R-taTME followed by radical proctectomy using the R-SSPO technique for patients with low rectal lesions is technically feasible and safe without compromising oncologic outcomes. However, there were considerable limitations and a steep learning curve using current robotic technology.

This is the first study reporting on the clinical outcomes of anorectal status after robotic ISR. Further studies are needed to assess the long-term effects of these anorectal complications.

The ROC curves of Ranson and Glasgow scores for mortality are comparable with that published in earlier studies. In a Singaporean population, the Ranson score is more accurate in the prediction of mortality. However, both scoring systems are poor predictors for severity of acute pancreatitis.

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Introduction Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short‐term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods A pre‐planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results Of 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02–2.48, P = 0.04) and robotic TaTME (OR 3.05, 1.10–7.34, P = 0.02) were associated with a higher risk of anastomotic leak than non‐transanal laparoscopic TME. However this association was lost in the mixed‐effects model controlling for patient and disease factors (OR 1.23, 0.77–1.97, P = 0.39 and OR 2.11, 0.79–5.62, P = 0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55–4.77, P < 0.001) and male gender (OR 2.29, 1.52–3.44, P < 0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%. Conclusion This contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results.

As the global population ages, the number of geriatric patients requiring surgery for colon cancer would inevitably increase. Radical oncological surgery in the elderly colorectal cancer patient has been recognized to be associated with a higher rate of postoperative complications and mortality compared to the young. While less aggressive management options may be reasonable in patients with limited life expectancy and significant comorbidities, many elderly patients have preserved function despite their chronological age. The advances in minimally invasive surgery (MIS) now provide a feasible means of achieving safe oncological treatment for these geriatric patients. This review focuses on the evidence behind MIS in the geriatric patient with colon cancer.

Introduction: Small gallbladder polyps (GBP) are usually asymptomatic and benign and are monitored with regular ultrasonography (US) surveillance. Although most centers repeat imaging within a year, there remains no consensus regarding appropriate scan intervals.Aims: To investigate the size stability of GBP and to review the need for close surveillance.Methods: All abdominal ultrasound scans performed in our hospital over 3-month period were reviewed. Patients with sonographic evidence of GBP and with subsequent surveillance were included. The demographics of patients, characteristics of polyps, and subsequent scans over the following five years were reviewed. Histological reports were obtained for patients who underwent cholecystectomy.Results: 96 patients were included in the study. Median age was 51 (range, 24-89) years with a male predominance (67.7%). Main indications for US were hepatitis follow-up (41.7%) and abdominal pain (20.8%). Most patients had multiple polyps (62.5%) and the median diameter of the largest polyp was 4 (range, 3-10) mm. An average of 4.5 scans were performed over five years following detection and most polyps remained stable in size, rarely growing beyond 10mm -only two patients had polyps beyond 10mm. No gallbladder carcinoma was detected during the follow-up period. Conclusion:GBP usually remain stable in size, seldom grow beyond 10mm, and are rarely malignant. Surveillance scans for polyps smaller than 10mm should not be performed at intervals less than a year.