Behind The Knife: The Surgery Podcast

INTRODUCING Behind the Knife OBGYN Oral Board Review! The oral boards aren't just about knowledge—they are about executing under pressure. This course is designed to give you the structure and confidence to command the room. We have curated 98 high-yield scenarios covering the "Big Three" of the exam: Obstetrics, Gynecology, and Office Practice. Whether it’s a surgical emergency or a complex clini...

Join Drs. Georgoff, Burke, and Premkumar in this episode of the EPA Playbook as they break down a practical, repeatable framework for managing patients in the trauma bay, one of the most high-pressure environments in surgical training. This episode focuses on the critical first minutes of evaluation, anchored in a structured primary survey. We emphasize how to recognize and immediately address lif...

Join Drs. Georgoff, Burke, and Premkumar in this episode of EPA Playbook , where we tackle the evaluation and management of small bowel obstruction. Through a realistic series of scenarios, we walk step-by-step through how junior residents can approach this diagnosis using an evidence-based approach. We break down the key components of the small bowel obstruction EPA, from rapid initial assessment...

In this episode of EPA Playbook, Drs. Jason Bingham, Emma Burke, and Agnes Premkumar discuss the evaluation and management of inguinal hernias through a case-based approach that reinforces key EPA concepts for surgical trainees. We specifically highlight the importance of a thorough history and physical exam, emphasize risk stratification, and indications for surgery versus watchful waiting. We br...

In this episode of EPA Playbook, Drs. Kevin Kniery, Emma Burke, and Agnes Premkumar discuss management of critically ill surgical patients, using case-based discussions to reinforce core principles of shock, resuscitation, and ICU care. We first review the four major types of shock. We then discuss two cases centered around managing a patient in septic shock and cardiogenic shock, delving into the...

Join Drs. Steele, Burke, & Premkumar in this episode of EPA Playbook , where we tackle a core general surgery EPA: the evaluation and management of benign and malignant colon disease. From common presentations like diverticulitis and lower GI bleeding to the diagnosis and workup of colon cancer, this episode provides a structured framework you can use on the wards, in clinic, and on call. Usin...

Two years into the EPA era — are we actually training surgeons differently, or just checking new boxes? In this episode, Behind the Knife co-director and Duke Trauma Surgeon Dr. Patrick Georgoff and Behind the Knife surgical education fellows Dr. Agnes Premkumar and Dr. Emma Burke sit down with Dr. Ruchi Thanawala, thoracic surgeon at OHSU, informatician, and founder of Firefly Labs, to get an hon...

In this episode, we use the recent SAGES guidelines to tackle one of the most common and controversial questions in general surgery. Through a case-based discussion, our experts review the evidence for intraoperative biliary imaging, discuss strategies for difficult anatomy, and compare IOC with other imaging modalities. Join us as we translate the latest recommendations into practical lessons tha...

Join our Hernia Team for a review of the current controversy around preoperative optimization and the practical implications. Hosts: Dr. Maggie Bosley - @MBosleyMD Dr. Sean Orenstein - @OrensteinSean Dr. Amber Sandoval Dr. Peter Ferrin Institution: Oregon Health & Science University References: Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications https://pubmed.ncbi.n...

As colorectal cancer rates rise among younger adults, surgeons are increasingly caring for patients with rectal cancer who are pregnant or hoping to preserve future fertility. With more individuals delaying childbearing, balancing effective cancer treatment with fertility preservation and maternal–fetal safety has become an important clinical challenge. This timely topic was recently highlighted b...

Why do millions of patients qualify for bariatric surgery, yet only a fraction ever make it to the operating room? Hosts ·      Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) ·      Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa...

Prehospital blood is one of the hottest debates in trauma resuscitation — and the evidence just got a lot more interesting. In this episode, Drs. Patrick Georgoff and Ayman Ali sit down with Dr. Ed Barnard, UK defense professor of emergency medicine and author of the landmark SWIFT trial, and Dr. Juan De Chesney, trauma surgeon and pioneer in prehospital blood programs, to break down what we actua...

Join the Behind the Knife Surgical Oncology Team as we discuss clinical challenges through case-based examples including the diagnosis, workup, and management of patients with cutaneous melanoma. Learning Objectives: In this episode, we review the workup and management of patients with cutaneous melanoma and both microscopic and macroscopic nodal disease.  References used in the making of this epi...

A 25-year-old pregnant woman presents with a 1-day history of progressive pain and swelling. The foot is cold, pulseless and neurologic function is deteriorating by the hour. Imaging shows a massive iliofemoral DVT. Now both the limb and the pregnancy are threatened. Do you anticoagulate, thrombolyse or operate? Join us as we break down the management and decision making behind this rare but devas...

Get a behind-the-scenes look at one of the most anticipated sessions from the Association of Surgeons of Great Britain and Ireland Annual Conference: “Bad Day on Call.” In this session, expert surgeons from the United States, United Kingdom, and Canada work through challenging real-world acute care and trauma cases. As each case unfolds, the panel explores key decision points while highlighting bo...

It’s hospital day five. The patient looked better yesterday… but now she’s hypotensive, on vasopressors, acidotic, and spiraling toward multi-organ failure. The CT scan doesn’t show perforation or megacolon, but your gut tells you this is going south. Do you keep pushing medical therapy… or is it time to operate? Join Drs. Rushabh Dev, Jeffrey Coughenour, Kevin Bartow, Raymond Okeke, and Desra Fle...

The majority of non-fatal gunshot wound survivors walk away with a bullet still inside them. Most are discharged without a removal attempt, without a surveillance plan, and without a conversation about what comes next. This episode fills that gap. Dr. Patrick Georgoff is joined by BIG T co-host Dr. Teddy Puzio (UT Houston), gun violence survivor and trauma surgeon Dr. Madhu Subramanian (Duke), and...

In this episode, hosts Drs. Maya Hunt, Nicole Santucci, Bryanna Stukes and Zoe Zhou explore the parallels between the literacy crisis in America and current challenges in surgical education, drawing insights from the podcast "Sold a Story." They discuss how both systems advance learners without true competency, blame struggling students rather than examining flawed teaching methods, and look to th...

Ileocolic resection is one of the most common operations performed for Crohn's disease, yet the optimal approach to anastomotic construction and mesenteric management remains an active area of debate. From the configuration of the anastomosis to the extent of mesenteric excision, emerging evidence suggests that surgical technique may play a meaningful role in disease outcomes. Join Drs. Jared Hend...

As cancer vaccines move into Phase II and III clinical trials, it is increasingly important for surgeons to understand their role in this evolving landscape. What exactly are these vaccines, how do they work, and what should the surgical community know about their implementation? Join BTK surgical education fellows Kara Button and Michelle LaBella as they sit down with Professor Robert Jones to br...

Can an algorithm actually give you your life back? A recent Stanford paper revealed that using large language models at home yields massive efficiency gains—up to 176%. For busy surgeons drowning in clinical duties and administrative bloat, every reclaimed second is priceless. In this episode of Behind the Knife , Ayman and Patrick sit down with Christian Péan—an orthopedic trauma surgeon, Duke’s...

What are the experts saying about thyroid cancer treatment in 2025?  Maybe it’s time to discuss deescalation of aggressive surgical care for lower risk thyroid cancers.  We can accept that less surgery may be appropriate in select cases, including more thyroid lobectomies versus total thyroidectomies, consider less invasive approaches such as percutaneous ablation techniques, and utilize more obse...

For decades, a tight carotid stenosis felt like a ticking time bomb — a plaque waiting to throw an embolus and cause the next stroke. We were taught that severe narrowing meant surgery, and trials like ACAS and ACST-1 seemed to prove it. But medicine has changed. Statins, antiplatelets, tighter blood pressure control, even PCSK9 and GLP-1 therapies have quietly slashed stroke risk, and now newer d...

In this episode, our expert panel dives into the critical, historically debated topic of early burn wound excision using a real-world case of a patient with massive surface area burns. We explore the dramatic shift from the pre-1970s "wait and watch" approach to the modern standard of early source control, backed by landmark literature showing reduced mortality and shorter hospital stays. The disc...

This episode includes a full, sample cardiothoracic scenario pulled directly from our Cardiothoracic Surgery Oral Board Review Course. Listen in and test your clinical pathways in real-time as we walk through the perfect answers and provide high-yield commentary to help you pass the "hot seat." About our Cardiothoracic Surgery Oral Board Review Course: 43 High-Yield Scenarios Dual-Format Learning:...