A US-based surgical education podcast running since 2015, created by Dr Kevin Kniery, Dr Scott Steele, Dr Jason Bingham, and Dr John McClellan. It covers surgical training, procedures, clinical updates, and interviews with surgical experts across various specialties.
Topical haemostats are adjuncts for diffuse surgical bleeding, not substitutes for controlling pulsatile haemorrhage. Product selection depends on coagulation and access to the bleeding surface. Faster haemostasis does not necessarily translate into fewer transfusions, reoperations or deaths.
Adding perioperative anti-PD-L1 immunotherapy to FLOT improves event-free survival in resectable gastric and gastro-oesophageal junction cancer. Delayed survival benefits, incomplete postoperative treatment and uncertainty about response-guided omission of surgery complicate interpretation and treatment planning.
Global surgery careers build on professional expertise, sustainable partnerships and meaningful contributions to surgical systems. Mentorship, delegation and attention to the personal costs of professional commitments matter more than visibility or prestigious titles.
Marginal ulcers after Roux-en-Y gastric bypass may persist, cause anastomotic strictures or perforate. Optimising proton pump inhibitor delivery, investigating nicotine exposure and anatomical contributors, confirming endoscopic healing and recognising when urgent operative source control is required shape management.
Extremity vascular trauma demands haemorrhage control and recognition of hard vascular signs before selective imaging. Ankle–brachial index can guide investigation but has limitations, while temporary shunts may restore limb perfusion when definitive repair must wait.
Successful total mesorectal excision depends on preserving the mesorectal envelope while protecting pelvic nerves and adjacent structures. Radiation-related fibrosis, adequate mobilisation and anastomotic tension complicate surgery, while specimen photography and pathological grading help assess oncological quality.
After adequate source control for complicated intra-abdominal infection, four antibiotic days are usually sufficient. Persistent inflammation or organ support alone should not automatically extend treatment; worsening physiology should instead prompt reassessment of source control, drug exposure and microbiology.
Postoperative anastomotic leak management depends on containment and clinical stability. A stable contained leak may allow antibiotics and percutaneous drainage, while diffuse pain, worsening tachycardia and hypotension demand immediate operative control of intra-abdominal sepsis.
Intravascular lithotripsy improves vessel preparation in calcified femoropopliteal disease compared with plain balloon angioplasty, with fewer flow-limiting dissections and provisional stents. Balloon sizing, lesion length and endpoint definitions are important when interpreting the reported procedural and patency results.
Breast cancer risk assessment should combine family, reproductive, biopsy and radiation history with cautious use of risk models, while surveillance, endocrine prevention and risk-reducing surgery answer different questions and require discussion of absolute benefit, harms and patient preferences.
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