500 episodes

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.

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

    • Health & Fitness
    • 4.8 • 1.3K Ratings

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.

    Big T Trauma Series Ep. 19 - Multimodal Pain Control

    Big T Trauma Series Ep. 19 - Multimodal Pain Control

    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

    • 28 min
    Journal Review in Vascular Surgery: Updates on Size Threshold for Repair of Abdominal Aortic Aneurysms

    Journal Review in Vascular Surgery: Updates on Size Threshold for Repair of Abdominal Aortic Aneurysms

    A 70 year old healthy female is referred to you with a 5.7 cm abdominal aortic aneurysm. As an astute clinician you are aware that current guidelines support surgical repair for her AAA. What if there was new data to suggest this patient may not benefit from repair? What would be the optimal size threshold that she would benefit from AAA repair? Tune into this episode of Behind the Knife, where the vascular surgery subspecialty team discusses a paper that challenges current size threshold guidelines for AAA repair. 

    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. Frank Davis is an Assistant Professor of Vascular Surgery 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 current size threshold guidelines for surgical repair of abdominal aortic aneurysms

    - Understand the limitations of the aforementioned guidelines

    - Understand the methodology, findings, limitations, and clinical applications of the manuscript “Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration.”

    References
    1.    Columbo JA, Scali ST, Jacobs BN, et al. Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration. Journal of Vascular Surgery. 2024;79(5):1069-1078.e8. doi:10.1016/j.jvs.2024.01.017
    https://pubmed.ncbi.nlm.nih.gov/38262565/

    2.    Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. Journal of Vascular Surgery. 2018;67(1):2-77.e2. doi:10.1016/j.jvs.2017.10.044
    https://pubmed.ncbi.nlm.nih.gov/29268916/

    3.    Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. Editor’s Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. European Journal of Vascular and Endovascular Surgery. 2024;67(2):192-331. doi:10.1016/j.ejvs.2023.11.002
    https://pubmed.ncbi.nlm.nih.gov/38307694/

    4.    The UK Small Aneurysm Trial Participants, Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms.  Lancet 1998;352 (9141) 1649- 1655
    https://pubmed.ncbi.nlm.nih.gov/9853436/

    5.    Lederle  FAWilson  SEJohnson  GR  et al. Aneurysm Detection and Management Veterans Affairs Cooperative Study Group, Immediate repair compared with surveillance of small abdominal aortic aneurysms.  N Engl J Med 2002;346 (19) 1437- 1444
    https://pubmed.ncbi.nlm.nih.gov/12000813/

    6.    United Kingdom EVAR Trial Investigators; Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D. Endovascular repair of aortic aneurysm in patients physically ineligible for open repair. N Engl J Med. 2010 May 20;362(20):1872-80. doi: 10.1056/NEJMoa0911056. Epub 2010 Apr 11. PMID: 20382982.
    https://pubmed.ncbi.nlm.nih.gov/20382982/

    7.    Lederle FA, Johnson GR, Wilson SE, Ballard DJ, Jordan WD Jr, Blebea J, Littooy FN, Freischlag JA, Bandyk D, Rapp JH, Salam AA; Veterans Affairs Cooperative Study #417 Investigators. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002 Jun 12;287(22):2968-72. doi: 10.1001/jama.287.22.2968. PMID: 12052126.

    8.    Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, Adams JL, Chang RW. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022 Jan;75(1):109-117. doi: 10.1016/j.jvs.2021.07.125. Epub 2021 Jul 26. PMID: 34324972.
    https://pubmed.ncbi.nlm.nih.gov/34324972/

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

    • 27 min
    Lung in a Box: The Present and Future of Lung Preservation for Transplant

    Lung in a Box: The Present and Future of Lung Preservation for Transplant

    Take a listen into the wild and fascinating world of lung transplantation! One of the biggest challenges for any transplant is organ preservation to provide the best possible recovery and outcome for recipients. That’s especially important for lung transplant, which remains one of the most complex and challenging areas in the field of transplantation. This episode takes a deep dive into the lung transplant landscape and discusses new technologies and innovations that are revolutionizing the field. Jon Williams is joined by Dr. Elliot Wakeam, MD, a thoracic surgeon and lung transplant expert from University of Toronto to discuss the advent of ex-vivo lung perfusion (EVLP) systems and how that and other preservation techniques may impact the future of lung transplantation. Also, Dr. Wakeam provides unique perspectives as faculty from one of the best lung transplant programs in the world. 

    If you have any questions or comments, or find the episode interesting and want to learn more, feel free to reach out to us at hello@behindtheknife.org. Dominate the Day!

    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

    • 46 min
    Clinical Challenges in Surgical Education: Precision Surgical Education

    Clinical Challenges in Surgical Education: Precision Surgical Education

    As we move towards a model of Competency-Based Surgical Education, individualization of training may be needed. How can we get the right education to the right trainee at the right time? How can we link education to actual patient outcomes? Precision education aims to do just that, while leveraging technology, data, and analytics to decrease burden on assessors. While this approach offers a lot of promise to advance surgical education, it can be difficult to conceptualize how this would be implemented in practice. We’re joined by an expert in the field of precision medical education, Dr. Jesse Burk-Rafel, to break down what precision education is and how it might integrate into our current system of surgical education


    Join hosts Nicole Brooks MD, Judith French PhD, and Jeremy Lipman MD, MHPE for this exciting conversation with Jesse Burk-Rafel MD.


    Learning Objectives


    1.     Listeners will define precision education.
    2.     Listeners will describe examples of how precision medical or surgical education is being used currently. 
    3.     Listeners will explain barriers that must be addressed with the implementation of precision surgical education, including bias and issues with data sharing. 
    4.     Listeners will consider how precision surgical education will evolve, including possible use within their own institution to completement competency-based surgical education.


    References


    Desai SV, Burk-Rafel J, Lomis KD, et al. Precision Education: The Future of Lifelong Learning in Medicine. Academic Medicine. 2024;99(4).

    https://pubmed.ncbi.nlm.nih.gov/38277444/

    Richardson J, Santen SA, Mejicano GC, et al. Learner Assessment and Program Evaluation: Supporting Precision Education. Academic Medicine. 2024;99(4).

    https://pubmed.ncbi.nlm.nih.gov/38166211/

    Perrone KH, Abdelaal AE, Pugh CM, Okamura AM. Haptics: The Science of Touch As a Foundational Pathway to Precision Education and Assessment. Academic Medicine. 2024;99(4).

    https://pubmed.ncbi.nlm.nih.gov/38109654/

    Sukhera J. Precision Education and Equity: A Participatory Framework to Advance Equitable Assessment. Academic Medicine. 2024;99(4).

     https://pubmed.ncbi.nlm.nih.gov/38109658/

    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

    • 31 min
    Journal Review in Hernia Surgery: What Defines a Hernia Center?

    Journal Review in Hernia Surgery: What Defines a Hernia Center?

    In this Journal Review episode, the Hernia Content Team from Carolinas Medical Center reviews the definition and meaning of a hernia center. In a subspecialty field that is in its relative infancy, the specialization of care at hernia centers is a relatively new concept. The team reviews two relevant publications on hernia centers that help to provide guidance on this topic for the hernia community.

    Hosts:
    - Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center (Charlotte, NC), @SAyusoMD (Twitter)
    - Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center (Charlotte, NC), @THeniford (Twitter)
    - Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center (Charlotte, NC), @VedraAugenstein (Twitter)
    - Dr. Monica Polcz, Attending Surgeon, Baptist Health (Miami, FL), No Twitter handle
    - Dr. Brittany Mead, GI & MIS Fellow, Carolinas Medical Center (Charlotte, NC), No Twitter handle

    References: 
    -Shulkin et al, Characterizing Hernia Centers in the United States: What Defines a Hernia Center?, Hernia, 2022
    https://pubmed.ncbi.nlm.nih.gov/33871743/ 

    -Köckerling et al, Accreditation and Certification Requirements for Hernia Centers and Surgeons: the ACCESS Project, Hernia, 2019
     https://pubmed.ncbi.nlm.nih.gov/33871743/

    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

    • 30 min
    Journal Review in Trauma Surgery: VTE Prophylaxis

    Journal Review in Trauma Surgery: VTE Prophylaxis

    VTE prophylaxis is more than just some squeezy leg socks and a one-size fits all dose of enoxaparin!  Ever wonder how VTE prophylaxis is similar to constipation?  Have you or a loved one been hurt by a hospital administrator telling you that VTE is a never event?  Come with us, and our special guest Dr. Bryan Cotton, on this journey to the frontier of research attempting to debunk this myth and improve patient care by reducing VTE rates in trauma patients.  

    Hosts:
    - Michael Cobler-Lichter, MD, PGY4/R2:
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @mdcobler (X/twitter)

    - Eva Urrechaga, MD, PGY-8, Vascular Surgery Fellow
    University of Pennsylvania
    Recent graduate of University of Miami/Jackson Memorial Hospital/Ryder Trauma Center General Surgery Residency
    @urrechisme (X/twitter)

    - 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

    - Brandon Parker, DO, Assistant Professor of Surgery, 5 years in practice
    University of Miami/Jackson Memorial Hospital/Ryder Trauma Center
    @BrandonParkerDO (X/twitter)

    - Bryan Cotton, MD, MPH, FACS, Professor of Surgery, 20 years in practice
     University of Texas Health Science Center at Houston/Red Duke Trauma Institute at Memorial Herman Hospital
    @bryanacotton1 (X/twitter)

    Learning Objectives:

    - Describe the rationale for the addition of aspirin to chemoprophylactic regimens for VTE

    -  Identify appropriate screening systems for trauma patients at high risk for VTE

    -  Describe the rationale for monitoring anti factor Xa levels in the trauma population receiving VTE chemoprophylaxis

    - List the major conclusions of the two studies discussed regarding the addition of aspirin to VTE chemoprophylaxis regimens in trauma patients, and the change in antithrombin activity levels over time in relation to enoxaparin responsiveness in polytrauma patients

    Quick Hits:

    1.     On adjusted analysis, the standard VTE PPX plus aspirin group had a lower OR of developing VTE, though limitations of this study highlight need for future prospective work
    2.     Trauma patients often suffer from decreased activity of antithrombin 3, which may mediate the relatively higher rates of VTE in this population.
    3.     Trauma patients who went on to develop VTE were more likely to not achieve satisfactory anti Xa levels, with a VTE rate of 30% in the never-responder group, the group for which Xa levels were never higher than 0.2
    4.     Ex vivo supplementation of antithrombin seems to improve enoxaparin responsiveness.  Remember, enoxaparin and heparin are HELPING AT3, not the other way around

    References

    1.     Lammers D, Scerbo M, Davidson A, et al. Addition of aspirin to venous thromboembolism chemoprophylaxis safely decreases venous thromboembolism rates in trauma patients. Trauma Surg Acute Care Open. 2023;8(1):e001140. doi:10.1136/tsaco-2023-001140
    https://pubmed.ncbi.nlm.nih.gov/37936904/

    2.     Vincent LE, Talanker MM, Butler DD, et al. Association of Changes in Antithrombin Activity Over Time With Responsiveness to Enoxaparin Prophylaxis and Risk of Trauma-Related Venous Thromboembolism. JAMA Surg. 2022;157(8):713-721. doi:10.1001/jamasurg.2022.2214
    https://pubmed.ncbi.nlm.nih.gov/35731524/

    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

    • 45 min

Customer Reviews

4.8 out of 5
1.3K Ratings

1.3K Ratings

MarahTillman ,

Unparalleled podcast for surgical residents

I was an avid listener in residency and this podcast was an excellent source of learning materials as a resident. I also used their oral boards course and it was better than the more expensive courses! This podcast and their related products were undeniably instrumental in my success as a surgical resident. Now as a board certified general surgeon I still find useful information in their journal review episodes. Can’t speak highly enough of this podcast!

Jordo_3000 ,

Well done.

The AOSA series is an excellent addition to the podcast and encouraging to young surgeons unsure if there is a seat at the table for themselves. Thank you for the inclusion.

Clint Gates ,

Thank you

I have listened to BTK since residency. It seems like the content just keeps getting better. Thoroughly appreciate what you all do! Thank you from a general surgeon in the midwest!

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