Laparoscopic surgery for recurrent ileocolic Crohn's disease is safe and can lead to significant short-term benefit, including earlier discharge. Conversion increases the length of stay in hospital and the overall morbidity.

STARR was successful for the treatment of selected patients with ODS and IRP. Postoperative faecal urgency rapidly decreases with time. It is not possible to predict who will develop urgency.

EUS is accurate at predicting T0/1 vs T2 disease in our institution, and we believe that it is a useful modality in assessing patient suitability for local excision.

FTBE diagnosed malignancy accurately and facilitated rapid staging. The TWW target was met in almost 90% of patients, whilst the impact on the colorectal outpatient and endoscopy service was minimized.

Intestinal obstruction is a common surgical emergency, accounting for up to 20% of admissions with acute abdominal pain. Of these, 80% will have small bowel obstruction, the most common cause being adhesions. Colorectal cancer is the most common cause of large bowel obstruction. The cardinal features of obstruction are abdominal pain, vomiting, distension and absolute constipation. Initial management comprises adequate fluid resuscitation, decompression with a nasogastric tube and early identification of strangulation (signs of which may include tachycardia, tenderness, fever and leucocytosis) requiring operative intervention. Appropriate use of contrast imaging can differentiate between patients that are likely to settle conservatively and those that will require surgery.

Due to the variation, we suggest urology departments should draw up guidelines for management; trainees should be encouraged to discuss the case pre-operatively with the consultant; core surgical training should include a urology placement.

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Laparoscopic TME surgery can safely be offered to unselected patients with rectal cancer with excellent medium-term results.