Optimisation is the action of making the best or most effective use of a situation or resource (Oxford Dictionary) but in the medical world it is preparing the patient (and the surgeon) for surgery and postoperative recovery.

The goal of “optimising” patients’ health prior to surgery is to minimise the risk of postoperative complications, decrease the length of hospital stay, reduce unplanned re-admissions and enhance overall health and surgical experience.

Pär Myrelid © ECCO

By now we are all hoping that the cases of COVID-19 that we still see represent the beginning of the end of the pandemic. For more than two years, the health care system has been overloaded globally and the whole world has been suffering. Initially we struggled with severely ill COVID-19 patients filling up ICU wards at more or less every hospital, and in addition theatre staff were often asked to help out with COVID-19 patients rather than assisting in theatres. At some hospitals the theatres were turned into extra ICU wards. This was made easier by the fact that during the early days of the pandemic the normal emergency cases seemed to have disappeared. Just like prior to a tsunami, where the water withdraws before the giant wave hits, the emergency rooms were left empty for some days or even weeks. A deceptive calmness soon gave way to chaos.

Christianne Buskens © ECCO

In contrast to what we had hoped, the 11^th S-ECCO Masterclass was again a virtual event due to the ongoing COVID-19 pandemic. However, as everyone has slowly got used to online conferences, it almost felt intimate to meet like this once more.

Pär Myrelid © ECCO

Many technical innovations are facilitating the education process involved in training a skilled surgeon today. At the same time, this process is in many ways still a joint collaboration between a master and his/her apprentice, and will continue to be so. Fruitful training in any practical setting is based on trust, from both parties, in combination with application of the experience of the master in order to sort out any perioperative complications. Beyond acquisition of the necessary technical skill, becoming a surgeon requires the development of a sound understanding of when to operate and when not to, as well as the ability to choose the right surgical option. This is, of course, important in all surgical fields but it is perhaps especially true within the field of Inflammatory Bowel Disease (IBD).

Michel Adamina © ECCO

For the past year the COVID-19 pandemic has raged across the world, with wave after wave of the disease. No country has been spared and no end is in sight in the near future. A recent position paper from the ECCO COVID-19 Taskforce presented the ten ‘dos and don’ts’ when caring for IBD patients. S-ECCO Members are involved in the specialised surgical care of IBD patients in many countries and a variety of institutions. Hence, we are offering this opinion piece on the performance of IBD surgery during the pandemic.

Omar Faiz © ECCO

High performance in surgery has been the subject of discussion for a number of years. In IBD surgery it’s been what you might call a ‘shaggy dog’ story. For those of you unfamiliar with this term – there is an entire Wiki page dedicated to it [1]. High performance in IBD surgery has, thus far, fulfilled the criteria for such a story perfectly – it’s: long-winded, anecdotal, arguably failed to reach relevance and a bit of an anti-climax – all the essential ingredients.

Note: Due to the COVID-19 pandemic, the 14^th European Colorectal Congress will be virtual. The article below was submitted prior to this decision. Please refer to the ECC Congress website to check on the latest update.

Michel Adamina © ECCO

The 14^th European Colorectal Congress opens on Sunday, November 29, 2020 with a Masterclass in Colorectal Surgery and a Course in Proctology, followed by three days of expert lectures until the Congress closes on Wednesday, December 2, 2020. A carefully devised safety approach overseen by the Swiss health authorities is allowing the organisation of this large European meeting, traditionally attended by more than 1000 participants from 80 countries who travel to the St.Gallen Colorectal Week (www.colorectalsurgery.eu, @ECCongress). Michel Adamina, from S-ECCO, is co-organising the meeting.

Yves Panis © ECCO

The 9^th S-ECCO Masterclass (held in collaboration with the European Association of Coloproctology, ESCP) was organised during the 15^th Congress of ECCO in Vienna. Thankfully, just before the coronavirus crisis!

As in previous years, it was a full-day masterclass, and once again it attracted a large number of participants, 149. This meant that in terms of attendance the S-ECCO Masterclass was second among all masterclasses and symposia, just after the N-ECCO Network Meeting.

Christianne Buskens © ECCO

Patients with Inflammatory Bowel Disease (IBD) have an increased risk of colorectal cancer (CRC), principally resulting from the pro-neoplastic effects of chronic intestinal inflammation [1]. Epidemiological studies, however, have suggested that the incidence of CRC has decreased over time [2]. This is partly because the estimated incidence in older studies was based on data from referral centres, which likely included a different patient population with more severe and complicated disease. The declining incidence has also been attributed to successful CRC surveillance programmes and in addition has been hypothesised to be a consequence of improved control of mucosal inflammation [3]. The expanding armamentarium of medical options in IBD, such as anti-TNF and anti-adhesion biologic therapies, has substantially improved our ability to control severe inflammation, theoretically decreasing the risk of CRC.

Paulo Gustavo Kotze © ECCO

The Surgeons of ECCO (S-ECCO) once more organised an international workshop outside of Europe. These international workshops constitute a tradition in Latin America, with previous meetings having been held in Brazil, Mexico and Colombia since 2013. This year, the meeting was held in Curitiba, the capital of the state of Paraná, in southern Brazil. This meeting was the result of a cooperation between ECCO and GEDIIB, the Brazilian Study Group of IBD.