A deep dive into the physiological and mechanical evaluation of pelvic floor disorders. The episode examines the hardware evolution of manometry from water-perfused catheters to high-resolution systems, and the standardization of dyssynergic defecation phenotypes via the London Protocol. It also reviews the diagnostic utility of the balloon expulsion test and compares the true physiological advantages of sitting fluoroscopic defecography against the anatomical clarity of supine MRI defecography.
Functional Disorders After Colorectal Surgery - IBS
2026/05/26 | 55 mins.
Focuses on distinguishing and managing Irritable Bowel Syndrome using the rigid Rome IV criteria. It issues a stark warning against operating on functional visceral hypersensitivity, detailing how elective resections for symptomatic uncomplicated diverticular disease frequently fail to relieve pain. The episode reviews targeted pharmacotherapy based on IBS subtypes (e.g., eluxadoline for IBS-D and lubiprostone for IBS-C), and addresses pelvic floor pain syndromes like proctalgia fugax, which surprisingly responds to inhaled albuterol.
Abdominal Wall Reconstruction and Parastomal Hernia
2026/05/21 | 39 mins.
Tackles the inevitable biomechanical failure of parastomal hernias, which eventually affect nearly all permanent stoma patients. It emphasizes strict preoperative optimization goals, including a BMI under 35, an A1C under 8, and absolute smoking cessation. The discussion covers the mechanical superiority of the Sugarbaker mesh drape geometry over the keyhole technique, and explores advanced retromuscular/TAR (Transversus Abdominis Release) approaches utilizing macroporous uncoated synthetic mesh in contaminated fields.
Intestinal Stomas
2026/05/19 | 36 mins.
A comprehensive guide to the physiological and mechanical management of stomas. Key topics include the massive clinical and financial benefits of preoperative WOCN education, and advanced troubleshooting for stoma complications like peristomal pyoderma gangrenosum and bleeding parastomal varices. The episode explores the exact sodium-glucose transporter (SGLT1) mechanics that make WHO oral rehydration solutions essential for high-output stomas, and reviews evolving trial data challenging the traditional 12-week wait period for stoma reversals.
Radiation, Microscopic, and Ischemic Colitis
2026/05/14 | 1h 12 mins.
This episode unpacks three deceptive colitis presentations. For chronic radiation proctitis, driven by obliterative endarteritis, the biggest takeaway is strictly avoiding mucosal biopsies to prevent catastrophic fistulas. Microscopic colitis (collagenous and lymphocytic) presents with watery diarrhea and normal gross mucosa, requiring specific targeted biopsies and treatment with budesonide. Finally, ischemic colitis is detailed as a low-flow microvascular event causing superficial necrosis with deep crypt sparing, where primary anastomosis is contraindicated in the acute setting.
An academic, sponsor-free audio review of core concepts in colon and rectal surgery. Using the power of A.I., created by Dr. Allen Kamrava, Associate Teaching Faculty at Cedars-Sinai Medical Center, this series is designed for residents, fellows, and practicing surgeons to stay current with concise, evidence-based updates. Covering textbook foundations, landmark trials, and evolving ASCRS guidelines, each episode delivers practical surgical education for the commute, workout, or even to wind down at night. Learn more at https://drkamrava.com/podcast
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