Surgical Readings

Initial Antibiotic Intervention May Have Long-Term Benefits for Uncomplicated Acute Appendicitis

Wed, 08 Jul 2026 05:00:00 -0500

A multicenter randomized clinical trial in Finland has found that, among patients initially treated with antibiotics for uncomplicated acute appendicitis, the rate of recurrence and appendectomy at 10-year follow-up supports the use of antibiotics. In this episode, host Rick Greene, MD, FACS, talks with Paulina Salminen, MD, PhD, FACS(Hon), from the University of Turku in Finland, who is lead author of the study, Antibiotic Therapy for Uncomplicated Acute Appendicitis Ten-Year Follow-Up of the APPAC Randomized Clinical Trial, in The Journal of the American Medical Association.

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Understanding the Importance of Body Composition Changes After Obesity Treatment

Wed, 10 Jun 2026 05:00:00 -0500

With a growing reliance on GLP-1 treatments for obesity, researchers at Vanderbilt
University in Nashville, Tennessee, compared body composition changes between
patients who used GLP-1s versus patients who underwent bariatric surgery for obesity
treatment. In this episode, host Rick Greene, MD, FACS, talks with Jason M. Samuels, MD,
FACS, one of the authors of Body Composition Changes After Bariatric Surgery or
Treatment With GLP-1 Receptor Agonists about the findings, which showed that while
both treatments reduced fat mass, surgery helped preserve fat-free mass such as muscle
and organ tissues.
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New ACS Report Highlights Key Trends in Cancer Treatment

Wed, 06 May 2026 05:00:00 -0500

In this episode, host Rick Greene, MD, FACS, talks with Ronald J. Weigel, MD, PhD, MBA, FACS, Medical Director of ACS Cancer Programs, about a new report from the ACS National Cancer Database (NCDB) that notes key trends in cancer treatment, as well as in-depth reports on outcomes for prostate cancer, esophageal cancer, and melanoma. Dr. Weigel also describes the history of the NCDB and future plans that will lead to more rapid and robust insights on cancer occurrence and treatment.

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Stenting Increases Benefits of Medical Management in Carotid Stenosis Patients

Wed, 01 Apr 2026 05:00:00 -0500

In this episode, host Rick Greene, MD, FACS, talks with Brajesh Lal, MBBS, FACS, professor of vascular surgery at the University of Maryland School of Medicine and chief of vascular service at the Baltimore Veterans Affairs Medical Center. Dr. Lal and colleagues recently published research on Medical Management and Revascularization for Asymptomatic Carotid Stenosis in The New England Journal of Medicine, finding that adding stenting to medical management for carotid stenosis helps reduce the risk of stroke or death within 4 years; however, Dr. Lal tells Dr. Greene it’s too soon to discount the benefits of carotid endarterectomy.

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Radioactive Seed vs. Wire: Rethinking Breast Cancer Localization

Wed, 04 Mar 2026 05:00:00 -0600

In this episode of Surgical Readings, host Rick Greene, MD, FACS, connects with Lejla Hadzikadic-Gusic, MD, MS, FACS, for an engaging conversation about a study that is reshaping the way surgeons localize nonpalpable malignant breast disease. Dr. Hadzikadic-Gusic discusses her randomized trial, published in the Annals of Surgery (A Randomized, Single-Center, Superiority Trial of Radioactive Seed Location versus Wire Localization for Malignant Breast Disease), comparing two commonly used localization methods: traditional wire placement and radioactive seed technique. Listeners will hear how her team set out to answer an important question in breast surgery: Can we improve the patient experience without compromising clinical outcomes? While both techniques performed similarly in achieving clear surgical margins, the study uncovered compelling differences in what matters to patients and care teams. Tune in to learn how radioactive seed localization led to higher satisfaction, less anxiety, and greater convenience for patients—and offered workflow advantages for surgeons.

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Novel Fluorophore Helps Reduce Surgical Risk in Patients Undergoing Prostatectomy

Wed, 04 Feb 2026 05:00:00 -0600

In this episode, host Rick Greene, MD, FACS, talks with Samuel A. Gold, MD, from the urology service in the Department of Surgery at Memorial Sloan Cancer Center in New York, New York, about using intraoperative fluorescence to illuminate nerve structures during robotic-assisted prostatectomy. Dr. Gold’s phase-1 study, published in JAMA Surgery (Rizedisben in Minimally Invasive Surgery), found that the fluorophore was generally well tolerated and clinically effective, which could revolutionize prostatic surgery and lead to wider applicability.

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Surgeon Risk of Mortality Is Highest Among All Physician Types

Wed, 07 Jan 2026 05:00:00 -0600

In this episode, host Rick Greene, MD, FACS, talks with Vishal R. Patel, MD, MPH, from Brigham and Women’s Hospital in Boston, about a recent article in JAMA Surgery on Mortality Among Surgeons in the United States. Dr. Patel and colleagues found that, among all physician types, risk of mortality is highest among surgeons. Dr. Greene probes for the common causes of death among surgeons and what mitigation strategies can be put in place to change this somewhat surprising statistics.

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Management of Pediatric Surgical Patients

Fri, 11 Jul 2025 07:00:00 -0500

In the latest episode of Surgical Readings from SRGS, host Rick Greene, MD, FACS, is joined by Associate Editors Carmelle Romain, MD, FACS, and Manish Raiji, MD, FACS, from the University of Chicago’s Department of Surgery. Together, they explore key topics in pediatric surgical care, including necrotizing enterocolitis, intestinal obstruction, pediatric trauma resuscitation, and more.

Learn more about Selected Readings in General Surgery, an American College of Surgeons publication that highlights highly relevant and practice-changing information from the world’s most prominent medical journals.

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Breast Diseases: Insights for the General Surgeon

Fri, 30 May 2025 07:00:00 -0500

In this episode of Surgical Readings, Dr. Rick Greene leads an insightful discussion with Drs. Carla Fisher and Kay Yoon-Flannery on the diagnosis and management of breast disease. The conversation explores a range of topics, including both benign and malignant breast conditions. A comprehensive review of breast cancer is presented, covering management of the primary lesion, evolving approaches to axillary staging and therapy, the use of genetic and genomic testing, and the value of chemotherapy and immunotherapy.

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Surgical Oncology, Part 2

Fri, 07 Mar 2025 07:00:00 -0600

In the second episode of a two-part series on surgical oncology, host Rick Greene, MD, FACS, is once again joined by Drs. John Stewart and Prakash Pendalai to discuss the important features of head and neck malignancies, benign and malignant gynecologic conditions, and principles of palliative care for patients with cancer.

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Surgical Oncology, Part 1

Fri, 29 Nov 2024 13:58:00 -0600

In this first episode of a two-part series on surgical oncology, host Rick Greene, MD, FACS, is joined by Drs. John Stewart and Prakash Pendalai to discuss the genetic and molecular features of cancer. They also discuss screening methods and other preventive interventions, with a focus on cutaneous oncology and gastrointestinal stromal tumors (GIST).

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Wound Healing and Burn Care

Fri, 26 Jul 2024 07:00:00 -0500

This episode of Surgical Readings features an informative conversation led by Rick Greene, MD, FACS, with the associate editors for the Wound Healing and Burn Care issue. Laura Haines, MD, FACS, and Deepak Bharadia, MBBS, FACS, provide valuable perspectives on the management of non-healing wounds, prevention of hypertrophic scarring, and achieving early wound coverage in patients with burn injury.

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Nutrition and Metabolic Disease

Fri, 24 May 2024 07:00:00 -0500

This episode focuses on important issues related to nutritional assessment and support in surgical patients. Host Rick Greene, MD, FACS, talks to Melissa Coleman, MD, and Joseph Rappold, MD, FACS, about nutritional assessment of critically ill patients, the role of nutrition in the management of a patient with esophageal cancer who is undergoing neoadjuvant chemotherapy, and more.

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Surgical Site Infections: Antimicrobial Therapy, Source Control, and Prevention

Fri, 01 Mar 2024 07:00:00 -0600

In this episode host Rick Greene, MD, FACS, talks to Lillian Kao, MD, FACS, from The University of Texas, Houston McGovern School of Medicine, about prevention and treatment of surgical site infections. Topics covered include bacterial resistance to antimicrobial drugs, novel therapies on the horizon, and lessons learned from viruses such as COVID and monkeypox.

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Trauma Part 2: Lessons from the ACS Advanced Trauma Life Support (ATLS) Program

Fri, 24 Nov 2023 09:00:00 -0600

In the second episode of a two-part series on trauma, host Rick Greene, MD, FACS, resumes his conversation with M. Zain Hashmi, MD, FACS, and Sabrina Goddard, MD, from the University of Alabama at Birmingham. They discuss lessons from the ACS Advanced Trauma Life Support® program such as managing the difficult airway, indicators of shock, a whole blood approach, and imaging of the trauma patient.

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Trauma Part 1: Quality Assessment of Trauma Centers and Injury Prevention

Fri, 01 Sep 2023 14:00:00 -0500

In the first episode of a two-part series on trauma, host Rick Greene, MD, FACS, talks with three trauma surgeons about a variety of topics, including a milestone that led to a significant decrease in motor vehicle mortality, quality assessment of trauma centers, trauma care for geriatric patients, and specific areas of injury prevention such as firearm injury prevention and violence prevention. His guests are Jeffrey D. Kerby, MD, PhD, FACS, director of the Division of Trauma & Acute Care Surgery at the University of Alabama at Birmingham (UAB) and Chair of the ACS Committee on Trauma; Sabrina Goddard, MD, assistant professor of surgery and assistant trauma medical director at UAB; and M. Zain Hashmi, MD, assistant professor of surgery at UAB.

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Liver Surgery Part 3: Liver Malignancies and Liver Transplantation

Fri, 19 May 2023 08:00:00 -0500

In this final episode in our liver surgery series, host Rick Greene, MD, FACS, continues to discuss liver malignances and transplantation with Zachary C. Dietch, MD, member of the abdominal transplant team at Northwestern University Hospital in Chicago, IL.

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Liver Surgery Part 2: Cystic Diseases, Neoplasms, and Metastatic Lesions of the Liver

Fri, 21 Apr 2023 08:02:53 -0500

In this second in a series of three episodes focused on liver surgery, host Rick Greene, MD, FACS, continues to discuss liver disease and injuries with Zachary C. Dietch, MD, member of the abdominal transplant team at Northwestern University Hospital in Chicago, IL.

Liver Surgery Part 1: Liver Disease and Liver Injuries

Fri, 03 Mar 2023 08:00:00 -0600

In this first in a series of episodes focused on liver surgery, host Rick Greene, MD, FACS, discusses liver disease and injuries with Zachary C. Dietch, MD, member of the abdominal transplant team at Northwestern University Hospital in Chicago, IL.

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Vascular Surgery Part 6: Varicose Veins, Post-Thrombotic Complications, and Venous Ulcers

Fri, 03 Feb 2023 08:00:00 -0600

In this final episode in the Vascular Surgery series from Surgical Readings from SRGS, host Rick Greene, MD, FACS, and vascular surgeon Girma Tefera, MD, FACS, review key data on the etiology, diagnosis, and management of varicose veins. Dr. Tefera outlines endoluminal ablation, foam injection, and traditional approaches of ligation and stripping. The discussion current guidance for compression treatment and strategies for successful wound care and management.

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Vascular Surgery Part 5: Mesenteric and Renal Disease

Fri, 06 Jan 2023 08:00:00 -0600

In this episode of our series focused on vascular surgery, host Dr. Rick Greene speaks with vascular surgeon Dr. Britt Tennessean about the clinical features and important management aspects of mesenteric and renal vascular disease.

Britt H. Tonnessen, MD, FACS, is Associate Professor of Surgery, Division of Vascular Surgery & Endovascular Therapy; Associate Program Director, Vascular Integrated Residency, Yale University School of Medicine.

Learn more about Selected Readings in General Surgery, an American College of Surgeons publication that highlights highly relevant and practice-changing information from the world’s most prominent medical journals.

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Vascular Surgery Part 4: Vascular Injuries

Fri, 02 Dec 2022 08:00:00 -0600

In this episode of our series focused on vascular surgery, host Rick Greene, MD, FACS, and vascular surgeon David Feliciano, MD, FACS, discuss topics related to vascular trauma, including the role of the physical examination in evaluating vascular injuries, distinguishing between hard and soft injury signs, indications for immediate operating room inventions, preferred incision options for subclavian and axillary arterial injuries, and the use of temporary intravascular shunts.

David V. Feliciano, MD, FACS, MAMSE, is a clinical professor of surgery at the University of Maryland School of Medicine, and an attending Surgeon at Shock Trauma Center/Department of Surgery, University of Maryland Medical Center, Baltimore, MD.

Learn more about Selected Readings in General Surgery, an American College of Surgeons publication that highlights highly relevant and practice-changing information from the world’s most prominent medical journals.

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Vascular Surgery Part 3: Venous Thromboembolism

Fri, 04 Nov 2022 08:00:00 -0500

In a continuing series focused on vascular surgery, host Rick Greene, MD, FACS, talks to vascular surgeon Marie L. Crandall MD, MPH, FACS, about venous thromboembolism.

Dr. Crandall is Professor and Associate Chair, Research; Chief, Division of Acute Care Surgery; Program Director, General Surgery Residency, Department of Surgery, University of Florida Jacksonville.

*Addendum from Dr. Crandall:

“The timing of VTE prophylaxis after neurosurgical intervention for TBI can be challenging. However, this JAMA Surg retrospective cohort study demonstrated that prophylaxis before 72hrs was associated with greater risk of reintervention and mortality and after 72 hours was associated with greater risk of VTE but not mortality. This suggests that perhaps 3 days would be safest balance for most patients after neurosurgical intervention for TBI.”

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Vascular Surgery Part 2: Carotid Occlusive Disease and Peripheral Arterial Disease

Fri, 07 Oct 2022 08:56:07 -0500

In a continuing series focused on vascular surgery, host Rick Greene, MD, FACS, talks to vascular surgeon Britt Tonnessen, MD, FACS, about carotid occlusive disease and peripheral arterial disease.

Britt H. Tonnessen, MD, FACS, is Associate Professor of Surgery, Division of Vascular Surgery & Endovascular Therapy; and Associate Program Director, Vascular Integrated Residency, Yale University School of Medicine.

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Vascular Surgery Part 1: Aneurysms

Fri, 02 Sep 2022 08:00:00 -0500

In this first of a series of episodes focused on Vascular disease, host Rick Greene, MD, FACS, joins vascular surgeon Girma Tefera, MD, FACS, in a discussion of aortic aneurysm disease, reviewing current screening guidelines, disease etiology, and the impact of cigarette smoking on disease progression. The conversation also addresses aortic aneurysm disease’s epidemiology, aneurysm definitions and classifications, and current modalities of treatment, including open surgical and endovascular approaches and their outcomes.

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Endocrine Surgery

Fri, 05 Aug 2022 08:00:00 -0500

In this episode, SRGS Editor Lewis Flint, MD, FACS, talks with Rachel Kelz, MD, FACS, and Lauren Krumeich, MD, both from the University of Pennsylvania in Philadelphia, about the latest developments in the diagnosis and treatment of thyroid disease, including the use of telehealth and the effect of gastric bypass surgery on patients with thyroid issues. They also discuss innovative treatments for thyroid cancer and preoperative management of pheochromocytoma.

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Colorectal Disease—Part 2

Fri, 22 Jul 2022 06:12:57 -0500

Host Rick Greene, MD, FACS, continues his conversation with Sandra Kavalukas, MD, about colorectal disease, including important concepts for treating anal fissures, Ogilvie syndrome, parastomal hernias, and malignancy of the colon, rectum, and anus. Dr. Kavalukas is a colorectal surgeon from the University of Louisville Medical Center.

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Colorectal Disease—Part 1

Thu, 07 Jul 2022 08:53:41 -0500

In the inaugural episode of this series, Rick Greene, MD, FACS, interviews Sandra Kavalukas, MD, a colorectal surgeon from the University of Louisville Medical Center about the management of perirectal abscess and diverticular disease, the use of fiber supplements, and the importance of engaging patients in informed decision-making.

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About Dr. Kavalukas

Dr. Sandra Kavalukas is our newest member of the team at University of Louisville Medical Center. Originally from Pittsburgh, she came to Louisville after completing her General Surgery Residency at Vanderbilt University and Colorectal Surgery Fellowship at Cleveland Clinic Florida.

Her clinical interests include inflammatory bowel disease (IBD), colorectal and anal cancer, constipation/motility disorders, diverticulitis, and anorectal problems. She performs both laparoscopic and robotic surgery. With an academic appointment at the University of Louisville, she is involved in educating medical students as well as the clinical training of residents and fellows.

Academically, her background research is in wound healing and fibrotic/inflammatory pathways, which she intends on extending into the realm of inflammatory bowel disease as well as exploring interactions with the microbiome. She sits on numerous committees for the American Society of Colon and Rectal Surgery and is a regular manuscript reviewer for several peer-reviewed journals in the colorectal field.