Episodios

  • Ep. 82 Building Effective Endometriosis Case Conferences with Dr. Peter Movilla and Dr. Anu Shenoy-Bhangle
    Apr 22 2025
    Curious how cross-specialty teamwork is reshaping endometriosis care? In this episode of BackTable OBGYN, host Dr. Mark Hoffman speaks with Dr. Peter Movilla, Associate Medical Director at Newton Wellesley Hospital, and Dr. Anuradha Shenoy-Bhangle, Assistant Professor of Radiology at Harvard Medical School, about their collaborative efforts in advancing endometriosis care. --- SYNPOSIS The discussion covers the development and benefits of monthly multidisciplinary conferences that include gynecologists, radiologists, colorectal, urologic, and thoracic surgeons. The conferences aim to improve preoperative planning, intraoperative accuracy, and postoperative care through detailed imaging techniques, primarily MRI. They also highlight the importance of educating fellows and colleagues, the role of ultrasound screening, and future directions like AI and PET imaging. The episode emphasizes the challenges and rewards of treating endometriosis and fostering better patient outcomes through teamwork and innovation. --- TIMESTAMPS 00:00 - Introduction 01:55 - The Journey to Specialization 07:02 - Building a Multidisciplinary Team 15:07 - The Value of Postoperative Reviews 22:49 - Patient Counseling and Personalized Care 29:36 - Challenges in Endometriosis Treatment 31:00 - Educating Beyond the Clinic 33:05 - Innovations in Imaging 46:22 - Future Directions in Endometriosis Research 53:15 - Conference Highlights and Final Thoughts --- RESOURCES Recommendations for MRI technique in the evaluation of pelvic endometriosis: consensus statement from the Society of Abdominal Radiology endometriosis disease‑focused panel: https://drive.google.com/file/d/1VRBpw5V3AH-rWGEG43K1CMCx2flCXl2M/view?usp=sharing
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    57 m
  • Ep. 81 Surgical Considerations in Chronic Pelvic Pain with Dr. Mark Dassel
    Apr 8 2025
    When should you consider surgical management of chronic pelvic pain conditions? In this episode of the BackTable OBGYN podcast, Dr. Mark Dassel, a MIGS surgeon at Intermountain Health in Salt Lake City, joins hosts Dr. Mark Hoffman and Dr. Amy Park to discuss medical and surgical management strategies for chronic pelvic pain, particularly endometriosis. --- SYNPOSIS Dr. Dassel emphasizes the importance of stopping the hormonal triggers associated with pain and explores various medical treatments, including hormonal therapies and the role of contraceptives. He also highlights his approach to surgical interventions such as endometriosis excision, endometrioma removal, and hysterectomy, and the importance of holistic treatment plans involving pelvic floor physical therapy and central pain modulators. The episode also covers the complexities of diagnosing and treating pelvic pain, the role of early intervention, and the value of multidisciplinary care. --- TIMESTAMPS 00:00 - Introduction 07:55 - Differentiating Causes of Chronic Pelvic Pain 10:13 - Multidisciplinary Care and Costs 14:26 - Acute vs Chronic Pain 17:00 - Centralized Pain 18:46 - When to Offer Surgery 23:42 - Fertility and Endometriosis 33:25 - Hormonal Suppression Post-Surgery 37:24 - Pelvic Floor Botox and Physical Therapy 44:42 - Hysterectomy for Pelvic Pain 51:53 - Nerve Ablation and Pain Management 57:10 - Final Thoughts
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    1 h
  • Ep. 80 Endometrial Ablation: Past, Present, and Future with Dr. Ted Anderson
    Mar 25 2025
    Endometrial ablation has become a cornerstone procedure in the treatment of abnormal uterine bleeding, but is it the right solution for every patient that meets the indication? In this episode of the BackTable OBGYN Podcast, Dr. Ted Anderson from Vanderbilt University joins host Dr. Mark Hoffman to discuss the evolution of endometrial ablation and its contemporary utilization, including patient selection, technical considerations, and alternative treatments for abnormal uterine bleeding. --- SYNPOSIS Dr. Anderson begins by detailing the history of abnormal uterine bleeding alongside the evolution of the endometrial ablation techniques that have been used to treat it. Shifting focus to current day practice, he then shares his approach to endometrial ablation, covering patient selection and the technical aspects of his approach. Throughout the conversation, Dr. Anderson emphasizes the importance of how we define success in endometrial ablation, explaining that eumenorrhea (normal bleeding that no longer interferes with life events) is the goal, as opposed to the more traditional view that amenorrhea is the target outcome. The episode closes with a discussion on the role of alternative treatments, such as the Mirena IUD and hysterectomy for abnormal uterine bleeding. --- TIMESTAMPS 00:00 - Introduction 09:29 - History of Abnormal Uterine Bleeding and Endometrial Ablation 23:31 - Evolution of Endometrial Ablation Devices/Techniques 31:11 - Selecting the Right Patient for Ablation Success 34:38 - Post-Tubal Sterilization Ablation Syndrome 38:27 - The Role of IUDs in Managing AUB 44:07 - Reevaluating Endometrial Ablation Success Metrics 49:55 - Innovative Ablation Techniques: Cryoablation and Steam 51:48 - Adenomyosis and Fertility-Sparing Treatments 57:28 - Final Thoughts
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    1 h y 1 m
  • Ep. 79 Laparoscopy in Pregnancy: Key Considerations for Surgeons with Dr. Craig Sobolewski
    Mar 11 2025
    What surgical techniques and safety measures are important to consider when operating in a pregnant patient? In this episode of the BackTable OBGYN podcast, Dr. Craig Sobolewski, a minimally invasive GYN surgeon at Duke, speaks with host Dr. Mark Hoffman about the intricacies of laparoscopic surgery in pregnant patients. --- SYNPOSIS The surgeons delve into the critical importance of understanding anatomy and ensuring proper exposure during surgeries, particularly the challenges and techniques for operating during pregnancy. Key discussions include the use of liver retractors, the management of symptomatic ovarian cysts, and the methods for performing and evaluating abdominal cerclages. They also explore the physiological changes in pregnant patients and the adjustments needed for anesthesia, laparoscopic entry, pressures during surgery, and pre/post-operative care. --- TIMESTAMPS 00:00 - Introduction 07:20 - Laparoscopy in Pregnant Patients 11:23 - Common Surgeries During Pregnancy 15:56 - Laparoscopic Surgery Techniques 24:04 - Physiologic Changes in Pregnancy 27:33 - Access Methods and Pressure Considerations 28:53 - Managing Torsion and Cysts in Pregnancy 30:21 - Energy Use and Safety in Pregnant Patients 31:38 - Preoperative and Postoperative Care 34:15 - Cerclage Procedures and Counseling 47:46 - Professional Reflections and Conclusions
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    52 m
  • Ep. 78 The Business of Gynecology in Canada with Dr. Jonathon Solnik
    Feb 25 2025
    How does gynecology care in the United States compare to Canada? In this episode of the BackTable OBGYN podcast, Dr. Jonathon Solnik, head of gynecology and minimally invasive surgery at Mount Sinai in Toronto, speaks with hosts Dr. Mark Hoffman and Dr. Amy Park about the significant differences between the healthcare systems in the US and Canada. --- SYNPOSIS The doctors cover financial incentives and constraints faced by hospitals in the US vs. Canada, the role of insurance companies, and how resource limitations impact clinical practice. Dr. Solnik shares insights from his career journey, emphasizing the challenges and opportunities he has encountered in Canada, including longer wait times for elective surgeries and the intricacies of the Canadian global budget system. The conversation also covers the impact of robotics in surgery, standardization of care, and the differences in the handling of high-acuity medical cases. The episode provides an insightful discussion on how different healthcare models affect patient care, physician practices, and hospital administration. --- TIMESTAMPS 00:00 - Introduction 01:39 - Dr. Solnik’s Career Journey 03:30 - Healthcare System Differences: US vs Canada 09:57 - Balancing Quality and Volume in Healthcare 12:18 - Private Practice in Canada 25:03 - Wait Times and Capacity Issues 34:44 - Oncology and Semi-Salaried Positions 39:03 - Negotiating CPT Codes and RVUs 42:14 - Access to Care in Remote Areas 44:42 - Robotics in Surgery 55:09 - Incentives and Productivity in Healthcare Systems 01:01:33 - Concluding Thoughts
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    1 h y 4 m
  • BackTable Brief: Diagnosing Female Urinary Incontinence with Dr. Sarah Boyles
    Feb 18 2025
    How can we streamline the proper diagnosis and treatment of female urinary incontinence? The solution often lies in bridging comprehensive patient workup to pelvic floor physical therapy. Learn more in this BackTable OBGYN brief with Dr. Sarah Boyles and host Dr. Suzette Sutherland! Key topics include what to look for during a pelvic exam, the importance of external skin inspection, prolapse evaluation, urethra assessment, and pelvic floor muscle strength testing. The doctors also address effective treatment options, the necessity (or lack thereof) of specific diagnostic tests, the significant role of bladder diaries, and the benefits of pelvic floor physical therapy. Practical advice for behavioral management, therapy for stress and urgency incontinence, and the reasons for structured evaluation methodologies are also highlighted. TIMESTAMPS 00:00 - Introduction 00:30 - Conducting a Thorough Pelvic Exam 02:45 - Evaluating Pelvic Floor Muscle Strength 04:28 - Initial Diagnostic Workup 06:07 - The Role of Bladder Diaries 09:49 - Treatment Algorithms for Urinary Incontinence 15:03 - Conclusion CHECK OUT THE FULL EPISODE OBGYN Ep. 61: Evaluating Female Urinary Incontinence: Essential Steps for the Generalist https://www.backtable.com/shows/obgyn/podcasts/61/evaluating-female-urinary-incontinence-essential-steps-for-the-generalist
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    17 m
  • BackTable Brief: Understanding Female Urinary Incontinence with Dr. Sarah Boyles
    Feb 11 2025
    Urinary incontinence can greatly impact our patients’ quality of life. It’s essential to recognize the different types and treat them appropriately. In this BackTable OBGYN Brief, Dr. Sarah Boyles and Dr. Suzette Sutherland provide an overview of female urinary incontinence for their general practice and specialized physician colleagues. The conversation dives into the different types of incontinence, including stress, urgency, mixed, and overflow incontinence, and the importance of accurate diagnosis and appropriate treatment plans. The discussion also emphasizes essential diagnostic steps, including urinalysis and measuring post-void residuals, and points out the importance of patient education and expectation management. TIMESTAMPS 00:00 - Introduction 00:30 - Prevalence of Female Urinary Incontinence 01:25 - Impact on Quality of Life 03:01 - Types of Urinary Incontinence 07:35 - Diagnostic Approaches CHECK OUT THE FULL EPISODE OBGYN Ep. 61: Evaluating Female Urinary Incontinence: Essential Steps for the Generalist https://www.backtable.com/shows/obgyn/podcasts/61/evaluating-female-urinary-incontinence-essential-steps-for-the-generalist
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    17 m
  • Ep. 77 Surgeon to CMO: Navigating the Career Shift with Dr. Mark Hoffman
    Feb 4 2025
    What skills and disciplines can a surgeon take from their training to succeed in a new leadership / hospital administration role? In this episode of BackTable OBGYN, Dr. Mark Hoffman discusses his transition from a minimally invasive gynecologic surgeon to the Chief Medical Officer at his hospital with co-host Dr. Amy Park. --- SYNPOSIS The doctors cover the importance of high-functioning teams, the unexpected challenges of hospital administration, and the impact of clinical experience on decision-making. Additionally, they explore the broader responsibilities and skill sets required for effective leadership in a hospital setting, and offer advice for others considering a similar career shift. Dr. Hoffman emphasizes the value of servant leadership, the benefits of focusing on strengths, and the necessity of building strong, resilient teams. --- TIMESTAMPS 00:00 - Introduction 05:16 - Transitioning to Hospital Administration 07:17 - Balancing Workload 10:33 - Teamwork and Leaning into Strengths 13:30 - Decision Making in Administration 26:20 - Unique Challenges for OBGYNs in Hospital Administration 31:48 - Engagement in Leadership 35:03 - Focusing on People to Improve Patient Care 44:18 - Building Effective Leadership Teams 45:25 - Transitioning to Hospital Administration 52:07 - Finding Joy in Leadership and Mentorship
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    57 m
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