Behind The Knife: The Surgery Podcast

Digital surgery has morphed from buzzword into ubiquitous high-impact technology. In this episode, the BTK MIS team steps into the rapidly evolving ecosystem of cameras, sensors, robotics, and software that are turning surgical operations into structured, analyzable datasets. From AI segmentation to real-time telepresence, don’t miss this opportunity to catch up on what’s new and what’s next, what’s exciting and what’s terrifying, just on the horizon of your surgical career. 
Hosts: 
·      James Jung, MD, PhD, Assistant Professor of Surgery, Duke University
·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University
·      Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD
·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actually
Learning Goals: 
By the end of this episode, listeners will be able to:
·      Define “digital surgery” and describe its core components, including video capture, instrumentation, robotics, data analytics, and system connectivity. 
·      Discuss current and emerging applications of digital surgery in surgical education, including video-based self-assessment, procedural segmentation, and structured feedback models. 
·      Describe how digital tools can be used to improve OR efficiency and resource utilization, including instrumentation usage, operative time analysis, and workflow optimization. 
·      Summarize current telepresence and teleproctoring technologies and their clinical use cases, including augmented reality–based collaboration across institutions and geographic boundaries. 
·      Identify key ethical, legal, and operational challenges in digital and tele-surgery, including credentialing, cross-state licensure, liability, and trust in remote expertise. 
·      Discuss how digital surgery may reshape surgical training and competency-based assessment, including implications for autonomy, deliberate practice, and feedback frequency. 
·      Recognize future directions of digital surgery integration, including predictive analytics, simulation using patient-specific imaging, and AI-assisted intraoperative decision support.
References: 

Balvardi S, Semsar-Kazerooni K, Kaneva P, et al. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy. Surg Endosc. 2023;37(3):2281-2289. doi:10.1007/s00464-022-09466-6 [https://pubmed.ncbi.nlm.nih.gov/36307525/]

Hospital Utilizes Intraoperative Idle Time Metrics to Improve Surgical Safety and Efficiency. Theator | The Surgical Intelligence Company. Accessed March 20, 2026. https://theator.io/customer-story/hospital-utilizes-intraoperative-idle-time-metrics-to-improve-surgical-safety-and-efficiency/

Campbell KK, Abreu AA, Zeh HJ, et al. Using OR Black Box Technology to Determine Quality Improvement Outcomes for In-situ Timeout and Debrief Simulation. Ann Surg. 2026;283(1):122. doi:10.1097/SLA.0000000000006438 [https://pubmed.ncbi.nlm.nih.gov/38317208/]

Al Abbas AI, Meier J, Daniel W, et al. Impact of team performance on the surgical safety checklist on patient outcomes: an operating room black box analysis. Surg Endosc. 2024;38(10):5613-5622. doi:10.1007/s00464-024-11064-7 [https://pubmed.ncbi.nlm.nih.gov/39069926/]

Proximie’s telepresence platform helps surgeons across the globe grow and exchange experience in real-time. World Health Expo Insights. Accessed March 20, 2026. https://www.worldhealthexpo.com/insights/telemedicine/proximie-s-telepresence-platform-helps-surgeons-across-the-globe-grow-and-exchange-experience-in-real-time

Hassan AE, Desai SK, Georgiadis AL, Tekle WG. Augmented reality enhanced tele-proctoring platform to intraoperatively support a neuro-endovascular surgery fellow. Interv Neuroradiol. 2022;28(3):277-282. doi:10.1177/15910199211035304 [https://pubmed.ncbi.nlm.nih.gov/34538166/]

SAGES Digital Surgery Working Group; Ali JT, Yang G, Green CA, Reed BL, Madani A, Ponsky TA, Hazey J, Rothenberg SS, Schlachta CM, Oleynikov D, Szoka N. Defining digital surgery: a SAGES white paper. Surg Endosc. 2024 Feb;38(2):475-487. doi: 10.1007/s00464-023-10551-7. Epub 2024 Jan 5. PMID: 38180541. [https://pubmed.ncbi.nlm.nih.gov/38180541/]

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/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate 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-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
OBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-review
EPA Playbook: https://behindtheknife.org/course/epa-playbook
Surgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcards
ABSITE Review: https://behindtheknife.org/course/absite-2026-exam-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Navigating the path to becoming a surgeon in the US as an International Medical Graduate (IMG) can definitely have its hurdles. In this episode we sit down with Professor of Surgery, Dr. Ourania Preventza about her journey as an IMG, and how to break down the barriers in one of the most competitive surgical subspecialties. Dr. Preventza teaches us why sponsorship is invaluable, and how we as a surgical community can help support this vulnerable group of providers. With years of experience to offer, both as an IMG herself, and now as a fierce advocate and mentor for trainees, this interview with Dr. Preventza is not one to miss.
References:
https://www.jtcvsopen.org/article/S2666-2736(25)00059-2/fulltext
The current landscape and challenges facing international medical graduates in cardiothoracic surgery training
https://pubmed.ncbi.nlm.nih.gov/39886768/
International Medical Graduates in Academic Cardiothoracic Surgery
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S2666273625002840?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2666273625002840%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
A career in cardiothoracic surgery in the United States: Guidance and resources for international medical graduates 
https://jtd.amegroups.org/article/view/38164/html
US women in Thoracic Surgery: Reflections on the Past and Opportunities for the Future
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/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate 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-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
OBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-review
EPA Playbook: https://behindtheknife.org/course/epa-playbook
Surgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcards
ABSITE Review: https://behindtheknife.org/course/absite-2026-exam-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Join our burn team as they dive into the complex world of skin substitutes in burn care, breaking down a practical four-axis framework to help clinicians navigate product selection, patient factors, and clinical goals when managing massive burn injuries.
Hosts: 
- Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento 
- Laura Johnson – Grady Memorial Hospital 
- Lauren Nosanov – Grady Memorial Hospital 
- Victoria Miles – Louisiana State University Health Science Center, University Medical Center New Orleans 
Learning objectives: 
1. Classify skin substitutes along four axes: layer replaced, cellularity, origin, and duration. 
2. Integrate wound, patient, phase-of-care, and goal factors to select an appropriate skin substitute or combination strategy. 
3. Critically appraise the evidence base for skin substitutes, including industry influence and the distinction between adjunctive tools and definitive autologous coverage.
If you would like the table mentioned in the episode, please email hello@behindtheknife.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://behindtheknife.org/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate 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-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
OBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-review
EPA Playbook: https://behindtheknife.org/course/epa-playbook
Surgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcards
ABSITE Review: https://behindtheknife.org/course/absite-2026-exam-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this episode of the Behind the Knife Global Surgery Series, we take a closer look at the real-world complexity of global surgery partnerships between high-income institutions and partners in the Global South. Words like equity, bidirectionality, partnership, and decolonization are used often in global surgery—but what do they actually mean when funding, mobility, research access, publication opportunities, and institutional power are unequally distributed?
Host Mike Mallah is joined by Dr. Hugo Stark from George Hospital in South Africa and Dr. Sydney Bertram from Emory for a candid discussion about the benefits and tensions of collaborations in an unequal world. Together, they explore how global surgery partnerships can create meaningful educational and clinical value, how good intentions can still reproduce unequal systems, and how surgeons can build partnerships that are locally useful, honest about power, and ultimately centered on better surgical care for patients.
Hosts/Guests:
- Mike M. Mallah, MD, FACS, FICS
Director of Global Surgery at Medical University of South Carolina
@MikeMMallahMD
@MUSCGlobalSurg
mallahm@musc.edu

- Hugo Stark, MD
Head of Department - Surgery, George Hospital, Western Cape, South Africa
Head of Surgical Services, Central Karoo Region
Sydney Bertram, MD
General Surgery Resident, Emory University
Trainee Advisory Council, Consortium of Universities for Global Health
@Sydney_Bertram

Learning objectives:
• Describe how global surgery partnerships can provide educational, clinical, professional, and research value for both high-income and Global South partners.
• Identify how asymmetries in funding, mobility, publication access, and institutional agenda-setting can create inequity within otherwise well-intentioned global surgery partnerships.
• Discuss practical principles for ethical global surgery engagement, including centering local needs, avoiding extraction, building durable partnerships, and focusing on patient access to surgical decision-making.
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/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate 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-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
OBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-review
EPA Playbook: https://behindtheknife.org/course/epa-playbook
Surgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcards
ABSITE Review: https://behindtheknife.org/course/absite-2026-exam-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Immune checkpoint inhibitors have rapidly reshaped care for triple-negative breast cancer (TNBC)—but surgical teams increasingly encounter their downstream perioperative consequences. In this episode, we define immunotherapy through the lens of checkpoint biology, review the landmark evidence supporting pembrolizumab in metastatic PD‑L1–positive TNBC (KEYNOTE‑355) and curative-intent stage II–III TNBC (KEYNOTE‑522), and translate immune-related adverse events (irAEs) into practical periop recognition, triage, and timing decisions—especially for endocrine, pulmonary, hepatic, dermatologic, and GI toxicities.

Hosts:
- Rashmi Kumar, MD, PhD
Resident, University of Michigan General Surgery Residency Program 
Twitter/X: @RashmiJKumar
- Melissa Pilewskie, MD
Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine
Twitter/X: @MPilewskie
- Stephanie Downs-Canner, MD
Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program
Twitter/X: @SDownsCanner
Learning Objectives:

Define immunotherapy and immune checkpoint inhibition in breast cancer 

Summarize current clinical indications and pivotal evidence for pembrolizumab in TNBC 

Equip perioperative clinicians to identify and manage immune-related adverse events (irAEs) or side effects of immunotherapy. 

Rationale for Immunotherapy in Breast Cancer Review
Selecting Triple Negative Breast Cancer Patients for Immunotherapy: https://pubmed.ncbi.nlm.nih.gov/37714640/

Landmark Clinical Trials Discussed in this Episode

KEYNOTE-355: https://pubmed.ncbi.nlm.nih.gov/33232653/

KEYNOTE-522: https://pubmed.ncbi.nlm.nih.gov/33232642/

IMpassion130: https://pubmed.ncbi.nlm.nih.gov/30345906/

IMpassion131: https://pubmed.ncbi.nlm.nih.gov/33930478/

Assessment of Surgical Outcomes in patients receiving chemoimmunotherapy
Surgical outcomes after neoadjuvant chemoimmunotherapy in triple-negative breast cancer: https://pubmed.ncbi.nlm.nih.gov/38332314/

Immune Related Adverse Events and Management

Schneider BJ, et al. Management of immune-related adverse events: https://pubmed.ncbi.nlm.nih.gov/34724392/

Brahmer JR, et al. SITC clinical practice guideline: https://pubmed.ncbi.nlm.nih.gov/34177534/

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/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate 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-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
OBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-review
EPA Playbook: https://behindtheknife.org/course/epa-playbook
Surgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcards
ABSITE Review: https://behindtheknife.org/course/absite-2026-exam-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US