflammation makes tissue “lie” (planes disappear, friable tissue, no landmarks) The danger-zone anatomy: internal/external sphincter + caudal rectal nerve = continence on a knife edgeWhen medical management is the right move (flush, antibiotics, pain control, restore drainage) True surgical indications: recurrence, chronic fibrosis/duct obstruction, fistulas, and neoplasia suspicion Why technique matters less than precision (open vs closed isn’t the point — millimeters are) Failure patterns boards love: fecal incontinence, stricture, incomplete excision → recurrenceBottom line: don’t turn a temporary inflammatory problem into a permanent functional disability. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    16 min
  2. 1D AGO

    Chapter 94- Part C: Rectal Tears, Dehiscence, and the Suture Lie

    In this BoardsCast episode, we continue Tobias Chapter 94 — Rectum, Anus, and Perineum by confronting the most dangerous belief in rectal repair: “If the sutures hold, the repair holds.” That’s the suture lie. Rectal failures are usually not knot failures — they’re biology failures inside a rigid pelvic cage, where three forces decide whether the patient survives: contamination + tension + perfusion. This episode builds the board-level failure framework for why rectal repairs can look stable in the OR, then dehisce in the post-op day 3–5 window when tissue strength drops, swelling peaks, and tenesmus turns a “tension-free” repair into a strangled one. You’ll learn: Why rectal tears are inoculation events (anaerobes + contamination drive rapid failure)Why pelvic anatomy creates hidden tension after anesthesia wears off (tone + edema + straining)Why “pink” is a trap: perfusion can be compromised even when tissue looks viableThe predictable dehiscence timeline: microleak → inflammation → edema → perfusion loss → necrosisThe board pattern: day 3–5 decline = septic dehiscence until proven otherwisePrevention priorities that actually move outcomes: source control, true tension-free repair, protect blood supply, and aggressive post-op straining controlIf you remember one line: sutures don’t save ischemic tissue. Biology wins. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    14 min
  3. 1D AGO

    Chapter 94 - Part B: Perineal Hernias: When the Pelvic Floor Fails

    In this BoardsCast episode, we continue Tobias Chapter 94 — Rectum, Anus, and Perineum by reframing perineal hernias the way the boards (and real life) demand: A perineal hernia isn’t a “hole.” It’s a structural collapse. If you treat it like a simple defect and just “stitch it shut,” you’re anchoring sutures into tissue that already failed — which is why recurrence rates are historically ugly. This episode builds the load-bearing model of the pelvic diaphragm and shows why durable repairs come from restoring support + force vectors, not closing a gap.  You’ll learn: Why is a perineal hernia a biomechanical support failure (load > support), not a localized tear The key anatomy: levator ani, coccygeus, external anal sphincter — and why levator ani is the usual “wet tissue paper” weak link Why intact older males dominate the stats — the hormonal/neurologic weakening pattern (relaxin + androgens + denervation) The prostate connection: how prostatic disease drives tenesmus and turns pressure into a battering ram The geometry trap: rectal deviation → sacculation → straining pushes feces into the pocket (self-amplifying loop) Emergency content you must recognize: bladder retroflexion and urethral kinking/obstruction Why traditional “pull it together” repairs fail — tension + weak anchors = recurrence Why internal obturator transposition is the gold standard: vascularized muscle flap, less tension, real reconstruction The non-negotiables that make repairs hold: castration (recurrence risk jumps if you don’t), stool management, and complication awareness (sciatic nerve) Key takeaway:  If you treat the gap, it comes back. If you treat the load, it stays closed. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    18 min
  4. 6D AGO

    Chapter 93 - Part E: Successful Colectomy, Failed Patient: The Colon Physiology Trap

    In this BoardsCast episode, we finish Tobias Chapter 93 — Colon by confronting the scenario that haunts surgeons: successful colectomy. failed patient. Margins were clean. The anastomosis looked perfect. No leak on the table. And then 36 hours later, the patient is hypotensive, septic, and crashing — because colon surgery doesn’t fail in the abdomen. It fails in physiology. This episode builds the framework the boards want you to recognize instantly: post-colectomy survival is driven by three killing forces — fluid shifts, bacteria, and motility — all colliding in the days 3–5 danger window when colonic wounds are at their weakest.  You’ll learn: Why the colon is a hostile environment: extreme bacterial density + segmental terminal blood supply (vasa recta) with no collateral “insurance.” The three killing forces after colectomy: fluid loss/third spacing, bacterial endotoxin, and ileus-driven distension/tension Why the days 3–5 window is deadly: collagen breakdown outpaces synthesis (lag phase), and wound strength is dramatically reduced early Why “cleaning the colon” can backfire: mechanical prep can turn solid stool into a leaking slurry The 5 predictable post-colectomy killers: masked hypovolemia, unrecognized septic peritonitis, progressive ileus, low albumin/protein, and inadequate analgesia (pain → vasoconstriction → ischemia) The board-pattern red flag: hypotension + abdominal pain at ~48 hours = assume leak/septic peritonitis (don’t wait for fever; don’t trust drains) This episode closes Chapter 93 with the shift that saves patients: don’t just close the colon — stabilize the biology. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    14 min
  5. 6D AGO

    Chapter 93 - Part D: Foreign Bodies, Linear Tension & Colonic Obstruction

    In this BoardsCast episode, we continue Tobias Chapter 93 — Colon by confronting the most common (and most lethal) trap in abdominal surgery: “It’s just constipated.” “It’s just a foreign body.” “Let’s wait until morning.” That “stable obstruction” is often a ticking time bomb — because colonic obstruction is not a plumbing issue. It’s a pressure-driven vascular emergency happening inside an organ packed with bacteria.  This episode builds the mental model the boards want you to recognize instantly: the colon becomes a closed-loop pressure chamber, venous outflow fails first, mucosa becomes ischemic, and bacteria translocate before you ever see a perforation.  You’ll learn: Why colonic obstruction is a vascular problem first, not “stool stuck in a tube” The normal function of colon (storage + dehydration) — and why obstruction turns that into a pressure amplifier The blood supply failure sequence: venous collapse → congestion/edema → arterial shutdown → necrosisWhy the colon crashes patients early: bacterial burden + barrier failure → translocation + endotoxemia (before a visible hole exists) Why linear foreign bodies are worse: pleating + tension that saws into the mesenteric border, especially in fixed colonic segments The healing trap: the colon gets weaker for 3–4 days (collagen lysis > synthesis), and collagen formation stops if tissue oxygen is too low The surgical rule: don’t trust gray colon — preserving questionable tissue is riskier than resection, and omentum should be used every time This episode teaches the shift that saves lives: time is not neutral in colonic obstruction — time is destructive. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    17 min
  6. 6D AGO

    Chapter 93 - Part C: Colonic Anastomosis: Why This Leak Is Worse Than the Last One

    In this BoardsCast episode, we continue Tobias Chapter 93 — Colon by confronting the nightmare scenario that feels like a betrayal: You’ve repaired small intestinal leaks before. You’ve done a hundred resections. And then you treat the colon the same way… and the patient crashes. Because a colonic anastomosis is not “plumbing.” It is a pressure-sealed septic barrier sitting in a hostile environment — and if it fails, it doesn’t smolder like small bowel. It detonates. This episode builds the failure model the boards want you to say out loud: the colon is a high-pressure storage organ with low perfusion reserve, a healing curve that gets weaker at 48 hours, and bacteria that actively accelerate collagen breakdown during the most vulnerable window.  You’ll learn: Why the colon is mechanically different: storage organ = higher luminal pressure and solid contents that don’t “flow away” The 4 requirements your anastomosis must meet from minute one: pressure-tight seal, preserve marginal blood supply, contain massive bacterial load, and heal in a hypovascular field Why colonic blood supply has no gray zone: short, irregular, terminal vessels = “alive or dead” The lag phase reality: at ~48 hours, colonic wound strength drops to ~30% of normal because collagen lysis exceeds productionWhy colonic bacteria aren’t just “dirtier” — they actively induce collagenase and speed repair breakdown The “make it reach” fallacy: tension kills perfusion, and if tissue oxygen drops too low, repair mechanisms stop The lethal triad the boards expect: tension + perfusion compromise + bacterial loadThe overbuild strategy: zero tension, wide perfusion margins (cut until it bleeds), submucosa bites, monofilament synthetic (never gut), and omentalization as insuranceThis episode teaches the shift that prevents disaster: you didn’t lose the patient because you forgot how to suture — you lost them because you treated the colon like small intestine. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    17 min

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About

  The Simini Boards-Cast is the go-to audio study tool for small animal surgery residents prepping for board exams.  Each episode simplifies high-yield surgical content from trusted sources  — built to help you pass faster and with less stress.  🎧 Audio-based learning for passive study ✂️ Practical relevance for surgical application 🧠 Flashcard-style recaps + board-style questions 📈 Designed with resident + program director input  Whether you're commuting, walking the dog, or post-op, turn that time into surgical mastery.  Subscribe now and get board-ready — fast.