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We report an unfortunate case of rectal perforation and subsequent peritonitis in a 74-year-old lady who underwent haemorrhoidal artery ligation in order to treat complex large external and internal haemorrhoids. Serious complications following haemorrhoid surgery are rare and this is the first documented case of delayed intra-abdominal rectal perforation following a haemorrhoid artery ligation operation and converted Ligasure open haemorrhoidectomy.

As a result of the COVID-19 pandemic, most institutions have changed the way patients are assessed or investigated. Using novel non-contact technology, it is possible to continuously monitor the lung function of peri-operative patients undergoing cardiothoracic procedures. Primarily, this results in increased patient surveillance, and therefore, safety. Many centres, globally, are starting to use structured light plethysmography (SLP) technology, providing a non-aerosol generating procedure in place of traditional spirometry. While more evidence is needed, our clinical usage; previous and on-going studies; demonstrate definite potential that SLP is a valuable tool.

Results obtained from retrospective patient satisfaction surveys indicate high efficacy for PCA as a pain management strategy. The large majority of patients did not seek more medication for pain alleviation and found in-hospital treatment sufficient. Further, all patients agreed that they were adequately informed of pain-risk prior to surgery.