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Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast

By: 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. Hygiene & Healthy Living Physical Illness & Disease Science
Episodes
  • Intraoperative Cholangiography Guidelines: Routine, Selective, or Never?

    Intraoperative Cholangiography Guidelines: Routine, Selective, or Never?
    Jun 29 2026
    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 that can be applied in the operating room.Take Home Points: Routine IOC is supported; however, this remains a conditional recommendation that should be individualized based on anatomy, surgeon experience, and available resources.Use a selective approach to IOC in special populations, including pediatric and pregnant patients, where risks and benefits may differ.Alternative imaging modalities including ICG fluorescence and laparoscopic ultrasound have complementary roles. Routine IOC may help maintain surgeon and team proficiency, and trainees should learn both IOC performance and interpretation Hosts: Jason Bingham, MD – General and Bariatric Surgeon Nicole L. Petcka, MD, MHPE – General Surgery Resident at Emory UniversityGuests: Emily Miraflor, MD – General and Colorectal Surgeon at UCSF East Bay, Senior Author on the SAGES Guidelines Kevin El-Hayek, MD - HPB and Foregut Surgeon at MetroHealth and Professor of Surgery at Case Western Reserve School of Medicine, Chair of the SAGES HPB/Solid Organ Committee Dena Shehata, MD - SAGES Guideline Fellow, Co-first author on the SAGES Guidelines Resources: Kumar, S. K., Shehata, D. G., Cetrulo, L. N., Ignacio, R., Chiu, J., Davis, B. R., McDonald, M., Bloom, M. B., Ayloo, S., Kchaou, A., Orthopoulos, G., Pucher, P. H., Oliphant, U., Hallowell, P. T., Serrot, F., Overby, D., Moreno-Paquentin, E., Slater, B. J., & Miraflor, E. (2025). SAGES guidelines for the use of intraoperative imaging of the common bile duct. Surgical endoscopy, 39(11), 7091–7102. https://doi.org/10.1007/s00464-025-12142-0 SAGES Safe Cholecystectomy Program - https://www.sages.org/safe-cholecystectomy-program/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/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate 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-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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    34 mins
  • Clinical Challenges in Hernia Surgery: Is Optimization Still Necessary for Hernia Surgery?

    Clinical Challenges in Hernia Surgery: Is Optimization Still Necessary for Hernia Surgery?
    Jun 25 2026
    Join our Hernia Team for a review of the current controversy around preoperative optimization and the practical implications.Hosts:Dr. Maggie Bosley - @MBosleyMDDr. Sean Orenstein - @OrensteinSeanDr. Amber SandovalDr. Peter Ferrin Institution: Oregon Health & Science UniversityReferences:Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complicationshttps://pubmed.ncbi.nlm.nih.gov/26206646/Risk factors for postoperative wound infections and prolonged hospitalization after ventral/incisional hernia repairhttps://pubmed.ncbi.nlm.nih.gov/24030572/lack of association between glycated hemoglobin and adverse outcomes in diabetic patients undergoing ventral hernia repair: an ACHQC studyhttps://pubmed.ncbi.nlm.nih.gov/35969297/Impact of preoperative haemoglobin A1c levels on postoperative outcomes in adults undergoing major noncardiac surgery: A systematic reviewhttps://pubmed.ncbi.nlm.nih.gov/38853752/Does active smoking really matter before ventral hernia repair? An AHSQC analysishttps://pubmed.ncbi.nlm.nih.gov/30220485/Abstinence from smoking reduces incisional wound infection: a randomized controlled trialhttps://pubmed.ncbi.nlm.nih.gov/12832959/The Association of Nicotine Replacement Therapy With Outcomes Among Smokers Hospitalized for a Major Surgical Procedurehttps://pubmed.ncbi.nlm.nih.gov/31790653/Is weight trajectory a better marker of wound complication risk than BMI in hernia patients with obesity?https://pubmed.ncbi.nlm.nih.gov/38082008/Gender, racial, and socioeconomic disparity of preoperative optimization goals in ventral hernia repairhttps://pubmed.ncbi.nlm.nih.gov/37658198/Limited or Lasting: Is Preoperative Weight Loss as Part of Prehabilitation Maintained after Open Ventral Hernia Repair?https://pubmed.ncbi.nlm.nih.gov/39907236/The impact of preoperative optimization for abdominal wall reconstruction on long-term glucose control and smoking cessationhttps://pubmed.ncbi.nlm.nih.gov/40739418/Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safehttps://pubmed.ncbi.nlm.nih.gov/26838293/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/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate 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-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
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    34 mins
  • Rectal Cancer in the Young and Pregnant: Fertility and Management Considerations

    Rectal Cancer in the Young and Pregnant: Fertility and Management Considerations
    Jun 22 2026
    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 by Dr. Sharon Suwanabol during a presentation at the American Society of Colon and Rectal Surgeons annual meeting 2026. In this episode, we explore the intersection of rectal cancer, fertility, and pregnancy through a multidisciplinary, case-based discussion. We review how surgery, chemotherapy, and pelvic radiation can affect fertility and sexual function in both men and women, and why early counseling and referral to reproductive endocrinology specialists are essential. The discussion also emphasizes that evaluation and treatment during pregnancy can often be performed safely, with care individualized based on tumor stage, gestational age, and the patient’s goals and values. Hosts and discussants · Dr. Betelhem Yohannes, General surgery resident at the University of Washington · Dr. Griffen Allen, General surgery resident at the University of Washington · Dr. Raga Siddharthan, Assistant Professor of Surgery in the Section of Colorectal Surgery at the University of Washington · Dr. Stacey Cohen, Professor in the Division of Hematology and Oncology at the University of Washington and a gastrointestinal medical oncologist at Fred Hutch Cancer Center, specializing in colorectal and other GI cancers. Learning objectives · Describe the impact of rectal cancer surgery on fertility, sexual function, and future childbearing potential. · Review the effects of chemotherapy and pelvic radiation on reproductive health and fertility preservation. · Discuss available fertility preservation strategies and the importance of early pre-treatment counseling and referral. · Recognize the diagnostic challenges of rectal cancer during pregnancy, including overlapping gastrointestinal symptoms. · Review appropriate staging and workup considerations for suspected rectal cancer in pregnant patients. · Discuss multidisciplinary management strategies for rectal cancer during pregnancy, including individualized treatment sequencing. · Examine ethical and patient-centered considerations when balancing maternal cancer treatment and fetal outcomes. References Siegel RL, Wagle NS, Star J, Kratzer TB, Smith RA, Jemal A. Colorectal cancer statistics, 2026. CA Cancer J Clin. 2026;76(2):e70067. doi:10.3322/caac.70067 [https://pubmed.ncbi.nlm.nih.gov/38240409/]Pregnancy at Age 35 Years or Older: ACOG Obstetric Care Consensus No. 11. Obstet Gynecol. 2022;140(2):348-366. doi:10.1097/AOG.0000000000004873 [https://pubmed.ncbi.nlm.nih.gov/35640237/]Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/]Druvefors E, Myrelid P, Andersson RE, Landerholm K. Female and Male Fertility after Colectomy and Reconstructive Surgery in Inflammatory Bowel Disease: A National Cohort Study from Sweden. J Crohns Colitis. 2023;17(10):1631-1638. doi:10.1093/ecco-jcc/jjad079 [https://pubmed.ncbi.nlm.nih.gov/37341355/]Ito M, Tsukada Y, Watanabe J, et al. Long-term survival and functional outcomes of laparoscopic surgery for clinical stage I ultra-low rectal cancers located within 5 cm of the anal verge: A prospective phase II trial (Ultimate trial). Ann Surg. Published online April 1, 2024. doi:10.1097/SLA.0000000000006290 [https://pubmed.ncbi.nlm.nih.gov/38629555/]Teh WT, Stern C, Chander S, Hickey M. The impact of uterine radiation on subsequent fertility and pregnancy outcomes. Biomed Res Int. 2014;2014:482968. Johnson GGRJ, Park J, Helewa RM, Goldenberg BA, Nashed M, Hyun E. Total neoadjuvant therapy for rectal cancer: a guide for surgeons. Can J Surg. 2023 Apr 21;66(2):E196-E201. doi: 10.1503/cjs.005822. PMID: 37085291; PMCID: PMC10125160. [https://pubmed.ncbi.nlm.nih.gov/37085291/]Naren G, Guo J, Bai Q, Fan N, Nashun B. Reproductive and developmental toxicities of 5-fluorouracil in model organisms and humans. Expert Rev Mol Med. 2022 Jan 31;24:e9. doi: 10.1017/erm.2022.3. PMID: 35098910; PMCID: PMC9884763. [https://pubmed.ncbi.nlm.nih.gov/35098910/]National Comprehensive Cancer Network. (2026). NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer (Version 2.2026). Retrieved from NCCN Guidelines for Rectal Cancer [https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1449]Oktay, Kutluk M.D., Ph.D.. Expert Commentary on Fertility Preservation in Colorectal Cancers: Current State and Practical Tips for the ...
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    28 mins
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