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Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast

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 Behind the Knife is the world’s #1 surgery podcast. From high-yield educational topics to interviews with leaders in the field, Behind the Knife delivers the information you need to know. Tune in for timely, relevant, and engaging content designed to help you DOMINATE THE DAY!

Behind the Knife is more than a podcast. Visit www.behindtheknife.org to learn more. Ciencia Enfermedades Físicas Higiene y Vida Saludable
Episodios
  • Clinical Challenges in Vascular Surgery: The Risk & Reality of EVAR Complications

    Clinical Challenges in Vascular Surgery: The Risk & Reality of EVAR Complications
    Jul 10 2025
    It’s 2 a.m. The on-call resident’s voice is shaky.
    The CT shows an 18cm abdominal aortic aneurysm with a Type 1B endoleak.
    There’s gas in the sac, fluid in the belly, and the patient has a defibrillator on both sides of his chest.
    Is it a rupture? A graft infection? An aortoenteric fistula? All of the above?
    You’re the vascular surgeon, what do you do?

    This episode dives deep into decision-making when EVAR fails, when infection strikes, and when the patient might not survive a definitive repair. Let’s talk about what happens when clinical textbooks meet real-world chaos.

    Hosts:
    · Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center
    · Paul Haser -Division chief, Vascular Surgery, Brookdale Hospital Medical Center
    · Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center
    · Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center

    Learning objectives:
    · Understand the clinical implications and management of late EVAR complications, including Type 1B endoleak and aortoenteric fistula.
    · Explore the decision-making process in critically ill patients with multiple comorbidities and infected aortic grafts.
    · Compare endovascular vs open surgical approaches in the setting of infected AAA, and when each is appropriate.
    · Recognize the role of multidisciplinary collaboration in complex vascular cases.
    · Discuss the ethical considerations and goals-of-care planning in high-risk, potentially terminal vascular patients.
    · Highlight the importance of long-term surveillance after EVAR and the consequences of noncompliance.

    References

    · Karl Sörelius et al.Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair.Circulation. 2016;134(22):1822–1832.
    PubMed: https://pubmed.ncbi.nlm.nih.gov/27799273/ pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15researchgate.net+15

    · PARTNERS Trial (OVER Trial).Outcomes Following Endovascular vs Open Repair of Abdominal Aortic Aneurysm: A Randomized Trial.JAMA. 2009;302(14):1535–1542.
    PubMed: https://pubmed.ncbi.nlm.nih.gov/19826022/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6jamanetwork.com+6

    · B.T. Müller et al.Mycotic Aneurysms of the Thoracic and Abdominal Aorta and Iliac Arteries: Experience with Anatomic and Extra-anatomic Repair in 33 Cases.J Vasc Surg. 2001;33(1):106–113.
    PubMed: https://pubmed.ncbi.nlm.nih.gov/11137930/ sciencedirect.com+5pubmed.ncbi.nlm.nih.gov+5periodicos.capes.gov.br+5

    · Chung‑Dann Kan et al.Outcome after Endovascular Stent Graft Treatment for Mycotic Aortic Aneurysm: A Systematic Review.J Vasc Surg. 2007 Nov;46(5):906–912.
    PubMed: https://pubmed.ncbi.nlm.nih.gov/17905558/ researchgate.net+15pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15

    · Hamid Gavali et al.Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra‑anatomic Bypass with In Situ Reconstruction: A Nationwide Multicentre Study.Eur J Vasc Endovasc Surg. 2021;62(6):918–926.
    PubMed: https://pubmed.ncbi.nlm.nih.gov/34782231/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6diva-portal.org+6

    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
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    27 m
  • Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!

    Clinical Challenges in Hepatobiliary Surgery: Necrotizing Pancreatitis, Time to Step Up!
    Jul 7 2025
    In the corner of the ICU, on multiple pressors, distended, oliguric, and intubated you’ll find the necrotizing pancreatitis patient. Sounds intimidating, but with the persistence, patience, and the proper care these patients can make it! In this episode from the HPB team at Behind the Knife listen in as we discuss the Step-Up approach, when to surgically intervene, various approaches to pancreatic Necrosectomy, and additional aspects of the multidisciplinary care required for the successful treatment of necrotizing pancreatitis.

    Hosts
    Anish J. Jain MD (@anishjayjain) is a current PGY3 General Surgery Resident at Stanford University and a former T32 Research Fellow at the University of Texas MD Anderson Cancer Center.

    Jon M. Harrison is a 2nd year HPB Surgery Fellow at Stanford University. He will be joining as faculty at the Massachusetts General Hospital in Boston, MA at the conclusion of his fellowship in July 2024.

    Learning Objectives
    · Develop an understanding of the severity of necrotizing pancreatitis and the proper indications to surgical intervene on this often-tenuous patients.
    · Develop an understanding of the Step-Up approach and key aspects (reimaging, clinical status, physiologic status, etc.) that determine when to “step-up” treatment for patients with necrotizing pancreatitis.
    · Develop an understanding of long term sequalae and complications associated with necrotizing pancreatitis and operative management
    · Develop an understanding of multidisciplinary care and long-term follow-up necessary for adequate treatment of patients suffering from necrotizing pancreatitis.

    Suggested Reading

    Maurer LR, Fagenholz PJ. Contemporary Surgical Management of Pancreatic Necrosis. JAMA Surg. 2023;158(1):81–88. doi:10.1001/jamasurg.2022.5695 https://pubmed.ncbi.nlm.nih.gov/36383374/

    Harrison JM, Day H, Arnow K, Ngongoni RF, Joseph A, Aldridge T, Wheeler KJ, DeLong JC, Bergquist JR, Worth PJ, Dua MM, Friedland S, Park W, Eldika S, Hwang JH, Visser BC. What's Behind it all: A Retrospective Cohort Study of Retrogastric Pancreatic Necrosis Management. Ann Surg. 2024 Sep 3. doi: 10.1097/SLA.0000000000006521. https://pubmed.ncbi.nlm.nih.gov/39225420/

    Harrison JM, Visser BC. Not Dead Yet: Managing the Abdominal Catastrophe in Necrotizing Pancreatitis. Pancreas. 2025 May 20. doi: 10.1097/MPA.0000000000002512. https://pubmed.ncbi.nlm.nih.gov/40388698/

    Harrison JM, Li AY, Sceats LA, Bergquist JR, Dua MM, Visser BC. Two-Port Minimally Invasive Nephrolaparoscopic Retroperitoneal Debridement for Pancreatic Necrosis. J Am Coll Surg. 2024 Dec 1;239(6):e7-e12. doi: 10.1097/XCS.0000000000001152. https://pubmed.ncbi.nlm.nih.gov/39051721/

    van Santvoort HC, Besselink MG, Bakker OJ, Hofker HS, Boermeester MA, Dejong CH, van Goor H, Schaapherder AF, van Eijck CH, Bollen TL, van Ramshorst B, Nieuwenhuijs VB, Timmer R, Laméris JS, Kruyt PM, Manusama ER, van der Harst E, van der Schelling GP, Karsten T, Hesselink EJ, van Laarhoven CJ, Rosman C, Bosscha K, de Wit RJ, Houdijk AP, van Leeuwen MS, Buskens E, Gooszen HG; Dutch Pancreatitis Study Group. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med. 2010 Apr 22;362(16):1491-502. doi: 10.1056/NEJMoa0908821. https://pubmed.ncbi.nlm.nih.gov/20410514/

    Bang JY, Arnoletti JP, Holt BA, Sutton B, Hasan MK, Navaneethan U, Feranec N, Wilcox CM, Tharian B, Hawes RH, Varadarajulu S. An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis. Gastroenterology. 2019 Mar;156(4):1027-1040.e3. doi: 10.1053/j.gastro.2018.11.031. https://pubmed.ncbi.nlm.nih.gov/30452918/

    Zyromski NJ, Nakeeb A, House MG, Jester AL. Transgastric Pancreatic Necrosectomy: How I Do It. J Gastrointest Surg. 2016 Feb;20(2):445-9. doi: 10.1007/s11605-015-3058-y. https://pubmed.ncbi.nlm.nih.gov/26691148/

    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
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    31 m
  • Intern Bootcamp: Dominate Intern Year

    Intern Bootcamp: Dominate Intern Year
    Jul 5 2025
    RE-RELEASE
    This was first published in 2023 but it's so good we are running it back!

    Buckle up, PGY-1’s! Intern year is starting whether you’re ready or not. Don’t fret, BTK has your back to make sure you dominate the first year of residency.

    In this last episode of the intern bootcamp mini-series, we’ll talk about tips & tricks as well as good habits to establish in order to dominate intern year.

    Hosts: Shanaz Hossain, Nina Clark

    Tips for New Interns:

    GENERAL TIPS FOR SUCCESS ON THE WARDS
    • Spend time with the patient!
    • Trust, but verify.
    • Be kind to everyone.
    • Stay humble.
    • Be flexible.
    • Seek and apply feedback.

    HOW TO LEARN IN THE OR
    • Double scrub as many cases as you can.
    • Write down/record everything after a case.

    MAINTAIN YOUR PERSONAL SANITY
    • Figure out your stress outlets and what brings you joy.
    • Decompress after work.
    • Maintain work/life boundaries.
    • Keep in touch with loved ones.
    • Vacations are meant for relaxation.
      • Repeat after me: NO WORK ON VACATION!
    Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

    If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/
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    13 m
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