Empowering patients and educating staff - An online solution for the COVID era and beyond!

Background: Bowel disease is a significant cause of significant morbidity and mortality around the world. Though colorectal cancer is a major cause for concern, there are a variety of other conditions which are chronic, debilitating and/or socially embarrassing. While the internet provides excellent resources, there is often conflicting and confusing material of doubtful veracity.

A Structured Modular Approach: The Answer to Training in Laparoscopic Colorectal Surgery.

: Laparoscopic techniques are now an integral part of the operative management of colorectal diseases. However, the specialist training that is required for this is not uniformly available. There is, therefore, a need for a structured competency-based training method so that trainees can navigate the learning curve safely.

Radiological Surveillance Post-Curative Colorectal Cancer Resection: Is There a Need for a Targeted Protocol?

Background The frequency of radiological surveillance after curative colorectal cancer resection has long been a controversial issue with the need to balance potential harm from ionizing radiation and the financial burden of intense surveillance against advantages of early detection of recurrent disease. NICE guidelines issued in 2018 suggested having two surveillance computed tomography (CT) scans within three years of surgery without specifying the timing or the interval. Aim To examine whether an evidence-based flexible approach based on individual patients' risk factors can add value to surveillance protocols.

Value of multi-disciplinary input into laparoscopic management of rectal cancer - An observational study.

Aim: To assess the impact of multi-disciplinary teams (MDTs) management in optimising the outcome for rectal cancers.

Methods: We undertook a retrospective review of a prospectively maintained database of patients with rectal cancers (defined as tumours ≤ 15 cm from anal verge) discussed at our MDT between Jan 2008 and Jan 2011. The data was validated against the national database to ensure completeness of dataset.

An innovative solution to raise public awareness using a mobile colorectal clinic - The 'bowel bus'.

Introduction: Colorectal cancer is the fourth most common cancer in the United Kingdom; however, figures show that the uptake for bowel cancer screening lags behind other cancer screening programmes.

Methods: This is a report of a multi-staged development of an outreach colorectal clinical community service provided through a Mobile Unit (a Bowel Bus). The unit delivers a one-stop colorectal clinic that provides a rapid access pathway to members of the public who have concerns about, or symptoms of, bowel cancer.

Does an enhanced recovery programme add value to laparoscopic colorectal resections?

Purpose: Enhanced recovery programmes (ERP) are now becoming integral to the management of patients undergoing colorectal resection. The benefits of ERP in patients undergoing open colorectal resections have been well recognized; however, the value of ERP in patients undergoing laparoscopic resections is still uncertain. This study was undertaken to assess the impact of ERP in our unit where nearly 90 % of elective colorectal resections are performed laparoscopically.

Long-term outcome of prucalopride for chronic constipation: a single-centre study.

Aim: Newer 5-hydroxytryptamine agonists, such as prucalopride, have been demonstrated to be effective in the short term for treatment of chronic constipation. To date, few studies have investigated their medium- and long-term effectiveness.

Method: An analysis was carried out of a prospectively maintained database of all patients started on prucalopride for chronic constipation between April 2011 and April 2014.

Multimedia educational tools for cognitive surgical skill acquisition in open and laparoscopic colorectal surgery: a randomized controlled trial.

Aim: Conventional teaching in surgical training programmes is constrained by time and cost, and has room for improvement. This study aimed to determine the effectiveness of a multimedia educational tool developed for an index colorectal surgical procedure (anterior resection) in teaching and assessment of cognitive skills and to evaluate its acceptability amongst general surgical trainees.

Method: Multimedia educational tools in open and laparoscopic anterior resection were developed by filming multiple operations which were edited into procedural steps and substeps and then integrated onto interactive navigational platforms using Adobe® Flash® Professional CS5 10.

A structured preceptorship programme for laparoscopic colorectal surgery in Wales: An early experience.

Introduction: A single experienced laparoscopic colorectal surgeon introduced an outreach preceptorship programme (OPP) for laparoscopic colorectal surgery (LCS) in Wales with the aim of supporting consultants in the early stages of their learning curve, as well as to help avoid some of the problems faced by self-taught laparoscopic surgeons. The structured programme consisted of a minimum 1 day master class at the preceptor's operating theatre, followed by multiple outreach visits by the preceptor. The aim of this study was to evaluate the effectiveness and early experience of this programme.

Rectal irrigation: a useful tool in the armamentarium for functional bowel disorders.

Aim: The efficacy of rectal irrigation (RI) was assessed in patients with various functional bowel disorders.

Method: A prospective analysis was carried out of patients presenting to our functional bowel clinic from 2005 to 2009. The Cleveland Clinic Constipation and Incontinence Scores were used to assess outcomes following rectal irrigation.

Use of uterine manipulator in laparoscopic colorectal surgery.

Laparoscopic colorectal surgery has become more common with the increase in the number of trained surgeons. We have used a disposable uterine manipulator to retract the uterus. This technique has been found to be very useful for laparoscopic low anterior resection and abdomino-perineal resection in females.

Laparoscopic drainage of retroperitoneal abscess secondary to pyogenic sacroiliitis.

Retroperitoneal abscesses are rare complications of pyogenic sacroiliitis. Diagnosis is often delayed due to the initial non-specific symptoms and signs and also a low awareness of the clinical presentation and diagnostic procedures among clinicians. We describe a case of an 18-year-old man who was diagnosed with septic arthritis of his left sacro-iliac joint which was complicated by a retroperitoneal abscess.

A tool-kit for the quantitative assessment of proficiency in laparoscopic colorectal surgery.

Aim: Laparoscopic colorectal surgery includes operative procedures of varying complexity, and traditional assessment tools may not be enough to assess competence. This study defines quantitative tools for assessing proficiency in laparoscopic colorectal surgery.

Method: A single surgeon's 11-year experience was subdivided into five phases with equal numbers of patients.

A unique approach to quantifying the changing workload and case mix in laparoscopic colorectal surgery.

Aim: Laparoscopic colorectal surgery includes a range of operations with differing technical difficulty, and traditional parameters, such as conversion and complication rates, may not be sensitive enough to assess the complexity of these procedures. This study aims to define a reproducible and reliable tool for quantifying the total workload and the complexity of the case mix.

Method: This is a review of a single surgeon's 10-year experience.

Implications of sub-specialisation on the waiting times of general surgical clinics.

Introduction: Controversy around sub-specialisation in a district general hospital (DGH) has been ongoing for years.

Aim: To study the effect of colorectal sub-specialisation on general surgical cases.

Methods: A retrospective audit between October 2002 and September 2003, including all referrals to the outpatient clinics of a single consultant surgeon in a DGH.

An unexpected supraclavicular swelling.

Background: Colorectal cancer is the third commonest cause of cancer death in UK. It commonly metastasises to the liver but rarely to small bones.

Case Presentation: We describe a case of a patient with adenocarcinoma of the descending colon who presented preoperatively with a right supraclavicular swelling.

Splenic rupture following colonoscopy: rare in the UK?

Splenic injury following colonoscopy is rare, with only 28 cases reported so far in the English language literature. Direct trauma during colonoscopy or traction on the spleno-colic ligament is the proposed mechanism of injury. Computed tomography (CT) of the abdomen is usually considered to be the most sensitive and specific modality for diagnosis.

Laparoscopic colorectal surgery: learning curve and training implications.

Aims: This paper is a review of experience of laparoscopic colorectal surgery at a district general hospital with particular emphasis on the learning curve and training implications.

Methods: All patients undergoing colorectal surgery where laparoscopy was attempted between March 1998 and October 2003 were included in this study.

Results: There were 80 patients of which 49 had malignancy.

Laparoscopic colorectal surgery in Great Britain and Ireland--where are we now?

Objective: We aimed to gather information from the members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) to assess trends in the current practice of laparoscopic colorectal surgery.

Methods: A postal questionnaire survey of the members of ACPGBI.

Results: The response rate was 37% (200/540).