Behind The Knife: The Surgery Podcast

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 Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss methods for ileocolic anastomosis in Crohn's disease while reviewing the latest literature.
Hosts: 
- Jared Hendren, MD
Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Elissa Dabaghi, MD
Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Joseph Trunzo, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
X/Twitter @joseph_trunzo
- Ajaratu Keshinro, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
X/Twitter- @AJKesh
- David Rosen, MD
Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
X/Twitter- @davidrrosenmd
Learning Objectives: By the end of this episode, listeners will be able to:
1.     Evaluate the evidence for the Kono-S anastomosis in reducing postoperative recurrence after ileocolic resection for Crohn's disease
2.     Describe the role of the mesentery in driving recurrence and discuss how mesenteric-targeting surgical approaches may influence outcomes
3.     Interpret the results of recent randomized controlled trials on extended mesenteric excision and apply them to surgical decision-making in ileocolic resection for Crohn's disease
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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 break
down the science of mRNA vaccines, the logistics of tissue
procurement, and the future of cancer care.
Hosts:
- Professor Robert Jones: Consultant Liver Surgeon, Liverpool University
Hospitals; UK National Institute for Healthcare Research, Co-Lead for
the Cancer Vaccine Innovation Pathway, Bowel Cancer UK and Royal
College of Surgeons UK Lead for Research into Advanced Bowel Cancer,
and UK Chief Investigator for the BNT122-01 trial.
https://www.linkedin.com/in/robert-jones-6103722a/
- Kara Button, DO: General Surgery Resident, Maine Medical Center;
Behind the Knife Surgical Education Fellow.
- Michelle LaBella, MD: General Surgery Resident; University of North
Carolina; Behind the Knife Surgical Education Fellow.
References:
https://clinicaltrials.biontech.com/trials/BNT122-01
Jones RP, Lee LYW, Corrie PG, et al. Individualized cancer vaccines
versus surveillance after adjuvant chemotherapy for surgically
resected high-risk stage 2 and stage 3 colorectal cancer: protocol for
a randomized trial. BJS. 2023;110(12):1883-1884.
doi:10.1093/bjs/znad332
https://pubmed.ncbi.nlm.nih.gov/37856683/
Tie J, Wang Y, Loree JM, et al. Circulating tumor DNA-guided adjuvant
therapy in locally advanced colon cancer: the randomized phase 2/3
DYNAMIC-III trial. Nat Med. 2025;31(12):4291-4300.
doi:10.1038/s41591-025-04030-w
https://pubmed.ncbi.nlm.nih.gov/41115959/
Rojas LA, Sethna Z, Soares KC, et al. Personalized RNA neoantigen
vaccines stimulate T cells in pancreatic cancer. Nature.
2023;618(7963):144-150. doi:10.1038/s41586-023-06063-y
https://pubmed.ncbi.nlm.nih.gov/37165196/
https://www.cancer.ox.ac.uk/research/lynchvax#:~:text=The%20LynchVax%20program%2C%20funded%20by,individuals%20with%20this%20genetic%20condition
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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 Executive Director of AI and IT Innovation, and the Founder/CEO of RevelAi Health. He’s also a Core faculty member at the Duke-Margolis Institute for Health Policy. Dr. Péan breaks down how naturally skeptical surgeons can adopt AI to save time, shares his granular daily workflow, and discusses his mission to cure physician burnout through tech. Whether you are a tech enthusiast or a total skeptic, this episode gives you the practical playbook for integrating AI into your surgical career today.
Hosts:
- Ayman Ali, MD
Ayman Ali is a PGY-4 at Duke Hospital and current Behind the Knife fellow.
- Patrick Georgoff, MD @georgoff
Patrick Georgoff is faculty in the Department of Surgery at the Duke University School of Medicine where he serves as an Associate Professor of Trauma, Acute, and Critical Care Surgery and Trauma Medical Director. He is a leading educator and creator for Behind the Knife, a premier digital education platform and podcast advancing surgical training through innovative, high-yield multimedia content.
- Christian Péan, MD @DrChristianPean
Christian Péan is faculty in the Department of Orthopaedic Surgery at the Duke University School of Medicine where he serves as Executive Director of AI and IT Innovation. He is the Founder and CEO of RevelAi Health, a health technology company advancing the transition to value-based care in musculoskeletal health with conversational AI. He is also author of the popular substack Techy Surgeon.  
https://www.revelaihealth.com/
https://techysurgeon.substack.com/
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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 observation with active surveillance.  Early assessment of treatment may allow appropriate reduction in use of radioactive iodine ablation and more relaxed routine monitoring can reduce surveillance burden to patients and providers. 
Hosts:  
- Amanda Doubleday, DO, MBA, Assistant Professor, Waukesha Surgical Specialists, ProHealth Care.  Affiliated with University of Wisconsin School of Medicine and Public Health, Department of Surgery.  
- Simon Holoubek, DO, MPH, Assistant Professor, University of Wisconsin School of Medicine and Public Health, Department of Surgery.  
- Alexander Chiu, MD, Assistant Professor, University of Wisconsin School of Medicine and Public Health, Department of Surgery.  
- Rebecca S Sippel, MD, FACS, Professor and Chair of Division of Endocrine Surgery, Vice Chair of Academic Affairs and Professional Development, University of Wisconsin School of Medicine and Public Health, Department of Surgery.  
Learning Objectives:
- Risk stratification system now includes 4 categories: low, low-intermediate, high-intermediate, and high
-TSH suppression targets are simplified:  below the normal range if there is structural or biochemical disease and in the normal range if disease free. 
- Thyroid lobectomy is recommended for tumors < 2cm cT1N0 tumors and can be considered for tumors 2-4 cm. 
- Micro-Papillary Thyroid Carcinoma (<1cm) can be managed with active surveillance and/or percutaneous ablation 
- Central compartment lymph node dissection includes levels 6-7. 
- RAI is strongly not recommended for low risk cancers.   Can be considered in low-intermediate and high-intermediate cancers.  It is routinely recommended in high risk cancers. 
References: 
Ringel MD, Sosa JA, Baloch Z, Bischoff L, Bloom G, Brent GA, Brock PL, Chou R, Flavell RR, Goldner W, Grubbs EG, Haymart M, Larson SM, Leung AM, Osborne JR, Ridge JA, Robinson B, Steward DL, Tufano RP, Wirth LJ. 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer. Thyroid. 2025 Aug;35(8):841-985. doi: 10.1177/10507256251363120. Erratum in: Thyroid. 2025 Nov;35(11):1350. doi: 10.1177/10507256251387671. PMID: 40844370.
https://pubmed.ncbi.nlm.nih.gov/40844370/

Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  
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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 data from CREST-2 suggest that for many asymptomatic patients, the knife — or the stent — may not add much at all. So if modern medical therapy works better than ever… who actually benefits from intervention anymore? Today, we unpack the evidence, the controversies, and how to counsel the patient who feels perfectly fine but has high-grade stenosis.
Hosts: Carolyn Judge, Andrew Huang, Luciano Delbono, Frank Davis, Robert Beaulieu
Institution: University of Michigan, Department of Surgery, Section of Vascular Surgery
Learning objectives:

Describe how modern intensive medical therapy has transformed the natural history of asymptomatic carotid stenosis and explain why contemporary patients experience substantially lower annual stroke risk than those in earlier eras.

Interpret and compare the results of landmark trials—including ACAS, ACST-1, and CREST-2—to assess the relative benefits of medical therapy, endarterectomy, and stenting.

Apply current evidence and guideline recommendations to patient care by selecting which asymptomatic patients are most likely to benefit from carotid revascularization versus optimized medical therapy alone.

References:
SVS Guidelines:
Brook, R. D., et al. (2022). Society for Vascular Surgery clinical practice guidelines for management of extracranial carotid artery disease. Journal of Vascular Surgery, 75(1), e1–e67. https://doi.org/10.1016/j.jvs.2021.09.031

CREST (1)
Brott, T. G., Hobson, R. W., Howard, G., et al. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine, 363(1), 11–23. https://doi.org/10.1056/NEJMoa0912321

CREST-2
Brott, T. G., Howard, G., Fong, P., et al. (2024). Randomized trial of carotid artery stenting or carotid endarterectomy vs best medical therapy for asymptomatic carotid stenosis: CREST-2 results. [Manuscript in preparation]. ClinicalTrials.gov Identifier: NCT02089217. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02089217

ACST-1
Halliday, A., Mansfield, A., Marro, J., et al. (2004). Randomised trial of carotid artery surgery for asymptomatic stenosis. Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16153-1

ACST-2
Halliday, A., Bulbulia, R., Bonati, L. H., et al. (2021). Carotid artery stenting versus carotid endarterectomy in patients with asymptomatic carotid stenosis (ACST-2): A randomised trial. Lancet, 398(10291), 1065–1073. https://doi.org/10.1016/S0140-6736(21)01980-1

ACAS
Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. (1995). Endarterectomy for asymptomatic carotid stenosis. JAMA, 273(18), 1421–1428. https://doi.org/10.1001/jama.1995.03520420033036

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Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  
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