Hey APPs - Are you ready to DOMINATE surgery?  Well let's go!  Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos.  Go beyond rote memorization and learn what really matters.  We are talking practical, high-yield, and engaging content all available at your fingertips.  Get the information you need to know FAST.  Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered.   

Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation Course Link: https://app.behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation

Hey APPs - Are you ready to DOMINATE surgery?  Well let's go!  Perform at the highest level on day one of your rotation using our easy to navigate text, tables, flashcards, podcasts, and videos.  Go beyond rote memorization and learn what really matters.  We are talking practical, high-yield, and engaging content all available at your fingertips.  Get the information you need to know FAST.  Whether it's learning how to two-hand tie, work up a patient with a colon mass, or organizing yourself for rounds, Behind the Knife has got you covered.   

Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation Course Link: https://app.behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation

In this episode, the Surgical Endoscopy team, accompanied by Chief Medical Officer Dr. Brian Dunkin of Boston Scientific, review primary and revisional endoscopic treatment options for bariatric patients. They focus on the emerging data available for procedures such as endoscopic sleeve gastroplasty (ESG) and endoscopic gastrojejunal revision (EGJR) and offer technical tips on how to perform the procedures. In addition, they discuss accessibility challenges for patients and provide insight into the future direction of bariatric endoscopy as a field. 

Hosts:

·      Dr. Sullivan “Sully” Ayuso, Minimally Invasive Surgery, Endeavor Health (Evanston, IL), @SAyusoMD (Twitter)

·      Dr. Trevor Crafts, Minimally Invasive Surgeon, Rocky Mountain VA Medical Center (Denver, CO), @CraftsTrevor (Twitter) 

·      Dr. H. Masson Hedberg, Minimally Invasive Surgeon, Endeavor Health (Evanston, IL)

·      Dr. Michael Ujiki, Professor and Louis Biegler Chair of Surgery, Endeavor Health (Evanston, IL), @UjikiMike

·      Dr. Brian Dunkin, Chief Medical Officer at Boston Scientific, @briandunkinmd

Learning Objectives: 

-       Identify and Describe Common Endobariatric Procedures: Learners will be able to name and briefly describe at least three common endobariatric procedures discussed in the episode, including Endoscopic Sleeve Gastroplasty (ESG), Endoscopic GJ Revisions (Transoral Outlet Reduction - TORR/EGJR), and Intragastric Balloons, along with their historical context and evolution.

-       Explain the Mechanism and Benefits of Endoscopic Sleeve Gastroplasty (ESG): Learners will be able to articulate the procedural technique of ESG, including the U-shaped suture pattern, its impact on gastric volume reduction, and the proposed mechanisms of weight loss, such as slowed gastric emptying and hormonal changes, as compared to laparoscopic sleeve gastrectomy.

-       Discuss the Role of Technology and Training in Endobariatrics: Learners will be able to explain the significance of endoscopic suturing devices like the Overstitch in the advancement of endobariatric procedures and recognize the importance of specialized training, including the recommendations against fundal suturing for safety during the initial learning curve.

-       Compare and Contrast Endobariatric Procedures with Surgical and Pharmacological Obesity Treatments: Learners will be able to discuss the position of endobariatric procedures as a "gap therapy" in the spectrum of obesity treatments, highlighting their benefits such as reduced invasiveness, lower complication rates, faster recovery, and increased patient access compared to surgery, as well as their potential role in conjunction with pharmacologic therapies like GLP-1 agonists.

-       Recognize Key Considerations and Potential Complications of Endobariatric Procedures: Learners will be able to identify important technical considerations during ESG, such as achieving full-thickness bites while avoiding injury to adjacent organs, and describe common post-procedure issues associated with intragastric balloons, including nausea, vomiting, and the need for general anesthesia during removal.

Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity: https://pubmed.ncbi.nlm.nih.gov/39888616/

** VIDEO LINK: https://app.behindtheknife.org/video/surgical-endoscopy-series-ep-2-endobariatrics

Surgical Endoscopy Series Ep. 1: An Introduction to Surgical Endoscopy: https://app.behindtheknife.org/podcast/surgical-endoscopy-series-ep-1-an-introduction-to-surgical-endoscopy

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://app.behindtheknife.org/listen

Thinking about doing an away rotation? In this episode of Behind the Knife, we break down everything you need to know about away rotations and sub-internships. From how to apply and what to expect to making a great impression and building connections, we’ve got you covered. Plus, we discuss whether you should even do an away rotation at all and how to decide if it's the right move for your application. We’re joined by a fantastic and diverse group of general surgery residents who share their insights, tips, and experiences.

–Dr. Josh Roshal, University of Texas Medical Branch, @Joshua_Roshal, [email protected]

–Dr. Colleen McDermott, University of Utah, @ColleenMcDMD, [email protected]

–Dr. Sophia Williams-Perez, Baylor College of Medicine, @SophWPerez, [email protected]

–CoSEF: @surgedfellows, cosef.org

Dr. Steven Thornton, Duke University Medical Center, @swthorntonjr

Dr. Nicole Santucci, Washing University in St. Louis, @nicolemsantucci 

Abbas Karim, MS3, University of Texas Medical Branch, @_AbbasKarim

Reagan Collins, MS4, Texas Tech University Health Sciences Center, @ReaganACollins, [email protected]

Dr. Annie Hierl, Indiana University, @annie_hierl

[email protected] 

Dr. Jorge Zarate Rodriguez, Washington University in St Louis, @jzaraterod, [email protected] 

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

Listen as we discuss the highly-awaited ESOPEC trial, which examines treatment regimens for esophageal and EGJ adenocarcinoma. Wildly impress your thoracic attendings or peers with your nuanced knowledge! FLOT who? You’ll know. Pull out the paper and listen along!

-Discuss the patient population in the ESOPEC trial

-Discuss the main differences between the ESOPEC trial and the CROSS trial

-Describe the main drawbacks between FLOT and the CROSS regimen.

Chloe Hanson MD, Brian Louie MD, and Peter White MD  

https://www.nejm.org/doi/full/10.1056/NEJMoa2409408

Hoeppner J, Brunner T, Schmoor C, Bronsert P, Kulemann B, Claus R, Utzolino S, Izbicki JR, Gockel I, Gerdes B, Ghadimi M, Reichert B, Lock JF, Bruns C, Reitsamer E, Schmeding M, Benedix F, Keck T, Folprecht G, Thuss-Patience P, Neumann UP, Pascher A, Imhof D, Daum S, Strieder T, Krautz C, Zimmermann S, Werner J, Mahlberg R, Illerhaus G, Grimminger P, Lordick F. Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer. N Engl J Med. 2025 Jan 23;392(4):323-335. doi: 10.1056/NEJMoa2409408. PMID: 39842010.

https://www.nejm.org/doi/full/10.1056/NEJMoa1112088

van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Cuesta MA, Blaisse RJ, Busch OR, ten Kate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van der Sangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van der Gaast A; CROSS Group. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012 May 31;366(22):2074-84. doi: 10.1056/NEJMoa1112088. PMID: 22646630.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32557-1/abstract

Al-Batran SE, Homann N, Pauligk C, Goetze TO, Meiler J, Kasper S, Kopp HG, Mayer F, Haag GM, Luley K, Lindig U, Schmiegel W, Pohl M, Stoehlmacher J, Folprecht G, Probst S, Prasnikar N, Fischbach W, Mahlberg R, Trojan J, Koenigsmann M, Martens UM, Thuss-Patience P, Egger M, Block A, Heinemann V, Illerhaus G, Moehler M, Schenk M, Kullmann F, Behringer DM, Heike M, Pink D, Teschendorf C, Löhr C, Bernhard H, Schuch G, Rethwisch V, von Weikersthal LF, Hartmann JT, Kneba M, Daum S, Schulmann K, Weniger J, Belle S, Gaiser T, Oduncu FS, Güntner M, Hozaeel W, Reichart A, Jäger E, Kraus T, Mönig S, Bechstein WO, Schuler M, Schmalenberg H, Hofheinz RD; FLOT4-AIO Investigators. 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. Lancet. 2019 May 11;393(10184):1948-1957. doi: 10.1016/S0140-6736(18)32557-1. Epub 2019 Apr 11. PMID: 30982686.

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen

In 2002 a group of surgeons got together and radically changed surgical training forever. They just got together again...

They call themselves the Blue Ribbon Committee. When they met in 2002 they addressed critical issues such as residency structure, specialization, work-life balance, and simulation-based training. Now, with rapid advancements in medicine and education, BRC II has revisited these topics and introduced new priorities to ensure that surgical education meets the demands of the modern era.

In this episode, we are joined by Dr. Steven Stain, co-chair of BRC II and a leader in surgical education. Dr. Stain shares insights into the motivations behind the second committee, its key findings, and how competency-based education, entrustable professional activities (EPAs), and other innovations are shaping the future of surgical training.

Join hosts Pooja Varman MD, Judith French PhD, and Jeremy Lipman MD, MHPE for an engaging discussion on what surgical educators, trainees, and institutions need to know about the new recommendations from BRC II and the future of surgical education.

Learning Objectives

By the end of this episode, listeners will be able to 

1.     Under the origins and impact of the first Blue Ribbon Committee (BRC I)

2.     Explain the factors that led to the formation of the BRC II and its major recommendations

3.     Identify challenges and opportunities in modern surgical education

4.     Discuss the role of competency-based education and EPAs in training future surgeons

5.     Recognize how institutions and educators can adapt to BRC II recommendations

References

1.     Recommendations on Surgical Education and Training in the United States: 2024. Ann Surg. 2024;280(4):535. doi:10.1097/SLA.0000000000006360 https://pubmed.ncbi.nlm.nih.gov/38814074/

2.     Blue Ribbon Committee II Advises Sweeping Changes in Surgical Education. ACS. Accessed January 12, 2025. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2024/may-2024-volume-109-issue-5/blue-ribbon-committee-ii-advises-sweeping-changes-in-surgical-education/

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen

Join Drs. Galandiuk, Bolshinsky, Kavalukas, and Simon, with guest Dr. Farr Nezhat, as they discuss management, surgical treatment, and outcomes of bowel endometriosis.  Come with us as we learn from expert Dr. Nezhat’s experience and discuss the importance of interdisciplinary approach to bowel endometriosis. 

- Susan Galandiuk, University of Louisville, Louisville, KY, @DCREdInChief

- Vladimir Bolshinsky, Peninsula Health, Victoria, Australia, @bolshinskyv

- Sandy Kavalukas, University of Louisville, Louisville, KY, @sandykava

- Hillary Simon, University of Louisville, Louisville, KY, @HillaryLSimon

- Farr Nezhat, Nezhat Surgery for Gynecology/Oncology (Cornell/NYU), New York, NY

-  Manasa Sunkara MS4, University of Louisville, Louisville, Kentucky, @manasasunkara12

-  Review pathophysiology of endometriosis.

- Understand key goals of bowel endometriosis treatment. 

- Discuss interdisciplinary surgical care and outcomes of bowel endometriosis. 

1.     Tsuei A, Nezhat F, Amirlatifi N, Najmi Z, Nezhat A, Nezhat C. Comprehensive Management of Bowel Endometriosis: Surgical Techniques, Outcomes, and Best Practices. J Clin Med. 2025 Feb 3;14(3):977. doi: 10.3390/jcm14030977 https://pubmed.ncbi.nlm.nih.gov/39941647/

2.     Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H. Surgical Outcomes after Colorectal Surgery for Endometriosis: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2021 Mar;28(3):453-466. doi: 10.1016/j.jmig.2020.08.015. https://pubmed.ncbi.nlm.nih.gov/32841755/

3.     Erdem S, Imboden S, Papadia A, Lanz S, Mueller MD, Gloor B, Worni M. Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results. Dis Colon Rectum. 2018 Jun;61(6):733-742. doi: 10.1097/DCR.0000000000001047. https://pubmed.ncbi.nlm.nih.gov/29664797/

4.     Nasseri Y, Ma R, Fani N, La K, Solis-Pazmino P, Xu V, Siedhoff MT, Wright KN, Schneyer R, Hamilton KM, Barnajian M, Meyer R. The impact of surgeon specialty on surgical outcomes following colorectal resection for endometriosis. Colorectal Dis. 2025 Feb;27(2):e70028. doi: 10.1111/codi.70028.  https://pubmed.ncbi.nlm.nih.gov/39949080/

5.     Chua, Heidi, and Michael J Snyder. "Endometriosis.” ASCRS Textbook of Colon and Rectal Surgery, 4th ed., Springer Nature Switzerland AG, 2022. ASCRS U, www.ascrsu.com/ascrs/view/ASCRS-Textbook-of-Colon-and-Rectal-Surgery/2285036/all/Endometriosis.

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen

BIG T TRAUMA is back with more TRAUMA PITFALLS!  Join Drs. Teddy Puzio (University of Texas in Houston), Jason Brill (Tripler Army Medical Center), Patrick Georgoff (Duke University, @georgoff) and special guest Dr. Tyler Simpson (Trauma Fellow at Duke University) for a fast-moving, no-nonsense discussion on the many pitfalls you are bound to encounter in the high-stakes world of trauma surgery.  Remember, the eyes do not see what the mind does not know...

More from the BIG T series: https://app.behindtheknife.org/podcast-series/big-t-trauma

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.

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen

BIG T TRAUMA is back with more TRAUMA PITFALLS!  Join Drs. Teddy Puzio (University of Texas in Houston), Jason Brill (Tripler Army Medical Center), Patrick Georgoff (Duke University, @georgoff) and special guest Dr. Jared Ourieff (Trauma Fellow at University of Texas in Houston) for a fast-moving, no-nonsense discussion on the many pitfalls you are bound to encounter in the high-stakes world of trauma surgery.  Remember, the eyes do not see what the mind does not know...

More from the BIG T series: https://app.behindtheknife.org/podcast-series/big-t-trauma

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.

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen

In the third episode of our rural surgery series, Dr. Cody Mullens meets with Dr. Randy Lehman, a rural general surgeon from Rensselaer, Indiana to discuss rural practice, lifestyle, resources, and tips & tricks for general surgery residents interested in pursuing rural practice.

The Rural American Surgeon Podcast and Contact:  https://www.theruralamericansurgeon.com/

The North American Rural Surgery Society: https://www.northamericanrss.org/

***Fellowship Application Link: https://forms.gle/PQgAvGjHrYUqAqTJ9

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://app.behindtheknife.org/listen