Journal Review in Thoracic Surgery: The Prehab Prescription- Evidence, Implementation, and Advocacy

Psst… wanna hear some tea? Join Drs. Maya Hunt, John Woodward, and Cait Silvestri as they discuss gossip - what it is, what it means, and how it can impact the surgical training environment. Joined by authors of a recent paper deconstructing gossip in surgical residency, Dr. Bobbi Ann Adair White and former CoSEF leader Dr. Joseph L’Huillier, the team examines the ways gossip can be positive and negative, how we can mitigate the harms that come with it, and reflect on some of our own experiences with gossip as trainees. Episode Hosts: - Dr. Maya Hunt, Indiana University, [email protected] - Dr. John Woodward, University at Buffalo, @JohnWoodward76, [email protected] -  Dr. Cait Silvestri, Columbia University, @CaitSilvestri, [email protected]  -  CoSEF: @surgedfellows, cosef.org   Guests: -  Dr. Joseph L’Huillier, University of Buffalo, @JoeLHuillier101, [email protected] -  Dr. Bobbi Ann Adair White, MGH Institute of Health Professions, @_BAAW_, [email protected]  Learning Objectives: -  Define gossip in the context of surgical education, distinguishing between its academic definition and common perceptions -  Identify how forms of gossip can be constructive, as well as destructive - Explore the process model of gossip in surgical residency programs, including what choices recipients have when receiving gossip -  Recognize environmental factors that contribute to gossip in surgical settings - Apply practical strategies to mitigate harmful gossip in training environments References: - L'Huillier JC, Silvestri C, Brian R, et al. The Anatomy of Gossip: Dissecting Dynamics and Impacts in Surgical Residency. Surgery. 2025;180:109126. doi:10.1016/j.surg.2024.109126 https://pubmed.ncbi.nlm.nih.gov/39862712/ - L'Huillier JC, Woodward JM, Lund S, et al. Is it gossip or feedback? Surgical attendings' perceptions of gossip within residency. J Surg Educ. 2024;81(10):1362-1373. doi:10.1016/j.jsurg.2024.07.004 https://pubmed.ncbi.nlm.nih.gov/39173427/ 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Ductal carcinoma in situ (DCIS) represents a clinical crossroads in breast surgery—balancing the risks of over-treatment with the need to prevent invasive cancer. With new data from active monitoring trials, the pressure is on for surgeons to personalize care. Tune in to this essential episode to stay ahead of the curve on DCIS management and to hear expert insights from two leading breast surgical oncologists. Hosts: - Rashmi Kumar, MD, PhD Resident, University of Michigan General Surgery Residency Program Twitter/X: @RashmiJKumar - Melissa Pilewskie, MD Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine Twitter/X: @MPilewskie -  Stephanie Downs-Canner, MD Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program Twitter/X: @SDownsCanner Learning Objectives: - Define DCIS and explain its significance as a precursor to invasive breast cancer. - Discuss challenges in diagnosing and risk-stratifying DCIS. - Review current standards for surgical and adjuvant management of DCIS. - Understand the implications of new research, including the COMET trial, for low-risk DCIS. - Evaluate patient-centered strategies for managing DCIS and preventing over-treatment. References: - Worni M, Akushevich I, Greenup R, et al. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ. J Natl Cancer Inst. 2015;107(12):djv263. PubMed - Francis A, Thomas J, Fallowfield L, et al. Addressing overtreatment of screen detected DCIS; the LORIS trial. Eur J Cancer. 2015 Jan;51(16):2296-303. PubMed - Elshof LE, Tryfonidis K, Slaets L, et al. Feasibility of a non-surgical management strategy for low-grade DCIS: The LORD study. Eur J Cancer. 2015;51(12):1497–1510. PubMed - Toss MS, et al. Ductal carcinoma in situ (DCIS): current management and future directions. Cancer Treat Rev. 2020;90:102091. PubMed - Comparative Effectiveness of Surgery versus Active Monitoring for Low-Risk DCIS (COMET) Trial Results. Early COMET Results: King TA, et al. Surgical excision versus active monitoring for low-risk ductal carcinoma in situ (DCIS): 2-year results of the COMET randomized trial. J Clin Oncol. 2024; e2400110. PubMed 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://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Welcome back our series on AI for the clinician! In this episode, we go over some basics of machine learning statistics with the goal to help you read and analyze contemporary studies. Some of this will be a review, and parts will be technical, but by the end we hope reading these studies is less daunting.  Hosts: Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery.  Julie Doberne, MD, PhD: @juliedoberne Julie Doberne is an Assistant Professor of Surgery, Assistant Professor of Medical Informatics and Clinical Epidemiology, cardiothoracic surgeon, and faculty member of the Surgical Data and Decision Sciences Lab at Oregon Health and Science University.  Phillip Jenkins, MD: @PhilJenkinsMD Phil Jenkins is a general surgery PGY-4 at Oregon Health and Science University and a National Library of Medicine Post-Doctoral fellow pursuing a master’s in clinical informatics.  Steven Bedrick, PhD: @stevenbedrick Steven Bedrick is a machine learning researcher and an Associate Professor in Oregon Health and Science University’s Department of Medical Informatics and Clinical Epidemiology.  Shelby Willis, MD Shelby Willis is a general surgery PGY-4 at Oregon Health and Science University. She is currently in her research time in the Surgical Data and Decision Sciences lab at OHSU pursuing advanced training in informatics. 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://behindtheknife.org/listen BTK Fan Favorites:  General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In the second episode of this new collaboration between BTK and Annals of surgery, we discuss another hot topic: academic surgery. Specifically, we discuss dedicated research time for residents and how surgical leaders think about building the academic surgery enterprise. This discussion was inspired by a couple of recent papers in Annals of Surgery that stirred up a lot of conversation on social media which can be found below.  Host: Cody Mullens, MD MPH — general surgery resident at University of Michigan current BTK Surgery Education Fellow (@Cody_Mullens) Guest: Justin Dimick, MD MPH — Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of you Michigan and Editor in Chief at Annals of Surgery (@jdimick1) Papers:  Career Trajectory After General Surgery Residency Do Academic Program Graduates Pursue Academic Surgery? https://journals.lww.com/annalsofsurgery/abstract/2025/05000/career_trajectory_after_general_surgery_residency_.10.aspx Training the Surgeon-scientist: Time (and Money) Well Spent? https://journals.lww.com/annalsofsurgery/citation/9900/training_the_surgeon_scientist__time__and_money_.1318.aspx Introducing a New Annals of Surgery Section Professional Development for the Contemporary Surgeon https://journals.lww.com/annalsofsurgery/fulltext/2025/08000/introducing_a_new_annals_of_surgery_section_.8.aspx 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://behindtheknife.org/listen BTK Fan Favorites:  General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this episode of Behind the Knife, Dr. Patrick Georgoff sits down with Dr. Keri Seymour and Dr. Joey Lew to tackle the complex world of gastrostomy tubes. What may seem like a routine and straightforward procedure is anything but—full of nuanced patient considerations, timing dilemmas, technical challenges, and potential complications that can turn a “simple” consult into a 2 a.m. call you won’t forget. From who truly needs a G tube and when to managing difficult post-op issues like dislodgement and buried bumper syndrome, this episode breaks down the practical, evidence-based approach every surgeon should know. Whether you’re managing stroke patients, trauma cases, or navigating the tricky administrative obstacles around enteral access, this episode will equip you with the insights and strategies to confidently dominate your G tube consults. Hosts:  ·      Dr. Patrick Georgoff (Acute Care Surgeon, Duke University) ·      Dr. Keri Seymour (Minimally Invasive & Acute Care Surgeon, Duke Regional) ·      Dr. Joey Lew (Surgical Resident, BTK MIS Team) Learning Goals: By the end of this episode, listeners will be able to:  ·      Understand the nuanced indications for gastrostomy tube (G tube) placement. ·      Learn which patients truly benefit from G tubes, and when enteral access is not appropriate or indicated. ·      Appreciate the importance of goals of care discussions, assessment of comorbidities, and decision-makers—especially in neurocritical and elderly populations. ·      Know evidence-based timing for gastrostomy tube placement in stroke, TBI, and other complex scenarios. ·      Understand guideline recommendations and the clinical reasoning behind trial periods of nasogastric feeding versus early G tube placement. ·      Describe technical approaches to G tube placement and how to tailor the method to patient anatomy and clinical context. ·      Solidify knowledge of when to choose endoscopic, laparoscopic, open, or interventional radiology-guided placement. ·      Recognize, manage, and strive to prevent common and serious complications of G tubes, including early and late dislodgement, buried bumper syndrome, infection, bleeding, and gastrocutaneous fistula. ·      Discuss perioperative considerations, including anticoagulation, patient stability, and post-procedural care. ·      Understand why routine suturing of the G tube or bumper is not recommended, and how administrative and facility factors can drive clinical decisions. ·      Gain practical pearls and quick decision trees to dominate G tube consults and troubleshooting, day or night. References: ·      Braun R, Han K, Arata J, Gourab K, Hearn J, Gonzalez-Fernandez M. Establishing a clinical care pathway to expedite rehabilitation transitions for stroke patients with dysphagia and enteral feeding needs. Am J Phys Med Rehabil. 2024;103(5):390-394. doi:10.1097/PHM.0000000000002387 https://pubmed.ncbi.nlm.nih.gov/36867953/ ·      Burgermaster M, Slattery E, Islam N, Ippolito PR, Seres DS. Regional comparison of enteral nutrition-related admission policies in skilled nursing facilities. Nutr Clin Pract. 2016;31(3):342-348. doi:10.1177/0884533616629636 https://pubmed.ncbi.nlm.nih.gov/26993318/ ·      Chaudhry R, Kukreja N, Tse A, Pednekar G, Mouchli A, Young L, Didyuk O, Wegner RC, Grewal N, Williams GW. Trends and outcomes of early versus late percutaneous endoscopic gastrostomy placement in patients with traumatic brain injury: Nationwide population-based study. J Neurosurg Anesthesiol. 2018;30(3):251-257. doi:10.1097/ANA.0000000000000434 https://pubmed.ncbi.nlm.nih.gov/28459729/ ·      Cleverdon SA, Costantini TW, McGrew TM, Santorelli JE, Berndtson AE, Haines LN. Dysphagia in patients with traumatic brain injury, how often do they really need feeding access? Presented at: Academic Surgical Congress; February 2025; Washington, DC. Abstract 92.33. ·      Cmorej P, Mayuiers M, Sugawa C. Management of early PEG tube dislodgement: simultaneous endoscopic closure of gastric wall defect and PEG replacement. BMJ Case Rep. 2019;12(9):e230728. doi:10.1136/bcr-2019-230728 https://pubmed.ncbi.nlm.nih.gov/31488448/ ·      Galovic M, Stauber AJ, Leisi N, et al. Development and validation of a prognostic model of swallowing recovery and enteral tube feeding after ischemic stroke. JAMA Neurol. 2019;76(5):561-570. doi:10.1001/jamaneurol.2018.4858 https://pubmed.ncbi.nlm.nih.gov/30742198/ ·      Gallo RJ, Wang JE, Madill ES. Things we do for no reason™. J Hosp Med. 2024;19(8):728-730. doi:10.1002/jhm.13263 https://pubmed.ncbi.nlm.nih.gov/38180160/ ·      George BP, Hwang DY, Albert GP, Kelly AG, Holloway RG. Timing of percutaneous endoscopic gastrostomy for acute ischemic stroke. Stroke. 2017;48(2):420-427. doi:10.1161/STROKEAHA.116.015119 https://pubmed.ncbi.nlm.nih.gov/27965430/ ·      Goldberg LS, Altman KW. The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review. Clin Interv Aging. 2014;9:1733-1739. doi:10.2147/CIA.S53153 https://pubmed.ncbi.nlm.nih.gov/25342891/ ·      Hartford A, Li W, Qureshi D, et al. Use of feeding tubes among hospitalized older adults with dementia. JAMA Netw Open. 2025;8(2):e2460780. doi:10.1001/jamanetworkopen.2024.60780 https://pubmed.ncbi.nlm.nih.gov/39976967/ ·      Hochu G, Soule S, Lenart E, Howley IW, Filiberto D, Byerly S. Synchronous tracheostomy and gastrostomy placement results in shorter length of stay in traumatic brain injury patients. Am J Surg. 2024;227:153-156. doi:10.1016/j.amjsurg.2023.10.012 https://pubmed.ncbi.nlm.nih.gov/37852846/ ·      Kobzeva-Herzog AJ, Nofal MR, Bodde J, et al. Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements. Am J Surg. 2025;(article 116522). doi:10.1016/j.amjsurg.2025.116522 https://pubmed.ncbi.nlm.nih.gov/40782502/ ·      Kurt Boeykens, Ivo Duysburgh. Prevention and management of major complications in percutaneous endoscopic gastrostomy. BMJ Open Gastroenterol. 2021;8:e000628. https://pubmed.ncbi.nlm.nih.gov/33947711/ ·      Murphy LM, Lipman TO. Percutaneous endoscopic gastrostomy does not prolong survival in patients with dementia. Arch Intern Med. 2003;163(11):1351-1353. doi:10.1001/archinte.163.11.1351 https://pubmed.ncbi.nlm.nih.gov/12796072/ ·      Papavramidis TS, Mantzoukis K, Michalopoulos N. Confronting gastrocutaneous fistulas. Ann Gastroenterol. 2011;24(1):16-19. https://pubmed.ncbi.nlm.nih.gov/24714282/ ·      Rajan A, Wangrattanapranee P, Kessler J, Kidambi TD, Tabibian JH. Gastrostomy tubes: fundamentals, periprocedural considerations, and best practices. World J Gastrointest Surg. 2022;14(4):286-303. doi:10.4240/wjgs.v14.i4.286 https://pubmed.ncbi.nlm.nih.gov/35664365/ ·      Reddy KM, Lee P, Gor PJ, Cheesman A, Al-Hammadi N, Westrich DJ, Taylor J. Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes. World J Gastrointest Pharmacol Ther. 2022;13(5):77-87. doi:10.4292/wjgpt.v13.i5.77 https://pubmed.ncbi.nlm.nih.gov/36157266/ ·      Singh D, Laya AS, Vaidya OU, Ahmed SA, Bonham AJ, Clarkston WK. Risk of bleeding after percutaneous endoscopic gastrostomy (PEG). Dig Dis Sci. 2012;57(4):973-980. doi:10.1007/s10620-011-1965-7 https://pubmed.ncbi.nlm.nih.gov/22138961/ ·      Thosani N, Rashtak S, Kannadath BS, et al. Bleeding risk and mortality associated with uninterrupted antithrombotic therapy during percutaneous endoscopic gastrostomy tube placement. Am J Gastroenterol. 2021;116(9):1868-1875. doi:10.14309/ajg.0000000000001348 https://pubmed.ncbi.nlm.nih.gov/34158462/ ·      Ward EC, Green K, Morton AL. Patterns and predictors of swallowing resolution following adult traumatic brain injury. J Head Trauma Rehabil. 2007;22(3):184-191. doi:10.1097/01.HTR.0000271119.96780.f5 https://pubmed.ncbi.nlm.nih.gov/17510594/ ·      Wick B. Timing of PEG tube placement in stroke patients with dysphagia: a multi-center retrospective cohort analysis using the TriNetX database. Am J Gastroenterol. 2024;119(10 Suppl):S1146-S1147. doi:10.14309/01.ajg.0001035684.98119.d5 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://behindtheknife.org/listen BTK Fan Favorites:  General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

A silent danger lurks within the descending thoracic aorta. While most Type B aortic dissections are managed medically, up to half of these patients will either require life-saving surgery or die within just five years. So how do we separate those who will quietly recover from those on the edge of catastrophe? How do we protect the spinal cord, bowel, and limbs from the devastating consequences of malperfusion? Join the University of Michigan Department of Vascular Surgery as they tackle the high-stakes decisions behind managing this unpredictable disease—where timing is critical, interventions are evolving, and lives hang in the balance. Hosted by the University of Michigan Department of Vascular Surgery: ·       Robert Beaulieu, Program Director ·       Frank Davis, Assistant Professor of Surgery ·       Luciano Delbono, PGY-5 House Officer ·       Andrew Huang, PGY-4 House Officer ·       Carolyn Judge, PGY-2 House Officer Learning Objectives: 1.         Discuss general approach to diagnosis and management of TBAD. 2.         Identifying high-risk features in uncomplicated TBAD and understanding their role in determining the need for surgical management. 3.         Review endovascular techniques for managing malperfusion of the limbs, viscera, and spinal cord and discuss associated decision making. References:  Authors/Task Force Members, Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., Kim, K. M., Kreibich, M., Lescan, M., Di Marco, L., Martens, A., Mestres, C. A., Milojevic, M., Nienaber, C. A., … Hughes, G. C. (2024). EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. The Annals of Thoracic Surgery, 118(1), 5–115. https://doi.org/10.1016/j.athoracsur.2024.01.021 de Kort, J. F., Hasami, N. A., Been, M., Grassi, V., Lomazzi, C., Heijmen, R. H., Hazenberg, C. E. V. B., van Herwaarden, J. A., & Trimarchi, S. (2025). Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection. Annals of Vascular Surgery, S0890-5096(25)00004-4. https://doi.org/10.1016/j.avsg.2024.12.060 Eidt, J. F., & Vasquez, J. (2023). Changing Management of Type B Aortic Dissections. Methodist DeBakey Cardiovascular Journal, 19(2), 59–69. https://doi.org/10.14797/mdcvj.1171 Lombardi, J. V., Hughes, G. C., Appoo, J. J., Bavaria, J. E., Beck, A. W., Cambria, R. P., Charlton-Ouw, K., Eslami, M. H., Kim, K. M., Leshnower, B. G., Maldonado, T., Reece, T. B., & Wang, G. J. (2020). Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections. Journal of Vascular Surgery, 71(3), 723–747. https://doi.org/10.1016/j.jvs.2019.11.013 MacGillivray, T. E., Gleason, T. G., Patel, H. J., Aldea, G. S., Bavaria, J. E., Beaver, T. M., Chen, E. P., Czerny, M., Estrera, A. L., Firestone, S., Fischbein, M. P., Hughes, G. C., Hui, D. S., Kissoon, K., Lawton, J. S., Pacini, D., Reece, T. B., Roselli, E. E., & Stulak, J. (2022). The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection. The Annals of Thoracic Surgery, 113(4), 1073–1092. https://doi.org/10.1016/j.athoracsur.2021.11.002 Papatheodorou, N., Tsilimparis, N., Peterss, S., Khangholi, D., Konstantinou, N., Pichlmaier, M., & Stana, J. (2025). Pre-Emptive Endovascular Repair for Uncomplicated Type B Dissection—Is This an Option? Annals of Vascular Surgery, S0890-5096(25)00007-X. https://doi.org/10.1016/j.avsg.2025.01.003 Trimarchi, S., Gleason, T. G., Brinster, D. R., Bismuth, J., Bossone, E., Sundt, T. M., Montgomery, D. G., Pai, C.-W., Bissacco, D., de Beaufort, H. W. L., Bavaria, J. E., Mussa, F., Bekeredjian, R., Schermerhorn, M., Pacini, D., Myrmel, T., Ouzounian, M., Korach, A., Chen, E. P., … Patel, H. J. (2023). Editor’s Choice - Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 66(6), 775–782. https://doi.org/10.1016/j.ejvs.2023.05.015 Writing Committee Members, Isselbacher, E. M., Preventza, O., Hamilton Black Iii, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Jones, W. S., Kalahasti, V., … Woo, Y. J. (2022). 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 80(24), e223–e393. https://doi.org/10.1016/j.jacc.2022.08.004 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

What if we could train patients for surgery the way elite athletes train for game day? In this episode, we review the science, shed light on the disparities, explore real-world challenges, and honor the behind-the-scenes workers that facilitate prehabilitation in thoracic cancer care. Join attending surgeon Doctor Jinny Ha, 3rd year general surgery resident Doctor Kyla Rakoczy, and Community Outreach Patient Navigator, Leslie Ricks Chandler, in discussing prehabilitation in thoracic surgery. Hosts:  Dr. Jinny Ha, MD, MHS, assistant professor of surgery and thoracic surgeon at Johns Hopkins Leslie Ricks Chandler, Community Outreach Program Advisor Johns Hopkins Thoracic Surgery Dr. Kyla Rakoczy, MD, 3rd year general surgery resident at Johns Hopkins LinkedIn: Kyla Rakoczy Learning objectives:  After listening to this episode, participants will be able to: Define the role and components of prehabilitation in the context of thoracic oncology and ERAS/ESTS guidelines. Interpret key findings from recent clinical trials on prehabilitation, including outcomes related to functional capacity and readmission rates. Identify socioeconomic and structural barriers to prehabilitation participation and discuss strategies to improve equitable access to these interventions. Apply evidence-based criteria to assess which patients may benefit most from preoperative nutrition and exercise interventions. Recognize the importance of interdisciplinary collaboration—including social work and patient navigation—in optimizing surgical readiness and long-term outcomes. References:  Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial - PubMed https://pmc.ncbi.nlm.nih.gov/articles/PMC12070588/ https://pubmed.ncbi.nlm.nih.gov/39775660/ https://ccts.amegroups.org/article/view/68030/html https://pubmed.ncbi.nlm.nih.gov/36435646/ https://www.sciencedirect.com/science/article/abs/pii/S1043067918301643?via%3Dihub https://pubmed.ncbi.nlm.nih.gov/30304509/ https://pubmed.ncbi.nlm.nih.gov/28385477/ https://pubmed.ncbi.nlm.nih.gov/27226400/ https://pubmed.ncbi.nlm.nih.gov/38546649/  https://pubmed.ncbi.nlm.nih.gov/38614212/ https://www.hopkinsmedicine.org/surgery/specialty-areas/thoracic-surgery/patient-education  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

Primary hyperparathyroidism is an underdiagnosed condition which leads to decreased bone mineral density, fracture, renal disease, among other symptoms that can decrease the quality of a patient’s life. Moreover, once diagnosed, only a small fraction of patients with the diease end up being offered surgery. Whether it is because of misunderstood indications and benefits of surgery, non-localization of disease, or various other reasons, we thought it was worthwhile to review relevant literature. Hosts: Dr. Becky Sippel is an endowed professor of surgery at Division Chief of endocrine surgery at University of Wisconsin Madison and she is the most recent past president of the AAES.  She is an internationally recognized leader in the field of endocrine surgery. She has over 250 publications. She was the PI for a RCT which studies prophylactic central neck dissections which is a widely read and quoted study in endocrine surgery. Dr. Amanda Doubleday is a fellowship trained endocrine surgeon in private practice with an affiliation to UW Health. Her primary practice is with Waukesha Surgical Specialists in Waukesha WI.  Dr. Simon Holoubek is a fellowship trained endocrine surgeons affiliated with UW Health. He works for UW Health with privileges at UW Madison and UW Northern Illinois. His clinical interests are aggressive variants of thyroid cancer, parathyroid autofluorescence, and nerve monitoring.  Learning Objectives: 1 Understand the natural history of primary hyperparathyroidism and how the disease process can affect bone mineral density. 2 Learn about fracture risk associated with primary hyperparathyroidism. 3 Learn about decreased fracture risk in patients with primary hyperparathyroidism who have parathyroidectomy compared to those who are observed.  References: 1 Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, Udesky J, Silverberg SJ. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab. 2008 Sep;93(9):3462-70. doi: 10.1210/jc.2007-1215. Epub 2008 Jun 10. PMID: 18544625; PMCID: PMC2567863. https://pubmed.ncbi.nlm.nih.gov/18544625/ 2 Frey S, Gérard M, Guillot P, Wargny M, Bach-Ngohou K, Bigot-Corbel E, Renaud Moreau N, Caillard C, Mirallié E, Cariou B, Blanchard C. Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia. J Clin Endocrinol Metab. 2024 May 17;109(6):1494-1504. doi: 10.1210/clinem/dgad718. PMID: 38152848. https://pubmed.ncbi.nlm.nih.gov/38152848/ 3 VanderWalde LH, Liu IL, Haigh PI. Effect of bone mineral density and parathyroidectomy on fracture risk in primary hyperparathyroidism. World J Surg. 2009 Mar;33(3):406-11. doi: 10.1007/s00268-008-9720-8. PMID: 18763015. https://pubmed.ncbi.nlm.nih.gov/18763015/ 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

Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android).  Users can take notes, pin chapters and download content for offline viewing.  Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email [email protected] to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

In this episode, the Behind the Knife team shares exciting updates, including updates to the General Surgery Oral Board Review with 123 expert-commentary scenarios, 10 interactive videos, and 97 operative descriptions. They announce upcoming projects such as an AI-powered oral board simulator, Spanish-language review, a free pediatric surgery resource, and detailed surgical instrument flashcards. The team also introduces Dominate Surgery courses for medical students and advanced practice providers, designed to modernize and elevate surgical education. ***Choledocholithiasis wtih Gastric Bypass Video Scenario Link: https://app.behindtheknife.org/video/behindtheknife-general-surgery-oral-board-review-video-sample-choledocholithiasis-w-gastric-bypass --- Behind the Knife's General Surgery Oral Board Review Course includes 123 Audio Scenarios + 10 Interactive Video Scenarios + 97 Operative Descriptions that cover all SCORE topic. Each scenario includes two parts. The first part is a perfectly executed oral board scenario that mimics the real thing. Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as general surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. All of our premium courses are available via our website and apps (iOS and Android).  Users can take notes, pin chapters and download content for offline viewing.  Learn more about the General Surgery Oral Board Review Course at https://app.behindtheknife.org/premium/general-surgery-oral-board-review **Institutional Discounts Available - Please email [email protected] to learn more.** Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.