*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** In January 2022, the University of Maryland Medical Center performed the world’s first transplant involving a genetically modified animal heart. Join Behind the Knife as we discuss this significant transplant milestone with the 2 surgeons who led this historic case - Dr. Bartley Griffith and Dr. Muhammad M. Mohiuddin! Dr. Bartley Griffith is the Thomas E. and Alice Marie Hales Distinguished Professor in Transplant Surgery at UMSOM. Dr. Muhammad Mohiuddin is a Professor of Surgery at UMSOM and established the Cardiac Xenotransplantation Program with Dr. Griffith, the first in the United States.  Tune in to learn about the history of xenotransplantation and the barriers that have been overcome to make xenotransplantation a reality. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** Inspired by recent transplant surgery headlines, in this episode we briefly review the history and challenges of xenotransplantation. We discuss an article recently published in the American Journal of Transplantation describing the transplant of a porcine kidney into a human decedent model. Learning Objectives ·       Understand the timeline of xenotransplantation and its historical challenges ·       Review a recent article that describes the transplantation of a genetically-modified porcine kidney into a brain-dead human model ·       Discuss ongoing obstacles to successful xenotransplantation and next steps   References Porrett, P. M., Orandi, B. J., Kumar, V., Houp, J., Anderson, D., Cozette Killian, A., Hauptfeld-Dolejsek, V., Martin, D. E., Macedon, S., Budd, N., Stegner, K. L., Dandro, A., Kokkinaki, M., Kuravi, K. v., Reed, R. D., Fatima, H., Killian, J. T., Baker, G., Perry, J., … Locke, J. E. (2022). First clinical-grade porcine kidney xenotransplant using a human decedent model. American Journal of Transplantation, 22(4). https://doi.org/10.1111/ajt.16930 Schlich, T., & Lutters, B. (2022). Historical perspectives on xenotransplantation. The Lancet, 399(10331). https://doi.org/10.1016/s0140-6736(22)00529-3 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

*** FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLScxkGQTz-rh5OfPJBBdyvVZ4Pq2R8NWgBUOC1dt8VQHtvawhw/viewform *** You are faced with a young patient with an advanced colon cancer. You suspect Lynch syndrome. He asks if he should undergo total colectomy as opposed to segmental colectomy. How do you approach such a patient?  Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about Lynch syndrome, also known as Hereditary Non-polyposis Colorectal Cancer (HNPCC).  Learning objectives  -       To understand the rationale for universal testing for MMR deficiency of newly diagnosed colorectal cancers.  -       To know when to recommend screening for CRC for patients with LS and to those who have undergone resection   -       To understand the prevalence of cancers other than CRCs associated with Lynch syndrome, especially endometrial cancer.  Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

The landscape of surgery is shifting, reflecting the diverse composition of graduating medical students and the efforts to recruit the most talented people into the field.  It is one thing to have a diverse group of people within surgery, but it is an entirely different thing to ensure a welcoming, supportive environment for them.  In this Journal Club episode, we review these topics from the perspective of eminent surgeons Drs. Caprice and Jake Greenberg, who share with us their insights on recent articles examining the experience of women surgeons and trainees.  We’re joined by Dr. Cary Schlick, who authored one of these articles, to shed light on a key issue for the field.  Learning Objectives: ·       Identify some of the challenges for women in surgical training programs ·       Discuss how stereotype threat can impact performance ·       Suggest ways to advocate for equity in surgery References: Experiences of Gender Discrimination and Sexual Harassment Among Residents in General Surgery Programs Across the US - https://doi.org/10.1001/jamasurg.2021.3195 Effects of Gender Bias and Stereotypes in Surgical Training: A Randomized Clinical Trial - https://doi.org/10.1001/jamasurg.2020.1127 Gender Bias and Stereotypes in Surgical Training: Is It Really Women Residents We Need to Worry About? - https://doi.org/10.1001/jamasurg.2020.1561 The effect of gender on operative autonomy in general surgery residents - https://doi.org/10.1016/j.surg.2019.06.006 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Mattox Vegas TCCACS 2022: Ep. 2  The Trauma, Critical Care, and Acute Care Surgery conference (aka the MATTOX conference, named after trauma surgery legend Kenneth L Mattox) is the longest running show in Las Vegas at 55 consecutive years.  The MATTOX conference is unique in its focus on clinical topics.  Every talk, every panel, and every case discussion is relevant and practical.  Join Behind the Knife as we use case-based discussions to hammer home key points from lectures given by some of the biggest names in trauma, critical care, and acute care surgery.  This is episode 2 of 2.   The lineup:   Hasan Alam, MD (@DrHasanAlam)  Scott Steele, MD (@ScottRSteeleMD)  Joseph Dubose, MD (check out his exceptional podcast here: https://www.tiger-country.org/)  Mathew Martin, MD (@docmartin22)  Red Hoffman, MD (@redMDND, check out her amazing podcast here: https://thesurgicalpalliativecarepodcast.buzzsprout.com/)  Bellal Joseph, MD (@TopKnife_B)  Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

The Trauma, Critical Care, and Acute Care Surgery conference (aka the MATTOX conference, named after trauma surgery legend Kenneth L Mattox) is the longest running show in Las Vegas at 55 consecutive years.  The MATTOX conference is unique in its focus on clinical topics.  Every talk, every panel, and every case discussion is relevant and practical.  Join Behind the Knife as we use case-based discussions to hammer home key points from lectures given by some of the biggest names in trauma, critical care, and acute care surgery.  This is episode 1 of 2.   The lineup:   Dennis Kim, MD (@traumaicurounds, check out his amazing podcast here: https://www.traumaicurounds.ca/)  Ali Salim, MD (@alisalimMD)  Jason Smith, MD (@DrJTrauma)  Andre Campbell, MD (@TraumaDocSF) Meghan Lewis, MD   Demetrios Demetriades, MD  Alexander Eastman, MD (@PMHTrauma_ALE)  Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

The mortality rate for unstable pelvic hemorrhage due to blunt trauma remains around 30 percent. However, technological advances promise to finally make a dent. But on the cutting edge, it’s not clear which treatments should be used when to maximize lives saved. With life-threatening pelvic exsanguination, time is critical. Do you know when to rush to pack the pelvis? Do you know when to deploy a REBOA instead? Are there scenarios where you should do both? Join Drs. Urréchaga, Neeman, and Rattan from Ryder Trauma Center in Miami as they try to tease out answers using two studies hot off the presses with seemingly contradictory results. Learning Objectives: Blunt Pelvic Hemorrhage ·       Expanding knowledge of management strategies for blunt pelvic hemorrhage ·       Describe propensity score matching and its use in non-randomized studies ·       Compare outcomes of REBOA and preperitoneal pelvic packing (PPP) ·       Critically appraise study design and methods of studies References 1.     S. Mikdad, I.A.M. van Erp, M.E. Moheb, et al. Pre-peritoneal pelvic packing for early hemorrhage control reduces mortality compared to resuscitative endovascular balloon occlusion of the aorta in severe blunt pelvic trauma patients: A nationwide analysis. Injury. 2020; 51:1834–1839. doi.org/10.1016/j.injury.2020.06.003 2.     S. Asmar, L. Bible, M. Chehab, et al. Resuscitative Endovascular Balloon Occlusion of the Aorta vs Pre-Peritoneal Packing in Patients with Pelvic Fracture. Journal of the American College of Surgeons. 2021; 232(1):17-26. doi.org/10.1016/j.jamcollsurg.2020.08.763 3.     B. Joseph, M. Zeeshan, J.V. Sakran, et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surg. 2019;154(6):500-508. doi:10.1001/jamasurg.2019.0096 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

EPAs are coming in 2023. This isn’t about your carbon emissions, but it will dramatically impact surgery training programs. Join Drs. Karen Brasel, Jeremy Lipman, Judith French, and Amy Han as they discuss Entrustable Professional Activities (EPAs) and how they will change the way we assess trainees. Learning Objectives 1.     Listeners will be able to define entrustable professional activities (EPAs) within the context of competency-based education during General Surgery residency training 2.     Listeners will be able to understand the impetus behind adopting EPA assessments for surgical trainees.  3.     Listeners will be able to interpret and apply EPA assessment data based on the discussion of the example scenarios. References: Brasel KJ, Klingensmith ME, Englander R, Grambau M, Buyske J, Sarosi G, Minter R. Entrustable professional activities in general surgery: development and implementation. Journal of surgical education. 2019 Sep 1;76(5):1174-86. Lindeman B, Brasel K, Minter RM, Buyske J, Grambau M, Sarosi G. A Phased Approach: The General Surgery Experience Adopting Entrustable Professional Activities in the United States. Acad Med. 2021;96(7S):S9-S13. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Dr. Michael Rosen returns to Behind the Knife – this time to discuss his RCT investigating biologic vs. synthetic mesh for single-stage repair of contaminated ventral hernias. Read the full article here in JAMA Surgery: https://jamanetwork.com/journals/jamasurgery/article-abstract/2788222 Dr. Rosen is the director for the Center of Abdominal Core Health at the Cleveland Clinic and has written the “Atlas of Abdominal Wall Reconstruction”. Want to learn more about his work and the Hernia Quality Collaborative? Catch up on Dr. Rosen’s previous episode on Behind the Knife:  Episode #21 (August 15, 2015): Hernias, Abdominal Wall Reconstruction, and Quality Collaboratives https://behindtheknife.org/podcast/21-hernias-abdominal-wall-recon-and-quality-collaboratives-dr-michael-rosen/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Welcome to the third of a six-part series focused on the integration of palliative care into the practice of surgery.  Malignant bowel obstructions occur in 5-43 percent of patients with a diagnosis of advanced primary or metastatic intra-abdominal malignancy and both acute care surgeons and surgical oncologists are called upon to manage this condition. Using the case of an elderly gentleman with gastric outlet obstruction secondary to gastric cancer, in this episode we discuss how to approach a patient with a malignant bowel obstruction, review the medical and surgical options for management, discuss the importance of primary palliative care, define palliative surgery and conclude with a short rant about the necessity of being cognizant of one’s feelings and of taking the time and creating the space to discuss them.  Fast Fact #45:  Medical Management of Bowel Obstructions https://www.mypcnow.org/fast-fact/medical-management-of-bowel-obstructions/ Chapter 8, Malignant Bowel Obstruction in Surgical Palliative Care: A Resident’s Guide https://www.facs.org/~/media/files/education/palliativecare/surgicalpalliativecareresidents.ashx Palliative surgery and the surgeon’s role in the palliative care team: a review. https://apm.amegroups.com/article/download/72758/pdf 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. Fabian Johnston (@fabianjohnston) is Associate Professor of Surgery and Oncology and Chief, Division of GI Surgical Oncology at Johns Hopkins University. 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.