Behind The Knife: The Surgery Podcast

What is one of the most energy-intensive and waste-generating areas of the hospital? The operating room! In the new BTK/Annals of Surgery Journal Club, we talk to Dr. Elizabeth Yates and Dr. Louis Nguyen about their new article – “Empowering Surgeons, Anesthesiologists, and Obstetricians to Incorporate Environmental Sustainability in the Operating Room.” They review the impact ORs have on the environment, the consequences this has for patients, and ways surgeons lead efforts to “green” the operating room. As the topic of environmental sustainability becomes a growing concern with each passing year, the surgical workplace is going to play a big role in moving in the right direction. Join us for a great discussion!   Dr. Yates earned her medical degree from the University of Michigan Medical School. She is currently a General Surgery resident at Brigham and Women’s Hospital where she is now completing two years of protected research time at the Center for Surgery and Public Health while also pursuing a Masters in Public Health focused on Occupational and Environmental Health. She conducts interdisciplinary research examining the interface between surgery, sustainability, and climate change. Dr. Nguyen is a vascular surgeon at Brigham and Women’s Hospital and associate professor of surgery at Harvard Medical School. He earned his medical and business degrees from the University of Chicago Pritzker School of Medicine, completed his General Surgery residency at Barnes-Jewish Hospital in St. Louis, and completed a vascular surgery fellowship at the Brigham as well. He also currently serves as Vice Chair of Digital Health Systems in the Department of surgery. He is a recognized leader in health services research and outcomes implementation, where he utilizes econometric analyses to better understand clinical outcomes. Link to article: https://journals.lww.com/annalsofsurgery/Abstract/2021/06000/Empowering_Surgeons,_Anesthesiologists,_and.15.aspx Climate change and equity issues permeate all aspects of our life and work.  If you are (or know) a current general surgery resident, help us understand the equity and environmental impacts of residency interviews! https://redcap.link/gensurginterview Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

In this episode we will explore two challenging transplant surgery cases. In the first, we discuss Nutcracker syndrome and the unique ethical questions that accompanied a living donor case. In the second, we examine a perplexing post-operative development in a complicated liver transplant patient.  Learning Objectives ·       Understand the presentation and general treatment strategies for renal nutcracker syndrome ·       Discuss protocol and ethical considerations for living donor renal transplants ·       Review portal hypertension physiology, clinical manifestations, and options for treatment Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Chemotherapy or surgery first? What is the contemporary management for patients with locally advanced, resectable gastric cancer, and what does the data show? In this episode from the Surgical Oncology team at Behind the Knife, join the discussion on perioperative treatment of locally advanced gastric cancer and future advances that will benefit surgical patients.  Learning Objectives:  In this episode, we review perioperative chemotherapy regimens for locally advanced, resectable Gastric cancer, standard of care, and the future role for immunotherapy.  Hosts:  Adam Yopp, MD, FACS (@AdamYopp) is an Assistant Professor of Surgery at the UT Southwestern Medical Center and is Chief of the Division of Surgical Oncology. He also serves as Surgical Director of the Liver Tumor Program. Caitlin Hester, MD (@CaitlinAHester) is a 2nd Year Complex General Surgical Oncology Fellow at the MD Anderson Cancer Center. Gilbert Murimwa, MD (@GilbertZMurimwa) is a PGY-3 General Surgery Resident at the UT Southwestern Medical Center and a research fellow in the Hamon Center for Therapeutic Oncology Research. Papers Referenced in this Episode: Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial Al Batran et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/fulltext Efficacy and Safety of Pembrolizumab or Pembrolizumab Plus Chemotherapy vs Chemotherapy Alone for Patients With First-line, Advanced Gastric Cancer. The KEYNOTE-062 Phase 3 Randomized Clinical Trial Shitara et al https://jamanetwork.com/journals/jamaoncology/fullarticle/2769922 First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial Janjigian et al https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00797-2/fulltext Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss neuroblastoma management in pediatric surgery. Journal Article links:  Croteau N, Nuchtern J, LaQuaglia MP. Management of Neuroblastoma in Pediatric Patients. Surg Oncol Clin N Am 2021;30(2):291-304. https://pubmed.ncbi.nlm.nih.gov/33706901/ Madonna MB, Newman E. Handbook for Children with Neuroblastoma. Updated Spring 2018. Cancer Committee American Pediatric Surgical Association. 2018. https://www.pedsurglibrary.com/apsa/ub?cmd=repview&type=682-76&name=4_1884004_PDF https://www.pedsurglibrary.com/apsa/ub?cmd=repview&type=682-76&name=4_1884004_PDF Newman EA, Abdessalam S, Aldrink JH, Austin M, Heaton TE, Bruny J, et al. Update on neuroblastoma. J Pediatr Surg 2019;54(3):383-9. https://pubmed.ncbi.nlm.nih.gov/30305231/ Nuchtern JG, London WB, Barnewolt CE, Naranjo A, McGrady PW, Geiger JD, et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children's Oncology Group study. Ann Surg 2012;256(4):573-80. https://pubmed.ncbi.nlm.nih.gov/22964741/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

You are faced with a young patient with low rectal cancer who is a complete responder to neoadjuvant chemoradiotherapy. He asks if he should undergo surgical resection despite the absence of visible tumour. How do you approach such a question?  Join Dr. Carole Richard, Dr. François Dagbert and Dr. Maher Al Khaldi in their conversation about the Watch and Wait strategy for rectal cancer, also known as the Organ Preservation strategy.  Learning objectives  -       To understand the rationale for Watch and Wait Strategy and the proportion of patients who become complete clinical responders.  -       To explain how patients under the Watch and Wait Strategy protocol should be followed up and when to consider a patient a clinical nonresponder. -       To understand the inclusion criteria for patients in the Watch and Wait Strategy References In order throughout the episode [1–3]: 1. Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U, Sousa AHS e, et al. Operative Versus Nonoperative Treatment for Stage 0 Distal Rectal Cancer Following Chemoradiation Therapy. Transactions Meet Am Surg Assoc. 2004;122(NA;):309–16. 2. Valk MJM van der, Hilling DE, Bastiaannet E, Kranenbarg EM-K, Beets GL, Figueiredo NL, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet. 2018;391(10139):2537–45. 3. Fernandez LM, Julião GPS, Figueiredo NL, Beets GL, Valk MJM van der, Bahadoer RR, et al. Conditional recurrence-free survival of clinical complete responders managed by watch and wait after neoadjuvant chemoradiotherapy for rectal cancer in the International Watch & Wait Database: a retrospective, international, multicentre registry study. Lancet Oncol. 2021;22(1):43–50. Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Marginal ulcers are a common cause of abdominal pain following Roux-en-Y gastric bypass. Ever wonder how bariatric surgeons triage abdominal pain in post-bariatric surgery patients? A simplified approach to the work-up of these patients as well as the long-term management of marginal ulcers is included in this episode from your bariatric surgery team at UNMC! Journal Articles discussed: 1.     Opened Proton Pump Inhibitor Capsules Reduce Time to Healing Compared with Intact Capsules for Marginal Ulceration following Roux-en-Y Gastric Bypass: https://pubmed.ncbi.nlm.nih.gov/27773764/ 2.     Thoracoscopic Truncal Vagotomy versus Surgical Revision of the Gastrojejunal Anastomosis for Recalcitrant Marginal Ulcers: https://pubmed.ncbi.nlm.nih.gov/30132208/ Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.  

Behind the Knife ABSITE 2022 - high yield learning to help you DOMINATE the exam. Don't forget to check out our ABSITE Podcast Companion Book available on Amazon: https://www.amazon.com/Behind-Knife-ABSITE-Podcast-Companion/dp/0578802767/ref=sr_1_2?keywords=behind+the+knife+podcast&qid=1639489872&sr=8-2 If you like the work that Behind the Knife is doing please leave us a review wherever you listen to podcasts.    Visit behindtheknife.org to access podcasts, videos, CME, and more.