400 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
    • 4.9 • 1.1K 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.  

    Journal Review in Surgical Palliative Care: Palliative Care in the Surgical ICU

    Journal Review in Surgical Palliative Care: Palliative Care in the Surgical ICU

    Welcome to the first Surgical Palliative Care Journal Club, the second of a six-part series focused on the integration of palliative care into the practice of surgery.  Join us as we discuss the first study of how to best integrate palliative medicine principles into the care of trauma ICU patients.  We then tackle the question:  Why are surgeons often unwilling to discontinue life-sustaining treatments in the post-operative period?   We discuss a 2013 study about “surgical buy-in” and review alternatives to making “informal contracts” with patients before surgery.  


    References:

    Mosenthal AC, Murphy PA, Barker LK, et al. Changing the culture around end-of-life care in the trauma intensive care unit. J Trauma. 2008;64(6):1587-1593. doi:10.1097/TA.0b013e318174f112.


    Schwarze ML, Redmann AJ, Alexander GC, Brasel KJ. Surgeons expect patients to buy-in to post-operative life support preoperatively: results of a national survey. Crit Care Med. 2013;41(1):1-8. doi: 10.1097/CCM.0b013e31826a4650.



    Dr. Red Hoffman (@redmdnd) is an acute care surgeon and associate hospice medical director in Asheville, North Carolina, host of the Surgical Palliative Care Podcast (@surgpallcare) and co-founder of the recently launched Surgical Palliative Care Society (www.spcsociety.org). 


    Dr. Zara Cooper (@zaracMD) is an acute care surgeon at Brigham and Women’s Hospital where she serves as Kessler Director for the Center of Surgery and Public Health (@csph_bwh).  She is Associate Professor of Surgery at Harvard Medical School, associate faculty at Adriane Labs, and adjunct faculty at the Marcus Institute for Aging Research. 


    Dr. Amanda Stastny (@manda_plez) is a PGY-2 in the General Surgery program at Mountain Area Health Education Center (MAHEC) in Asheville, NC.


    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 32 min
    Journal Review in Surgical Education: Operative Performance Assessment

    Journal Review in Surgical Education: Operative Performance Assessment

    5 years of General Surgery residency? Check. Case numbers? Check. Ready for independent practice? Hmmm.  




    Join Drs. John D. Mellinger, Jeremy Lipman, Judith French, and Amy Han as we discuss the past, present and future of operative assessment.




    Learning objectives:




    In this episode, we discuss the current practices of operative assessment in surgical training and the opportunities for improvement. We delve into evidence-based framework for operative performance assessment outlined in “A Proposed Blueprint for Operative Performance Training, Assessment, and Certification.” We explore the distinction between high versus low frequency operations, standards setting, training of assessors, and the role of technology in improving reliability, generalizability, and frequency of operative assessments.    




    References:




    Bansal N, Simmons KD, Epstein AJ, Morris JB, Kelz RR. Using Patient Outcomes to Evaluate General Surgery Residency Program Performance. JAMA Surg. 2016;151(2):111–119. doi:10.1001/jamasurg.2015.3637




    Bell RH Jr, Biester TW, Tabuenca A, et al. Operative experience of residents in US general surgery programs: a gap between expectation and experience. Ann Surg. 2009;249(5):719-724. doi:10.1097/SLA.0b013e3181a38e59




    Williams RG, Sanfey H, Chen XP, Dunnington GL. A controlled study to determine measurement conditions necessary for a reliable and valid operative performance assessment: a controlled prospective observational study. Ann Surg. 2012;256(1):177-187. doi:10.1097/SLA.0b013e31825b6de4




    Williams RG, George BC, Bohnen JD, et al. A Proposed Blueprint for Operative Performance Training, Assessment, and Certification. Ann Surg. 2021;273(4):701-708. doi:10.1097/SLA.0000000000004467

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 35 min
    Clinical Challenges in Surgical Critical Care: Arrhythmias

    Clinical Challenges in Surgical Critical Care: Arrhythmias

    Cardiac arrhythmias such as atrial fibrillation are common in any ICU. But, adequately addressing additional perioperative considerations is key in the surgical ICU. In this Critical Care episode of Behind the Knife, Drs. Bankhead, Dumas, & Park will address how to approach a critically ill patient who presents with an arrythmia. Hemodynamically stable vs. unstable patients are discussed, as well as the current ACLS guidelines for management of a patient in cardiac arrest. 




    Referenced Articles and Guidelines:




    1. Van Gelder I, Groenveld H, Crijns H, et al. Lenient versus Strict Rate Control in Patients with Atrial Fibrillation. NEJM 2010. 




    2. Walkey A, Hogarth K, Lip G. Optimizing Atrial Fibrillation Management: From ICU and Beyond. CHEST 2015. 




    3. AFFIRM Investigators. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NEJM 2002. 




    4. ACLS Training Center: Tachycardia with a Pulse Algorithm. https://www.acls.net/acls-tachycardia-algorithm




    5. ACLS Training Center: Cardiac Arrest Algorithm. https://www.acls.net/acls-secondary-survey




    6. ACLS Training Center: Acute Coronary Syndromes Algorithm. https://www.acls.net/acute-coronary-syndromes-algorithm

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 28 min
    Journal Review in Thoracic Surgery: Adjuvant Therapy in Lung Adenocarcinoma

    Journal Review in Thoracic Surgery: Adjuvant Therapy in Lung Adenocarcinoma

    November is Lung Cancer Awareness Month, and what better way is there to spend your time than getting to know the recent advances in adjuvant therapy for early-stage lung adenocarcinoma? 





    Learning Objectives




    -        Review work-up and treatment of lung adenocarcinoma

    -        Review evidence behind Osimertinib as an adjuvant therapy in EGFR mutation positive disease

    -        Review recent advances in gene expression profiles for targeted application of adjuvant chemotherapy

    -        Discuss future directions for research

    -        Discuss additional advancements in diagnosis, monitoring, and immunotherapy





    Referenced Material




    -        Wu Y, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small-cell lung cancer. N Engl J Med 2020; 383:1711-1723. DOI: 10.1056/NEJMoa2027071  https://www.nejm.org/doi/full/10.1056/NEJMoa2027071


    -        Woodard GA, Wang SX, Kratz JR, et al. Adjuvant Chemotherapy Guided by Molecular Profiling and Improved Outcomes in Early Stage, Non-Small-Cell Lung Cancer. Clin Lung Cancer 2018;19(1):58-64. DOI: 10.1016/j.cllc.2017.05.015

    https://www.clinical-lung-cancer.com/article/S1525-7304(17)30150-X/fulltext

    -        Woodard GA, Kratz JR, Haro G, et al. Molecular Risk Stratification is Independent of EGFR Mutation Status in Identifying Early-Stage Non-Squamous Non-Small Cell Lung Cancer Patients at Risk for Recurrence and Likely to Benefit From Adjuvant Chemotherapy. Clin Lung Cancer. 2021;20:S1525-7304(21)00212-6. DOI: 10.1016/j.cllc.2021.08.008


    https://www.clinical-lung-cancer.com/article/S1525-7304(21)00212-6/fulltext

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 25 min
    cT2N0 Middle Rectal CA: Neoadjuvant Therapy or Resect?

    cT2N0 Middle Rectal CA: Neoadjuvant Therapy or Resect?

    Join Behind the Knife's very own Dr. Scott Steele, Chairman of the Department of Colorectal Surgery at Cleveland Clinic, for a high-level talk on the treatment of T2N0 rectal cancer. 

    There is an associated video that goes along with this episode.  Check it out at behindtheknife.org or YouTube.

    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 18 min
    Clinical Challenges in Emergency General Surgery: Cancer Emergencies

    Clinical Challenges in Emergency General Surgery: Cancer Emergencies

    Join Drs. Ashlie Nadler, Jordan Nantais and Graham Skelhorne-Gross as they tackle Cancer Emergencies.  

    Case 1 - Learning Points:


    These are complex patients and multidisciplinary care should be provided with input from oncology. 
    A step-up approach should be used, starting with medical management prior to considering surgery in appropriate patients.
    Highly selected patients may benefit from surgery, namely those with a high performance status, a prognosis of months if the bowel obstruction was resolved, minimal carcinomatosis, and a single transition point. Diversion, bypass, or resection are all options, but a patient’s capacity to heal related to recent systemic therapy needs to be taken into account. 
    Consent for surgery should focus on goals of care, quality of life, and achievable outcomes, and highlight the inherent risk in patients with advanced disease and a limited lifespan. 




    Case 2 - Learning Points:


    Colorectal malignancy is an exceedingly common cause of general surgical emergency and requires a thoughtful, systematic approach
    The role of stenting as a bridge to surgery in obstructing distal colon malignancy is somewhat controversial but can help to avoid permanent stomas; however there is some potential risk of perforation and possibly disease recurrence
    Treatment decisions should take place in the context of an informed discussion with the patient and consideration of both quantity and quality of life whenever possible
    Consistent involvement of a multidisciplinary team, including radiology, enterostomal therapy, and surgical oncology can be extremely useful in guiding complex decisions



    References:



    Shariff F, Bogach J, Guidolin K, Nadler A. Malignant Bowel Obstruction Management Over Time: Are We Doing Anything New? A Current Narrative Review. Ann Surg Oncol. 2021 Oct 18. doi: 10.1245/s10434-021-10922-1. Epub ahead of print.
    Ripamonti C, Gerdes H and Easson A. Management of malignant bowel obstruction. Eur J Cancer 2008 May;44(8):1105-15
    Chen, T, Huang, Y. & Wang, G. Outcome of colon cancer initially presenting as colon perforation and obstruction. World J Surg Onc 15, 164 (2017). 
    Olmsted C, Johnson A, Kaboli P, et al. Use of palliative care and hospice among surgical and medical specialties in the Veterans Health Administration. JAMA Surg. 2014;149(11):1169–75.
    Dunn GP, Martensen R, Weissman D.  Surgical palliative care: a resident’s guide. Essex: American College of Surgeons; 2009.
    Biondo S, Martí-Ragué J, Kreisler E, et al. A prospective study of outcomes of emergency and elective surgeries for complicated colonic cancer. Am J Surg. 2005;189:377–83.
    National Comprehensive Cancer Network. https://www.nccn.org/. Accessed October 15, 2021.
    Shariat-Madar B, Jayakrishnan TT, Gamblin TC, Turaga KK. Surgical management of bowel obstruction in patients with peritoneal carcinomatosis. J Surg Oncol. 2014 Nov;110(6):666-9. doi: 10.1002/jso.23707. 




    Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

    • 35 min

Customer Reviews

4.9 out of 5
1.1K Ratings

1.1K Ratings

JC super colon ,

World class podcast

Listened to BTK since my junior residency years and continue to enjoy and find it helpful today as a young attending surgeon. Honored to have contributed during some of the mock colorectal episodes. Ever grateful for its clinically useful tips and tricks, and for all the absite review. Incredible variety of interesting topics w world surgical leaders. Dominate the Day!

KO_TXP ,

Great tool for learning surgery!!

I have listened this podcast from the beginning. BTK has lots of improvement and expansions. I am listening at regular basis. I enjoyed a lot and helped me to study ABSITE. I cannot wait for new episodes. I really appreciate BTK teams’ efforts and hope BTK will dominate surgical educations.

@jjulsonMD ,

Essential for surgical residents

One of the pillars of my ABSITE review and for keeping me up to date on changes in the field. Couldn’t do residency without it!

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