Behind The Knife: The Surgery Podcast

Join leading experts in the field as Benjamin Schlechter, a Senior Physician at Dana-Farber, dives into the evolution of Total Neoadjuvant Therapy (TNT) in rectal cancer treatment. Julio Garcia-Aguilar, from MSK, shares insights from the impactful OPRA trial on organ preservation strategies. Emmanouil Fokas reveals findings from German trials on radiation scheduling. They explore benefits of preoperative chemotherapy, survival outcomes, and how emerging trials and research are shaping future treatment options.

Dr. Adnan Al-Sadi is a hepatobiliary surgeon, educator, and former U.S. Navy physician with a passion for diving, underwater photography, and cooking. He shares how underwater experiences inspire humility and creativity in his surgical practice. Exploring stunning dive destinations, Dr. Al-Sadi discusses leaving the camera behind to immerse himself in the moment. He also reflects on the connections between culinary arts and surgery, emphasizing the importance of creativity and mentorship in medical education, while encouraging future surgeons to embrace diverse career paths.

Dr. Kathryn Coan, an endocrine surgeon and educator, Dr. Anathea Powell, a colorectal surgeon and personal trainer, and Dr. Danielle Tanner, a general surgery resident, explore the critical importance of surgical ergonomics. They discuss how poor posture and inadequate support lead to chronic pain and injuries in surgeons. Listeners will learn about practical OR adjustments, the significance of micro-breaks, and the value of fitness in preventing injuries. Candid stories highlight the necessity of addressing pain and investing in long-term health for surgical longevity.

Carotid artery disease management has come a long way. From the days when every stroke meant an endarterectomy to a modern era defined by precision, evidence, and evolving technology. With advances in medical therapy and newer techniques like TCAR, the vascular surgeon has even more to consider when choosing the best treatment for carotid disease. Join us as we break down the major landmark trials NASCET, CREST and the Asymptomatic Carotid trials, and discuss how their findings shape our clinical decisions in practice today. Hosts: ·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center ·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center ·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center ·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning Objectives: · Review the key findings and clinical implications of the NASCET, ACST, and CREST trials. · Discuss patient selection for carotid endarterectomy (CEA) vs carotid artery stenting (CAS). · Understand how age, calcification, and aortic arch anatomy affect stenting outcomes or choice between stent and CEA. · Identify how advances in medical therapy have influenced management of asymptomatic disease.  · Discuss appropriate screening/ follow up plans for patients who do not meet criteria for intervention References: -       North American Symptomatic Carotid Endarterectomy Trial Collaborators. (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. The New England Journal of Medicine, 325(7), 445–453. https://pubmed.ncbi.nlm.nih.gov/1852179/ -       Brott, T. G., Hobson, R. W. II, Howard, G., Roubin, G. S., Clark, W. M., Brooks, W., ... & Howard, V. J. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. The New England Journal of Medicine, 363(1), 11–23. https://pubmed.ncbi.nlm.nih.gov/20505173/ -       Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D.; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: Randomized controlled trial. The Lancet, 363(9420), 1491–1502. https://pubmed.ncbi.nlm.nih.gov/15135594/ -       Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., & Pan, H., & the ACST-2 Collaborative Group. (2021). Second asymptomatic carotid surgery trial (ACST-2): A randomised comparison of carotid artery stenting versus carotid endarterectomy. The Lancet, 398(10305), 1065-1073. https://doi.org/10.1016/S0140-6736(21)01910-3 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Joining the conversation are Teddy Puzio, a pediatric trauma specialist at UT Houston, Charles Cox, a trauma expert in pediatric care, and Tyler Simpson, a trauma fellow with expertise in imaging guidelines. They dive into the intricacies of pediatric trauma, discussing how injury mechanisms can predict specific outcomes. The trio highlights notable differences in pediatric anatomy, the risks of ionizing radiation from imaging, and the critical red flags for non-accidental trauma. Their practical insights aim to enhance clinical decision-making in treating injured children.

Pediatric trauma hits differently—both emotionally and clinically. In this Big T Trauma episode (1 of 2), Drs. Teddy Puzio, Charles Cox, and Bhupaul Ramsuchit join Dr. Patrick Georgoff to break down real-world pediatric trauma cases that highlight the ABCs, airway pitfalls, and the art of staying one step ahead when things go sideways. From weight-based dosing and needle cricothyrotomy, to recognizing subtle signs of shock, this one’s packed with practical pearls you can use on your next pediatric activation. UT Houston Pediatric MTP: https://med.uth.edu/surgery/pedimtp/ This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. BIG T Trauma Series: https://app.behindtheknife.org/podcast-series/big-t-trauma 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dr. Amber Sandoval, an abdominal wall reconstruction fellow, and Dr. Peter Farron, chief surgical resident at OHSU, dive into the complexities of mesh infections in hernia repair. They discuss risk factors like BMI and smoking, effective source control methods, and the importance of tailored antibiotic strategies. The duo explores mesh properties that influence infection rates and recovery, and the optimal approach to explant—favoring complete removal over partial. A practical treatment algorithm guides listeners through effective management strategies for these challenging cases.

Matthew Swenson, a general surgeon and Air Force veteran, discusses his groundbreaking oral board simulator, designed to revolutionize exam preparation. He shares how massive community feedback has fine-tuned technical features, improving user experience. The simulator now boasts a more accurate readiness score and 20 diverse examiner voices, simulating real test scenarios. Exciting new features—like the Coach, OpGuide, and Wingman—equip users with tailored support, making training more interactive and effective. Swenson emphasizes the importance of comprehensive clinical thinking in board exams.

In this episode, we explore practical tips for caring for older adults in the clinical setting through a case-based discussion highlighting common perioperative challenges and strategies for success. We also take a deeper dive into the American College of Surgeons Geriatric Surgery Verification Program, including its goals, impact, and how clinicians can get involved in advancing surgical care for the aging patient population. Take Home Points:  The older adult population is the fastest growing patient population and it is important we focus on patient-centered care for this population, as this is a population that almost all of us will engage with.  If you or your hospital isn’t prepared to get verified yet, there are still small processes that can be implemented that can make an impactful difference on your patients. Geriatric Surgery Verification is at the cutting edge of quality improvement. Like other verification programs (trauma, bariatric) patients will soon seek out these centers that can best address their personal needs. Hosts:  Agnes Premkumar, MD - General Surgery Resident at Creighton University, @agnespremkumar Nicole L. Petcka, MD – General Surgery Resident at Emory University, @npetcka2022 Guests:  Marcia M. Russell, MD - Professor of Surgery and Vice Chair for Quality and Safety at the David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Healthcare System Caroline Smolkin, MD - General Surgery Resident at Northwell and American College of Surgeons Clinical Scholar Resources:  American College of Surgeons Geriatric Surgery Verification Program: https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/  Katlic MR, Wolf J, Demos SJ, Rosenthal RA. Making a Financial Case for the Geriatric Surgery Verification Program. Ann Surg Open. 2024 May 13;5(2):e439. doi: 10.1097/AS9.0000000000000439. PMID: 38911623; PMCID: PMC11191881. https://pubmed.ncbi.nlm.nih.gov/38911623/ Remer SL, Zhou L, Cohen ME, Russell MM, Rosenthal R, Ko CY. Discharge to Post-Acute Care as a Benchmarking Metric for Elderly Surgical Patients. J Am Coll Surg. 2025 Aug 14. doi: 10.1097/XCS.0000000000001495. Epub ahead of print. PMID: 40810404. https://pubmed.ncbi.nlm.nih.gov/40810404/ Jones TS, Jones EL, Richardson V, Finley JB, Franklin JL, Gore DL, Horney CP, Kovar A, Morin TL, Robinson TN. Preliminary data demonstrate the Geriatric Surgery Verification program reduces postoperative length of stay. J Am Geriatr Soc. 2021 Jul;69(7):1993-1999. doi: 10.1111/jgs.17154. Epub 2021 Apr 7. PMID: 33826150. https://pubmed.ncbi.nlm.nih.gov/33826150/ *** UNC Surgery is inviting you to participate in a national survey designed to understand general surgery residents’ perspectives on core curriculum content, structure, & delivery. The results of this survey will inform the development of a standardized general surgery education curriculum.    SURVEY LINK: https://docs.google.com/forms/d/e/1FAIpQLSeJztQwgB1rJXpCtvboHprGB_gmHGG4UzY1HITAHRmMx9FcRQ/viewform 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this episode, the Surgical Endoscopy team reviews applications of per oral endoscopic myotomy (POEM) at different locations in the gastrointestinal tract. Specifically, they discuss esophageal POEM for achalasia, G-POEM for gastroparesis, and Z-POEM for management of a Zenker’s diverticulum. The team describes outcomes for these procedures as well as an overview of the procedural steps and postoperative management. Common pitfalls to POEM are deliberated along with advice on how to mitigate challenging situations when they arise. VIDEO LINK: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-3-per-oral-endoscopic-myotomy Hosts: • Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery Fellow, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter) • Dr. H. Mason Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL) • Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) • Dr. Michael McCormack, Minimally Invasive Surgeon, Swedish Hospital (Chicago, IL) Learning Objectives: • Describe the basic steps of the Peroral Endoscopic Myotomy (POEM) technique. • Identify the different applications for POEM in the esophagus, stomach, and pharynx. • Recognize the primary indications and success rates for esophageal, gastric, and Zenker's diverticulum POEM procedures. Surgical Endocsopy Series: - Surgical Endoscopy Series Ep. 1: An Introduction to Surgical Endoscopy: https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-1-an-introduction-to-surgical-endoscopy - Surgical Endoscopy Series Ep. 2: Endobariatrics - https://behindtheknife.org/podcast/surgical-endoscopy-series-ep-2-endobariatrics 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US