In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Liu, MD, MS, MPH, from the Department of Surgery, Harbor UCLA Medical Center. They discuss Dr Liu’s recent article, “Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review,” in which the authors identified the current diagnostic issues, clinical tools, and clinician feedback strategies in the older adult emergency general surgery (EGS) setting. While challenges unique to older adults exist, variability in the use of tools to improve identification of older adult conditions in EGS and gaps in feedback to improve diagnosis remain.

Disclosure Information: Drs Erdahl and Liu have nothing to disclose.

To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.

Liu, Jessica K MD, MS, MPH; Peters, Xane D MD, MS; Remer, Sarah L MD; Beestrum, Molly MLIS; Cooper, Zara MD, FACS, MPH; Russell, Marcia M MD, FACS; Hall, Bruce L MD, FACS, PhD; Ko, Clifford Y MD, FACS, MSHS, MS. Identifying Diagnostic Gaps and Mitigation Strategies for Older Adult Emergency General Surgery Patients: A Scoping Review. Journal of the American College of Surgeons 241(5):p 904-916, November 2025. | DOI: 10.1097/XCS.0000000000001480

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

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In this episode, JACS Editor-in-Chief Tom Varghese, MD, FACS, and Digital Media Editor Lillian Erdahl, MD, FACS, review 6 impactful articles from the past year, highlighting key themes shaping modern surgical practice. Dr Erdahl focuses on the surgeon as a subject, discussing research on moral distress, second-victim syndrome, health policy challenges, and peer surgical coaching. Dr Varghese then explores advances in surgical science, including pragmatic applications of artificial intelligence for risk prediction and operative documentation, as well as comparative evidence on robotic, laparoscopic, and open operation. Together, they emphasize clinically relevant research, thoughtful innovation, and ongoing critical inquiry to support surgeons and improve patient care. Listen to the podcast episodes mentioned at facs.org/operative-word.

Articles discussed:

Disclosure Information: Drs Varghese and Erdahl have nothing to disclose.

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

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In this episode, Tom Varghese, MD, FACS, is joined by Ziad Sifri, MD, FACS, from Rutgers New Jersey Medical School, and Matthew Linz, MD, from Rutgers Robert Wood Johnson Medical School. They discuss Drs Sifri and Linz’s recent article, “Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons,” in which they found that surgeons in the US prescribe significantly more opioids after inguinal hernia repair compared with when they operate on short-term surgical trips to low- and middle-income countries, despite continued efforts to reduce opioid overprescription in the US.

Disclosure Information: Drs Varghese, Linz, and Sifri have nothing to disclose.

Linz, Matthew S MD1; Parvin-Nejad, Fatemeh P MD2; Srinivasan, Nivetha MD3; Vegunta, Geetasravya MD1; Eng, Ashley K BS1; Kim, Eugene BA MBS; Alexander, Imani BS1; Elgammal, Fatima MD2; Benson, Ryan MD2; Benneh, Albert Y MD4; Gyakobo, Mawuli K MD5,6; Lopez, Lorena MD7; Jalloh, Samba MD8; Sifri, Ziad C MD FACS2. Postoperative Pain Management in the US vs Low-and-Middle-Income Countries by US Surgeons. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001538, July 30, 2025. | DOI: 10.1097/XCS.0000000000001538

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

In this episode, Lillian Erdahl, MD, FACS, is joined by Eilidh Gunn, MBChB MRCSEd, from the Surgical

Disclosure Information: Drs Gunn and Erdahl have nothing to disclose.

Gunn, Eilidh GM MBChB MRCSEd1; Sinyard, Robert D MD MBA2; Cummins, Emily R PhD3; Yule, Steven PhD4; Smink, Douglas S MD, MPH, FACS5. What About the Coach? Mixed-Methods Study Assessing the Experience of Coaches in a Peer Surgical Coaching Program. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001506, July 24, 2025. | DOI: 10.1097/XCS.0000000000001506 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

In this episode, Lillian Erdahl, MD, FACS, is joined by Jordan Rook, MD, from UCLA, and Lorraine Kelley-Quon, MD, FACS, from Children’s Hospital Los Angeles and Keck School of Medicine of USC. They discuss Drs Rook and Kelley-Quon’s recent article, “Expanding the Public Health Role of Pediatric Trauma Centers: Drug Screening for Adolescent Trauma Patients,” in which the authors found that biochemical drug screening for injured adolescents is decreasing at pediatric trauma centers, despite increasing national adolescent overdose deaths. Given high rates of substance use among injured adolescents, this is a missed opportunity to intervene on problematic substance use and prevent future adolescent overdose deaths.

Disclosure Information: Drs Rook, Kelley-Quon, and Erdahl have nothing to disclose.

Rook, Jordan M MDa,b; Spurrier, Ryan G MD FACSc,d; Lee, Jenna S MDc; Safavi, Arash MD MHSC FACSc,d; Barrington-Trimis, Jessica PhDe; Ignacio, Romeo C MD MS MPath FACSf; Juillard, Catherine J MD MPH FACSa; Kelley-Quon, Lorraine I MD MS FACSc,d,e. Expanding the Public Health Role of Pediatric Trauma Centers: Drug Screening for Adolescent Trauma Patients. Journal of the American College of Surgeons ():10.1097/XCS.0000000000001596, August 22, 2025. | DOI: 10.1097/XCS.0000000000001596 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

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In this episode, Tom Varghese, MD, FACS, is joined by Timothy Pawlik, MD, FACS, from The Ohio State University. They discuss Dr Pawlik’s recent article, “Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Cost,” in which the authors found that discharge against medical advice (DAMA) among surgical patients is associated with increased 30-day readmission, complication, fragmented care, and higher healthcare cost. DAMA patients were younger, socioeconomically vulnerable, and often had substance use or psychiatric disorders.  

Disclosure Information: Drs Varghese and Pawlik have nothing to disclose. 

To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.

Sarfraz, Azza MBBS; Khalil, Mujtaba MD; Woldesenbet, Selamawit PhD; Altaf, Abdullah MD; Rashid, Zayed MD; Zindani, Shahzaib MD; Kawashima, Jun MD; Pawlik, Timothy M MD, PhD, MPH, MTS, MBA, FACS. Association of Discharge Against Medical Advice with Surgical Outcomes and Healthcare Costs. Journal of the American College of Surgeons 241(5):p 822-832, November 2025. | DOI: 10.1097/XCS.0000000000001469 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. 

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In this episode, Lillian Erdahl, MD, FACS, is joined by Stephanie M Jensen, MD, MPH, and A Britt Christmas, MD, MBA, FACS, from the Carolinas Medical Center, Charlotte, NC. They discuss the recent article by Drs Jensen and Christmas, “Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes,” in which the authors analyzed a decade of motorcycle collision data from an American College of Surgeons-verified Level I Trauma Center positioned at the border of 2 states with differing motorcycle helmet laws. The study found that helmeted patients had reduced injury severity, and that state helmet laws significantly influence

Jensen, Stephanie M MD, MPH; Ricker, Ansley MD; Sing, Ronald F DO, FACS; Ross, Sam MD, MPH, FACS; Cunningham, Kyle W MD, MPH, FACS; Christmas, A Britton MD, MBA, FACS. Association of State Helmet Laws with Helmet Use and Injury Outcomes in Motorcycle Crashes. Journal of the American College of Surgeons 241(3):p 418-425, September 2025. | DOI: 10.1097/XCS.0000000000001400 

In this episode, Tom Varghese, MD, FACS, is joined by Brett Johnson, MD, and Clifford Ko, MD, FACS, from the American College of Surgeons (ACS). They discuss the recent article by Drs Johnson and Ko, “Evaluating Outcomes of Initial Site Visits Across American College of Surgeons Accreditation Programs,” in which the authors found that ACS accreditation identifies significant gaps in hospital quality, with only 61% of hospitals passing on their initial attempt. However, most ultimately succeed after remediation. These findings highlight that ACS accreditation both validates hospitals meeting rigorous standards and drives quality improvement in those that initially fall short.

Disclosure Information: Drs Varghese, speaker, has no relevant financial conflicts to disclose. Drs Johnson and Ko, speakers, are employees of the American College of Surgeons.

Johnson, Brett A MD, MS, MS; Hobika, Geoffrey G MD; McNamara, Erica J MPH, MM; Ko, Clifford Y MD, MS, MSHS, FACS. Evaluating Initial Site Visit Pass Rate Across American College of Surgeons Accreditation Programs. Journal of the American College of Surgeons 241(4):p 594-600, October 2025. | DOI: 10.1097/XCS.0000000000001441 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

In this episode, Tom Varghese, MD, FACS, is joined by Todd Heniford, MD, FACS, and Alexis Holland, MD, from the Carolinas Medical Center. They discuss the recent article by Drs Heniford and Holland, “Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?” This study supports the implementation of preoperative optimization and weight loss before hernia surgery, which remains controversial. Long-term maintenance of preoperative weight loss before abdominal wall reconstruction is achievable and sustainable.

Disclosure Information: Drs Varghese and Holland have nothing to disclose. Dr Heniford is a surgical research grant recipient and receives speaking honoraria from WL Gore.

To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.

Holland, Alexis M MD; Lorenz, William R MD; Ayuso, Sullivan A MD; Katzen, Michael M MD; Kundu, Souma MD, MPH; Rosas, David A MD, MBA; Mead, Brittany S MD; Scarola, Gregory T MS; Augenstein, Vedra A MD, FACS; Heniford, B Todd MD, FACS. Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?. Journal of the American College of Surgeons 241(2):p 171-179, August 2025. | DOI: 10.1097/XCS.0000000000001348 

Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.

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In this episode, Tom Varghese, MD, FACS, is joined by Haytham Kaafarani, MD, MPH, FACS, and Vahe Panossian, MD, from the Department of Surgery, Massachusetts General Hospital and Harvard Medical School. They discuss the recent article by Drs Kaafarani and Panossian, “Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study.” This study found that POTTER accurately predicts mortality and postoperative complication, and the superior accuracy, user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative counseling. 

Disclosure Information: Drs Varghese and Panossian have nothing to disclose. Dr Kaafarani receives honoraria payments from UpToDate. The POTTER calculator is available online for free, and Dr Kaafarani has not been compensated for the development or ongoing use of the calculator. 

Panossian, Vahe S MD; Argandykov, Dias MD; Arnold, Suzanne C MD; Gebran, Anthony MD; Paranjape, Charudutt N MD, FACS; Hwabejire, John O MD, MPH, FACS; DeWane, Michael P MD; Velmahos, George C MD, PhD, FACS; Kaafarani, Haytham MA MD, MPH, FACS;  for the POTTER Validation Group. Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study. Journal of the American College of Surgeons 240(3):p 254-262, March 2025. | DOI: 10.1097/XCS.0000000000001234