Ever wonder why some bariatric patients received extended VTE prophylaxis and others do not? Or what the ideal chemical VTE prophylaxis is for bariatric patients? All of your questions answered in this journal review discussion! Journal articles: A single-center comparison of extended and restricted thromboprophylaxis with LMWH after metabolic surgery: https://pubmed.ncbi.nlm.nih.gov/31641983/ Risk factors for postdischarge venous thromboembolism among bariatric surgery patients and the evolving approach to extended thromboprophylaxis with enoxaparin: https://pubmed.ncbi.nlm.nih.gov/33814315/

You’re faced with a challenging case of a patient with rectal cancer and synchronous liver lesion. Where do you start: chemotherapy, chemoradiotherapy, upfront surgery, liver first, rectum first?  Join Drs. Carole Richard, François Dagbert and Maher Al Khaldi as they discuss the management of a patient with rectal cancer with a synchronous hepatic metastasis.  Learning objectives In this episode, we discuss the workup of a rectal tumour associated with synchronous liver metastases, indications for resection of the hepatic lesion, neoadjuvant and adjuvant treatment modalities, survival benefit of resection and patient follow-up.   Reference list: Moulton C-A, Gu C-S, Law CH, Tandan VR, Hart R, Quan D, et al. Effect of PET Before Liver Resection on Surgical Management for Colorectal Adenocarcinoma Metastases: A Randomized Clinical Trial. JAMA. 2014;311(18):1863–9. Bahadoer RR, Dijkstra EA, Etten B van, Marijnen CAM, Putter H, Kranenbarg EM-K, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol. 2021;22(1):29–42.

"The eyes do not see what the mind does not know." Trauma surgery is riddled with pitfalls.  Take your guard down for a minute and BAM, you are eating humble pie.  Don't let this happen to you!   Join Drs. Bryan Cotton, Teddy Puzio, Krislynn Mueck, and host Patrick Georgoff for a fun, high-yield review.  In this episode (2 of 2), we cover:  Splenic pseudoaneurysm Compartment syndrome Urogenital injury Diaphragm injury Esophageal injury

Please join Drs. Brian Gray, Amanda Jensen and Manisha Bhatia from Indiana University as they discuss ovarian mass in pediatric surgery. Journal Article links:  Madenci AL, Vandewalle RJ, Dieffenbach BV, Laufer MR, Boyd TK, Voss SD, et al. Multicenter pre-operative assessment of pediatric ovarian malignancy. J Pediatr Surg 2019;54(9):1921-5. https://pubmed.ncbi.nlm.nih.gov/30867096/ Dasgupta R, Renaud E, Goldin AB, Baird R, Cameron DB, Arnold MA, et al. Ovarian torsion in pediatric and adolescent patients: A systematic review. J Pediatr Surg 2018;53(7):1387-91. https://pubmed.ncbi.nlm.nih.gov/29153467/

"The eyes do not see what the mind does not know." Trauma surgery is riddled with pitfalls.  Take your guard down for a minute and BAM, you are eating humble pie.  Don't let this happen to you!   Join Drs. Bryan Cotton, Teddy Puzio, Rushabh Dev, and host Patrick Georgoff for a fun, high-yield review.  In this episode (1 of 2), we cover:  Extraperitoneal rectal injury Blunt cerebrovascular injury Chance fractures Cardiac injuries with a negative FAST exam Missed injuries during trauma ex lap

The chief residents in your program are at their wits end with some of their colleagues. Residents are yelling at nurses, skin closures look like they’re from a horror movie and a patient almost died because of a delay in being seen. How can the chiefs and program director help these struggling residents? Join Drs. Kyla Terhune, Jeremy Lipman, Judith French and Amy Han as they discuss how to identify and support the struggling surgical resident. Learning objectives: After listening to this episode, the participant will be able to: Recall some of the assessment tools available to identify struggling residents Discuss strategies for identifying struggling surgical residents Provide guidance to a struggling surgical resident who is struggling

Tune in to listen to two of the BTK original founders, Dr. Jason Bingham and Dr. Scott Steele, as they discuss clinical challenges in colorectal surgery, specifically large bowel obstruction.   Want to win a free Behind the Knife ABSITE review book?  Simply leave us a review on Apple Podcasts before September 1st and you will be entered into the drawing.  Be sure to include your Twitter or Instagram handle in the review.  Or email us at BTKpodcast@gmail.com to let us know that you showed BTK some love.  DOMINATE THE DAY!

Incisional hernia is one of the most common long-term complications associated with surgical interventions. In this episode from the Hernia and Abdominal Wall Reconstruction team at Behind the Knife, we discuss evidence-based decision making to reduce incisional hernia rates following laparotomy. We review preoperative factors associated with hernia occurrence, intraoperative decision making related to fascial closure technique, and review literature on prophylactic mesh augmentation.  ·       Dr. Vahagn Nikolian is an Assistant Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair.  ·       Dr. Sean Orenstein is an Associate Professor of Surgery at Oregon Health & Science University, focused on abdominal wall reconstruction and hernia repair. ·       Dr. Emaad Iqbal is a resident in General Surgery at Columbia University Medical Center.  ·       Dr. Shahrose Rahman is a resident in General Surgery at Oregon Health & Science University.  Seminal Papers in Hernia Prevention Techniques STITCH Trial: https://pubmed.ncbi.nlm.nih.gov/26188742/ PRIMAAT Trial: https://pubmed.ncbi.nlm.nih.gov/26943336/ PRIMA Trial: https://pubmed.ncbi.nlm.nih.gov/28641875/   Want to win a free Behind the Knife ABSITE review book?  Simply leave us a review on Apple Podcasts before September 1st and you will be entered into the drawing.  Be sure to include your Twitter or Instagram handle in the review.  Or email us at BTKpodcast@gmail.com to let us know that you showed BTK some love.  DOMINATE THE DAY!

Welcome to the first of a six-part series focused on the integration of palliative care into the practice of surgery.  Dr. Geoffrey Dunn defines Surgical Palliative Care as “the treatment of suffering and the promotion of quality of life for seriously ill or terminally ill patients under surgical care.”  He has proposed that the Family Meeting is like a surgical procedure in which we “Prepare, Do and Close.”  Using the case of a geriatric trauma patient in multi-system organ failure, in this episode we discuss how to run a family meeting, how to discuss code status and how to discuss goals of care. Family Meeting: Fast Fact #16:  Moderating the Family Meeting https://www.mypcnow.org/fast-fact/moderating-an-end-of-life-family-conference/ Fast Fact #222:  The Family Meeting Part 1- Preparing https://www.mypcnow.org/fast-fact/the-family-meeting-part-1-preparing/ Fast Fact #223: The Family Meeting Part 2- Starting the Conversation https://www.mypcnow.org/fast-fact/the-family-meeting-part-2-starting-the-conversation/ Fast Fact #227: The Family Meeting Part 6-  Goal Setting and Future Planning https://www.mypcnow.org/fast-fact/the-family-meeting-part-6-goal-setting-and-future-planning/ In-hospital CPR: CPR in adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation https://pubmed.ncbi.nlm.nih.gov/12969608/ Development and validation of the good outcome following attempted resuscitation (GO-FAR) score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation https://pubmed.ncbi.nlm.nih.gov/24018585/ 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.   FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLSfxhjxgCE9Ek263XuGkpqqbaNiK9sVnu3M7_LFYUZxhr38SZw/viewform Want to win a free Behind the Knife ABSITE review book?  Simply leave us a review on Apple Podcasts before September 1st and you will be entered into the drawing.  Be sure to include your Twitter or Instagram handle in the review.  Or email us at BTKpodcast@gmail.com to let us know that you showed BTK some love.  DOMINATE THE DAY!

Behind the Knife – ACS Cancer Surgery Standards Program Host: Shreya Gupta, MD (@shreyaguptaMD)  Guests: Mediget Teshome, MD, MPH, FACS (@drmediget) is an Assistant Professor in the Department of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center. She is the Chair of the Education Committee of the Cancer Surgery Standards Program (CSSP). Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center. He is the Vice Chair of the Education Committee of the CSSP. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-4 General Surgery resident at Brooke Army Medical Center and a member of the Education Committee of the CSSP. Description: The American College of Surgeons Cancer Surgery Standards Program is an initiative to improve the quality of cancer surgery by implementing evidence-based operative standards and its associated documentation. This episode discusses the CSSP’s role in not only enhancing the quality of care for patients, but also providing educational tools for trainees, resources for community surgeons caring for cancer patients, and a vehicle for research.  Learning Objectives In this episode, we learn about the mission and vision of the American College of Surgeons Cancer Surgery Standards Program and the associated operative standards. We discuss the current rollout of standards 5.7 and 5.8, concerning synoptic pathology reporting of total mesorectal excision for mid/low rectal cancer and mediastinal and hilar lymph node sampling in lung cancer. In addition, we discuss future implementation of synoptic operative reporting standards for melanoma, breast cancer, and colon cancer. These standards are important not only for the sub-specialist, but also to surgical residents and any general surgeon that cares for cancer patients. Resources Referenced in this Episode The ACS CSSP homepage: facs.org/cssp Operative Standards for Cancer Surgery – find it on Amazon!             Volume 1: Breast, Lung, Pancreas, Colon             Volume 2: Thyroid, Gastric, Rectum, Esophagus, Melanoma Follow CSSP on Twitter at @AmColSurgCancer, with the hashtag #CSSP FELLOWSHIP APPLICATION: https://docs.google.com/forms/d/e/1FAIpQLSfxhjxgCE9Ek263XuGkpqqbaNiK9sVnu3M7_LFYUZxhr38SZw/viewform Want to win a free Behind the Knife ABSITE review book?  Simply leave us a review on Apple Podcasts before September 1st and you will be entered into the drawing.  Be sure to include your Twitter or Instagram handle in the review.  Or email us at BTKpodcast@gmail.com to let us know that you showed BTK some love.  DOMINATE THE DAY!