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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
  • Journal Review in Artificial Intelligence: Four Times Better Than Us

    Journal Review in Artificial Intelligence: Four Times Better Than Us
    Jul 17 2025
    You have probably seen recent headlines that Microsoft has developed an AI model that is 4x more accurate than humans at difficult diagnoses. It’s been published everywhere, AI is 80% accurate compared to a measly 20% human rate, and AI was cheaper too! Does this signal the end of the human physician? Is the title nothing more than clickbait? Or is the truth somewhere in-between? Join Behind the Knife fellow Ayman Ali and Dr. Adam Rodman from Beth Israel Deaconess/Harvard Medical School to discuss what this study means for our future.
    Studies:
    Sequential Diagnosis with Large Language Models: https://arxiv.org/abs/2506.22405v1
    METR study: https://metr.org/blog/2025-07-10-early-2025-ai-experienced-os-dev-study/
    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 applications of data science and artificial intelligence to surgery.
    Adam Rodman, MD, MPH, FACP, @AdamRodmanMD
    Dr. Rodman is an Assistant Professor and a practicing hospitalist at Beth Israel Deaconess Medical Center. He’s the Beth Israel Deaconess Medical Center Director of AI Programs. In addition, he’s the co-director of the Beth Israel Deaconess Medical Center iMED Initiative.
    Podcast Link: http://bedside-rounds.org/

    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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    23 m
  • Clinical Challenges in Robotic Bariatric Surgery: The Robot is Here to Stay!

    Clinical Challenges in Robotic Bariatric Surgery: The Robot is Here to Stay!
    Jul 14 2025
    Join us as we dissect the use of robotics in bariatric surgery – where precision meets programming, and the scalpel gets a software upgrade. Video Clip Link: https://app.behindtheknife.org/video/clinical-challenges-in-robotic-bariatric-surgery-the-robot-is-here-to-stay This videos includes: - Robotic RYGB - Robotic Sleeve Gastrectomy - SADI: Single Anastomosis Duodenoileostomy 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 Health System (Akron, Ohio) - Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) - Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) Learning objectives: Strengths of the robot: Surgical robots are at the forefront of technology and continue to improve with detailed, precision cameras and the ability to remove baseline tremorsAllows for smooth movements, fine dissection, and precise tissue handling Ergonomics are more advantageous to the surgeon when compared to laparoscopy Weaknesses of the robot:The loss of haptic feedback can be challenging for surgeons early in their learning curveEmphasis on surgical robots means some trainees may be losing exposure to laparoscopic techniquesLonger operative time when working robotically, and more time under anesthesia for the patient Increased cost for robotic surgery Outcomes data: Mixed data from the MBSA QIP database (metabolic and bariatric surgery accreditation and quality improvement program)The most recent study looked at 824,000 patients from 2015-2022 who had a sleeve gastrectomy or RNY gastric bypass, either laparoscopically (lap sleeve 61%, lap RYGB 24%) or robotically (robo sleeve 11%, robo RYGB 4%).Robotic sleeves were reported to have higher complication rates compared to laparoscopy, seen as higher overall morbidity and an increased rate of leaks While the robotic RYGBs have lower overall complications, including decreased morbidity and bleeding. Robotic RYGB can be especially advantageous with revisional surgeries when compared to lap. Setting up for successTrain your eyes to determine tension on tissue, since there is no haptic feedbackLearn how to assist yourself (manipulating the camera and effectively utilizing the fourth arm)Understand how techniques of the surgery change when doing it robotically, as compared to laparoscopy Experienced operating room team When learning, recommend putting all cases feasible on the robot (including easier cases), to master the straightforward cases before moving to technically challenging revision cases.Don’t hesitate to add an additional trocar or assistant port when needed Education in Robotic learning Learning by observation/mirroring – ex: robotic bilateral inguinal hernia (mirroring the attending/instructor) Easy for the attending/instructor in the case to switch instruments seamlessly, then give them back intermittently at the appropriate time Helpful when the attending annotates the screen to depict where to go Data-driven teaching tools on the Davinci system Tips for robotic sleeve gastrectomy: Of the robotic bariatric surgeries, sleeve gastrectomy is most similar to its laparoscopic procedure30-40 degrees of reverse TrendelenburgLiver hammock stitch instead of a liver retractor (one less trocar), which makes a total of 4 trocars needed for the caseGreen staple load for the first firing, then the rest are typically blue loadsMixed opinions on reinforced staple loads versus non-reinforced staple loads and oversewing the staple line (discussed cost-benefit) Tips for robotic gastric bypass: Watch videos from colleagues to learn what they doGastric bypass is a multi-quadrant surgery; thus, you must set yourself up for success so that your arms are not fighting when moving through different quadrants A size 12 trocar on the left can make the formation of the gastric pouch easierGJ and JJ anastomosis formed with a linear fire, then a two-layer closure with absorbable barb sutureDon’t forget to close the mesenteric defect (non-absorbable braided suture) Tips for robotic DS and SADI: If doing a duodenal anastomosis hand-sewn, then recommend planning the exact number of sutures and locations of each for easeHand-sewn anastomosis can have less bleeding and fewer strictures for patients, and is completed in a much more seamless fashion with the robot Future of Robotics Haptic feedbackIntegrated visual overlays to identify anatomical structures/serve as an intraoperative mapArtificial intelligence integration Telesurgery – ex, small surgical robot deployed to space Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, ...
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    44 m
  • 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
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