Episodios

  • BackTable Brief: Diagnosis and Management of Endometriosis with Dr. Ted Lee

    BackTable Brief: Diagnosis and Management of Endometriosis with Dr. Ted Lee
    Jul 16 2024
    In this BackTable OBGYN Brief, Dr. Mark Hoffman and Dr. Ted Lee discuss the clinical approach to diagnosing endometriosis through physical exam and imaging, and the collaborative surgical approach to treating it. Dr. Lee explains the importance of detailed patient history and various examination techniques, including palpation and rectovaginal exams, to identify potential signs of endometriosis. He emphasizes the specificity of these exams in differentiating endometriosis pain from other causes. The discussion also covers the role of imaging, such as MRI, particularly in advanced cases, and the collaborative approach with colorectal surgeons for bowel-related complications. Dr. Lee shares insights on the use of physical therapy and managing musculoskeletal pain related to endometriosis, highlighting the importance of multi-disciplinary care for optimal patient outcomes. TIMESTAMPS 00:00 - Introduction 00:15 - Initial Patient Assessment for Endometriosis 01:00 - Detailed Physical Exam Techniques 07:00 - Imaging and Further Diagnostic Steps 10:55 - Collaborative Surgical Approach CHECK OUT THE FULL EPISODE BackTable OBGYN Ep. 30: Ambulatory Workup of Endometriosis Patients https://www.backtable.com/shows/obgyn/podcasts/30/ambulatory-workup-of-endometriosis-patients
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    12 m
  • Ep. 59 Tackling the Big Uterus with Dr. Uchenna Acholonu

    Ep. 59 Tackling the Big Uterus with Dr. Uchenna Acholonu
    Jul 9 2024
    In this episode of the BackTable OBGYN podcast, host Dr. Mark Hoffman is joined by MIGS specialist Dr. Uchenna Acholonu to discuss the intricacies of complex gynecologic surgeries, focusing particularly on handling large uteruses during total laparoscopic hysterectomy (TLH). --- SYNPOSIS The discussion begins with talk of the doctors’ practices and friendship. They then cover comprehensive patient evaluations and various surgical techniques, including skeletonizing the uterines, colpotomy tricks, uterine manipulators, and morcellation. Dr. Acholonu also shares his personal routines and preferences, including the use of a flexible scope to get around the big uterus. The duo exchange insights on surgical techniques, patient-centered care, and the continuous learning necessary in the medical field. They emphasize the significance of safety, adequate planning, and the benefits of engaging in community networks for better surgical outcomes. The conversation concludes with a light-hearted note on their shared experiences and camaraderie, offering both educational value and a glimpse into the dynamic relationship between two seasoned professionals. --- TIMESTAMPS 00:00 - Introduction 04:01 - Building a Subspecialty Practice 07:34 - Patient Referrals 12:41 - Surgical Approach 16:06- The Big Uterus 28:36 - Surgical Steps in TLH, Skeletonizing the Uterines 32:56 - Challenges and Solutions 36:49 - Energy Sources and Surgical Tools 42:34 - Colpotomy 44:43 - Tissue Extraction and Morcellation 50:27 - Closing and Post-Operative Care 52:05 - Use of Lupron 53:16 - Final Thoughts
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    56 m
  • BackTable Brief: vNOTES IV with Dr. Jan Baekelandt

    BackTable Brief: vNOTES IV with Dr. Jan Baekelandt
    Jul 5 2024
    In this BackTable OBGYN Brief, host Dr. Mark Hoffman interviews Dr. Jan Baekelandt from Belgium about vNOTES (vaginal natural orifice transluminal endoscopic surgery) incision placement to allow future vaginal deliveries and prevent dyspareunia. First, Dr. Hoffman discusses the nuances of laparoscopy, particularly the preference for smaller incisions to reduce hernia rates and postoperative pain. The conversation covers the specifics of performing colpotomy and the risks associated with different types of incisions, including vaginal and abdominal. Dr. Baekelandt emphasizes the importance of proper training and starting with simpler cases when introducing new surgical techniques like vNOTES. TIMESTAMPS 00:00 - Introduction 00:32 - Concerns About Hernia Rates and Incisions 01:05 - Vaginal Incisions and Their Implications 02:35 - Vaginal Deliveries After vNOTES 03:55 - Dyspareunia After vNOTES 04:13 - Technical Details on Incision Placement 05:53 - Closing Techniques 06:45 - Advice for Surgeons Introducing vNOTES
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    10 m
  • BackTable Brief: vNOTES III with Dr. Jan Baekelandt

    BackTable Brief: vNOTES III with Dr. Jan Baekelandt
    Jul 2 2024
    In this BackTable OBGYN Brief, host Dr. Mark Hoffman speaks with Dr. Jan Baekelandt about the specific challenges and complications associated with vNOTES, as well as contraindications to be mindful of. They discuss the nuances of uterine artery management and the benefits and risks of the Alexis ring, especially for hemostasis. The doctors go on to discuss contraindications for vNOTES, including complex endometriosis and pelvic scarring. Dr. Baekelandt also shares insights on avoiding ureteric and bladder injuries and future direction of vNOTES. TIMESTAMPS 00:00 - Introduction 00:14 - Understanding vNOTES Complications 00:50 - Techniques for Uterine Artery Management 02:13 - Hemostasis 03:24 - Challenges with Ureter and Bladder Management 09:44 - Contraindications to vNOTES 12:07 - Future Directions
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    15 m
  • Ep. 58 Understanding Rising Endometrial Cancer Rates with Dr. Amanda Fader and Dr. Matthew Powell

    Ep. 58 Understanding Rising Endometrial Cancer Rates with Dr. Amanda Fader and Dr. Matthew Powell
    Jun 25 2024
    Gynecologic oncology experts Dr. Matthew Powell from Washington University School of Medicine and Dr. Amanda Fader from Johns Hopkins Hospital discuss the increasing rates of endometrial cancer along with future directions of treatments and screenings. --- SYNPOSIS First, the physicians discuss trends in endometrial cancer rates and delve into the factors driving these trends, such as the obesity epidemic and aging population. They explore the differences between endometrioid and non-endometrioid cancers, along with the impact of racial and geographic disparities. The conversation also covers advances in diagnostics and treatments—including immunotherapy and targeted therapies—and the critical need for better awareness, screening practices, and research funding to combat this public health threat. --- TIMESTAMPS 00:00 - Introduction 03:11 - Types of Endometrial Cancer 04:44 - Rising Rates and Risk Factors 08:03 - Disparities in Endometrial Cancer Care 10:37 - Symptoms and Diagnosis 13:52 - Ultrasound vs. Biopsy 16:17 - Challenges in Biopsies 20:58 - Management/Treatment Approaches 23:03 - Geographic Disparities/Access to Care 26:07 - Vaginal Brachytherapy 32:11 - Innovations in Treatment and Research 40:34 - Future Directions: Endometrial Screening 43:54 - AI in Gynecologic Oncology --- RESOURCES Beavis, A. L., Blechter, B., Najjar, O., Fader, A. N., Katebi Kashi, P., & Rositch, A. F. (2023). Identifying women 45 years and younger at elevated risk for endometrial hyperplasia or cancer. Gynecologic Oncology, 174, 98–105. https://doi.org/10.1016/j.ygyno.2023.04.019 Mirza, M. R., Sharma, S., Roed, H., Landrum, L. M., Gilbert, L., Gold, M. A., Novák, Z., Edelson, M., Meirovitz, M., Diaz, J. P., Huygh, G., Buscema, J., Pothuri, B., Eshed, H. D., Coleman, R. L., Slomovitz, B. M., Kostadinov, R., Stevens, S., Ronzino, G., & Powell, M. A. (2024). Post hoc analysis of progression-free survival (PFS) and overall survival (OS) by mechanism of mismatch repair (MMR) protein loss in patients with endometrial cancer (EC) treated with Dostarlimab plus chemotherapy in the ruby trial. Journal of Clinical Oncology, 42(16_suppl), 5606–5606. https://doi.org/10.1200/jco.2024.42.16_suppl.5606 Society of Gynecologic Oncology (SGO): https://www.sgo.org/
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    51 m
  • Ep. 57 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana

    Ep. 57 AI Scribes: Enhancing Patient and Physician Interaction with Elie Toubiana
    Jun 21 2024
    Dr. Aditya Bagrodia sits down with Elie Toubiana, founder and CEO of ScribeMD.ai, to discuss the transformative potential of artificial intelligence (AI) in medical documentation. --- SYNPOSIS Their conversation covers the capabilities and benefits of using an AI-driven medical scribe that ensures HIPAA compliance, reduces physician burnout, and enhances patient interactions. Elie also shares his insights about the technology’s adaptability across various medical fields. Finally, Dr. Bagrodia and Elie discuss ethical considerations surrounding applications of AI in other aspects of healthcare, such as medical workup and diagnosis. --- TIMESTAMPS 00:00 - Introduction 06:00 - How ScribeMD AI Works 14:14 - Integration with EMR 20:31 - Legal Considerations with AI Technology 26:34 - Cost Implications of AI Scribes 38:46 - Future of AI in Medical Diagnosis 41:45 - Conclusion and Final Thoughts --- RESOURCES ScribeMD.ai https://www.scribemd.ai/
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    45 m
  • Ep. 56 AI Advancements in Gynecologic Surgery with Dr. Vadim Morozov

    Ep. 56 AI Advancements in Gynecologic Surgery with Dr. Vadim Morozov
    Jun 18 2024
    Hosts Dr. Mark Hoffman and Dr. Amy Park invite Dr. Vadim Morozov, a minimally invasive gynecologic surgeon at MedStar Washington Hospital Center, to discuss the applications and implications of artificial intelligence (AI) in gynecologic surgery both currently and in the future. --- SYNPOSIS Dr. Morozov shares his insights on the basics of AI as well as how it is currently being used in medicine and research. He shares his experiences working with AI to develop algorithms for robotic gynecologic procedures. Furthermore, he predicts the direction AI is going in medicine and highlights the complexities and ethical considerations of integrating AI into medical practice. The conversation delves into the advancements, potentials, and concerns surrounding AI, addressing its impact on surgery, privacy, and the future of medical practice. --- TIMESTAMPS 00:00 - Introduction 03:52 - AI in Gynecologic Surgery 06:10 - Understanding AI Basics 13:24 - AI in Medical Applications 17:09 - Future of AI in Medicine 33:24 - AI in Surgery 45:10 - Data and Privacy Concerns 57:35 - Call to Action: Get Involved --- RESOURCES BUMP Study: Goodday, S.M., Karlin, E., Brooks, A. et al. Better Understanding of the Metamorphosis of Pregnancy (BUMP): protocol for a digital feasibility study in women from preconception to postpartum. npj Digit. Med. 5, 40 (2022). https://doi.org/10.1038/s41746-022-00579-9
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    1 h y 2 m
  • BackTable Brief: vNOTES II with Dr. Jan Baekelandt

    BackTable Brief: vNOTES II with Dr. Jan Baekelandt
    Jun 14 2024
    In this BackTable OBGYN Brief, host Dr. Mark Hoffman and Dr. Jan Baekelandt explore the benefits of vNOTES, especially in certain patient populations – obese patients, patients with a history of multiple abdominal surgeries, and those with a large uterus. Dr. Baekelandt highlights the aesthetic advantages of minimized scarring in vNOTES alongside clinical benefits such as reduced postoperative pain, lower analgesia use, and shorter hospitalization times. They discuss the outcomes of randomized controlled trials that compare vNOTES with laparoscopy and the specific groups of patients who benefit most from vNOTES. The episode also delves into the technical aspects of vNOTES and its potential advantages in oncology procedures. TIMESTAMPS 00:00 - Introduction 00:14 - Benefits of vNOTES 03:21 - Special Patient Groups 06:10 - Technical Aspects and Surgical Techniques 08:31 - Oncology Applications and Future Potential
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    14 m