Behind The Knife: The Surgery Podcast

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series.  Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife.  Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Exploring the vascular supply and nerves of the thyroid gland, anatomy and physiology of the thyroid gland, diagnosis and management of hyperthyroidism, Grave's disease, and multinodular goiters, detailed analysis of various thyroid disorders and their treatment options, and discussion on the timing of prophylactic thyroidectomy for different risk patients.

Behind the Knife ABSITE 2024 – Brand new, up-to-date, high yield learning to help you DOMINATE the exam. Don’t forget to check out our NEW ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/B0CLDQWZG3/ref=monarch_sidesheet Behind the Knife would like to sincerely thank Medtronic for sponsoring the entire 2024 ABSITE podcast series.  Medtronic has a rich history of supporting surgical education, and we couldn’t be happier that they chose to partner with Behind the Knife.  Learn more at https://www.medtronic.com/ If you like the work that Behind the Knife is doing, please leave us a review wherever you listen to podcasts.   Visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

In this discussion, John Phay, a clinical professor and co-discoverer of parathyroid near-infrared autofluorescence, dives into its origins and clinical impact. Priya Dedhia, an assistant professor specializing in endocrine surgery, shares insights on comparing autofluorescence with indocyanine green (ICG) for identifying parathyroids. Samantha Ruff, a surgical oncology fellow, reviews studies highlighting how autofluorescence reduces early hypocalcemia, making a case for its use in complex surgeries. Together, they explore the future of surgical adjuncts in endocrine procedures.

What is the best surgical treatment for a vasculopathy with critical limb threatening ischemia? In this episode of Behind the Knife the vascular surgery subspecialty team discusses two pivotal trials (BEST-CLI and BASIL-2) and how the findings of these trials can help answer this question. In this episode, we will discuss the age old question: open bypass versus best endovascular treatment.  Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. David Schechtman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives Review the definition, prevalence, and prognosis of critical limb threatening ischemia Review basic treatment options for patients with critical limb threatening ischemia Understand the methodology, findings, limitations, and clinical applications of the BEST-CLI trial Understand the methodology, findings, limitations, and clinical applications of the BASIL-2 trial Compare open bypass and best endovascular therapy for patients with critical limb threatening ischemia References Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. N Engl J Med. 2022 Dec 22;387(25):2305-2316. doi: 10.1056/NEJMoa2207899. Epub 2022 Nov 7. PMID: 36342173. https://pubmed.ncbi.nlm.nih.gov/36342173/ Bradbury AW, Moakes CA, Popplewell M, Meecham L, Bate GR, Kelly L, et al. A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial. The Lancet. 2023. 401(10390), 1798-1809. https://doi.org/10.1016/S0140-6736(23)00462-2 Conte MS Bradbury AW Kolh P et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. Eur J Vasc Endovasc Surg. 2019; 58 (109.e33.): S1-109 https://pubmed.ncbi.nlm.nih.gov/31182334/ Bradbury AW Adam DJ Bell J et al. Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb ischaemia due to infrainguinal disease. The bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial. Health Technol Assess. 2010; 14: 1-210 https://pubmed.ncbi.nlm.nih.gov/20307380/ Adam DJ Beard JD Cleveland T et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366: 1925-1934 https://pubmed.ncbi.nlm.nih.gov/16325694/ Bradbury AW Adam DJ Bell J et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010; 51: 5S-17 https://pubmed.ncbi.nlm.nih.gov/20435258/ Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019 Jun;69(6S):3S-125S.e40. doi: 10.1016/j.jvs.2019.02.016. Epub 2019 May 28. Erratum in: J Vasc Surg. 2019 Aug;70(2):662. PMID: 31159978; PMCID: PMC8365864. https://pubmed.ncbi.nlm.nih.gov/31159978/ Menard MT, Rosenfield K, Farber A. The BEST-CLI Trial: Implications of the Primary Results. Eur J Vasc Endovasc Surg. 2023 Mar;65(3):317-319. doi: 10.1016/j.ejvs.2022.12.032. Epub 2023 Jan 6. PMID: 36621707. https://pubmed.ncbi.nlm.nih.gov/36621707/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out other vascular surgery episodes: https://behindtheknife.org/podcast-category/vascular/

If you operate for long enough, chances are you will come across the unique, and potentially daunting scenario of operating on a pregnant patient. If, and when, you do, would you know what to do? Join University of Washington and MIS faculty Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and residents Drs. Ben Vierra and Paul Herman as they discuss non-obstetric surgery in the pregnant patient so that you will be better informed when the challenge arises. Hosts: 1. Andrew Wright, UW Medical Center—Montlake and Northwest, @andrewswright 2. Nick Cetrulo, UW Medical Center—Northwest, @Trules25 3. Nicole White, UW Medical Center—Northwest, @NicoleWhiteTho1 4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm 5. Ben Vierra, UW General Surgery Resident PGY-2 Learning Objectives 1. Describe important physiologic changes in pregnancy that are relevant for the surgeon to know. 2. Review the epidemiology of non-obstetric general surgery in the pregnant patient. 3. Discuss specific imaging considerations in the pregnant patient. 4. Become more familiar with the technical aspects of approaching a typical surgical case in a pregnant patient. References 1. Pearl, J.P., Price, R.R., Tonkin, A.E. et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc 31, 3767–3782 (2017). https://doi.org/10.1007/s00464-017-5637-3 2. Vasileiou G, Eid AI, Qian S, Pust GD, Rattan R, Namias N, Larentzakis A, Kaafarani HMA, Yeh DD; EAST Appendicitis Study Group. Appendicitis in Pregnancy: A Post-Hoc Analysis of an EAST Multicenter Study. Surg Infect (Larchmt). 2020 Apr;21(3):205-211. https://pubmed.ncbi.nlm.nih.gov/31687887/ 3. Dongarwar D, Taylor J, Ajewole V, Anene N, Omoyele O, Ogba C, Oluwatoba A, Giger D, Thuy A, Argueta E, Naik E, Salemi JL, Spooner K, Olaleye O, Salihu HM. Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal-Fetal Mortality. World J Surg. 2020 Dec;44(12):3999-4005. https://pubmed.ncbi.nlm.nih.gov/32737556/ 4. Fong ZV, Pitt HA, Strasberg SM, Molina RL, Perez NP, Kelleher CM, Loehrer AP, Sicklick JK, Talamini MA, Lillemoe KD, Chang DC; California Cholecystectomy Group. Cholecystectomy During the Third Trimester of Pregnancy: Proceed or Delay? J Am Coll Surg. 2019 Apr;228(4):494-502.e1. https://pubmed.ncbi.nlm.nih.gov/30769111/ 5. Hong J, Yang J, Zhang X, Su J, Tumati A, Garry D, Docimo S, Bates AT, Spaniolas K, Talamini MA, Pryor AD. Considering delay of cholecystectomy in the third trimester of pregnancy. Surg Endosc. 2021 Aug;35(8):4673-4680. https://pubmed.ncbi.nlm.nih.gov/32875420/ 6. ACOG Committee Opinion No. 775: Nonobstetric Surgery During Pregnancy. Obstet Gynecol. 2019 Apr;133(4):e285-e286. https://pubmed.ncbi.nlm.nih.gov/30913200/ 7. Ashbrook M, Cheng V, Sandhu K, Matsuo K, Schellenberg M, Inaba K, Matsushima K. Management of Complicated Appendicitis During Pregnancy in the US. JAMA Netw Open. 2022 Apr 1;5(4):e227555. https://pubmed.ncbi.nlm.nih.gov/35426921/ 8. Capella CE, Godovchik J, Chandrasekar T, Al-Kouatly HB. Nonobstetrical Robotic-Assisted Laparoscopic Surgery in Pregnancy: A Systematic Literature Review. Urology. 2021 May;151:58-66. https://pubmed.ncbi.nlm.nih.gov/32445766/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out other Behind the Knife minimally invasive surgery episodes: https://behindtheknife.org/podcast-category/minimally-invasive/

Join the Hernia Team from Carolinas Medical Center as they discuss applications of artificial intelligence in predicting outcomes for patients undergoing abdominal wall reconstruction. Emerging technologies are allowing us to understand hernia patients who are at risk for increased surgical complexity and postoperative complications – find out more in this Journal Review episode. Hosts: Dr. Sullivan “Sully” Ayuso, Chief Resident, Carolinas Medical Center, @SAyusoMD   Dr. Todd Heniford, Chief of GI & MIS, Carolinas Medical Center, @THeniford   Dr. Vedra Augenstein, Professor of Surgery, Carolinas Medical Center, @VedraAugenstein  Dr. Monica Polcz, Attending Surgeon, Baptist Health (FL)  Learning Objectives: Provide and introduction to artificial intelligence Develop an understanding of the applications of artificial intelligence in surgical outcome prediction for patients undergoing hernia repair Learn how risk stratification of hernia patients can affect their care References: Elhage et al, Development and Validation of Image-Based Deep Learning Models to Predict Surgical Complexity and Complications in Abdominal Wall Reconstruction, JAMA Surgery, 2021 https://pubmed.ncbi.nlm.nih.gov/34232255/ Ayuso et al, Predicting Rare Outcomes in Abdominal Wall Reconstruction Using Image-Based Deep Learning Models, Surgery, 2023  https://pubmed.ncbi.nlm.nih.gov/36229252/  Hassan et al, Novel Machine Learning Approach for Prediction of Hernia Recurrence, Surgical Complication, and 30-Day Readmission after Abdominal Wall Reconstruction, JACS, 2022 https://pubmed.ncbi.nlm.nih.gov/35426406/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out more Behind the Knife hernia episodes: https://behindtheknife.org/podcast-category/hernia/

We’re all told to find mentors in medical training, but how does this actually work when you’re a new medical student interested in surgery? And how do you leverage those relationships into getting research experience and lines on your CV?  Hosts:  Nina Clark, MD Jessica Millar, MD Jon Williams, MD Guests:  Michael Englesbe, MD, University of Michigan Erika Bisgaard, MD, University of Washington Some tips from the episode: Get involved Even if you’re not destined for an academic career, getting involved in research early on can help you to participate with the scientific literature, understand data, and incorporate new research into your practice.   Realistically, research is an important component of your ERAS application and your CV. It’s also a great opportunity to learn new skills and develop strong relationships with mentors. Remember why you’re in medical school You came to medical school to become a doctor first – don’t forget that or let research take away from it. Your mentors have been through it and understand that things get busy. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our Medical Student Intern Survival Guide Series: https://behindtheknife.org/podcast-series/medical-student-and-intern-survival-guide/ 

Experts discuss the importance and strategies of mentorship for medical students in the field of surgery. They highlight the need for different mentors who can provide support, facilitate opportunities, and hold students accountable. Effective communication, follow-through, and professionalism are emphasized. The chapter also addresses the challenges and evolving nature of mentorship relationships.

Challenges continue to plague the residency application process, with programs receiving increased application volume that makes holistic review difficult, and medical student applicants burdened with application costs and uncertainty about what programs best align with their values. As a specialty, Ob/Gyn is facing these problems head on, and have united within their field to create a new independent residency application system, ResidencyCAS. While substantial changes to an already stressful process can be intimidating, the new platform offers many advantages that hope to improve the residency application experience for applicants, programs, and the Ob/Gyn community as a whole. We’re joined by Dr. Maya Hammoud and Dr. AnnaMarie Connolly, two of the leaders in this effort, to break down the creation of ResidencyCAS, plans for its implementation starting in the 2024-2025 application cycle, and the reaction of the Ob/Gyn and medical education communities to this change. Learning Objectives 1.     Listeners will describe current challenges to applicants and programs in the residency application process. 2.     Listeners will identify the coming changes to the Ob/Gyn residency application process, with awareness of the planned design and use of the ResidencyCAS system. 3.     Listeners will describe the value of potential changes to the residency application process. 4.     Listeners will explain the barriers and efforts required to coordinate large-scale changes within medical education like the creation and implementation of ResidencyCAS. 5.     Listeners will consider how changes to the residency application process could affect and improve their own field, program, or application. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our other Surgical Education Episodes: https://behindtheknife.org/podcast-category/surgical-education/