COVID crisis has significantly impacted the delivery of gastrointestinal (GI) surgery services. It may also adversely compromise the patient survival. Initially, COVID crisis lead to complete shutdown of all GI surgery cases. However, with time, we have learnt from global experiences and adapted them to our own institution to resume essential GI surgery cases. This narrative review chronicles the changes in our protocol and practices to navigate through these difficult times. These may act as roadmaps for other GI surgery centers to implement. Furthermore, the planned strategies to resume nonessential GI surgery cases have also been reviewed.

Background: Minimally invasive surgery is being increasingly implemented for Gastrointestinal (GI) malignancies. Site of specimen extraction after surgery influence the postoperative course by adding up-to the parietal wound morbidity. We studied the effect of alternative specimen extraction techniques on postoperative recovery and ease of implementation of ERAS protocol. Results: A single center prospective data of 32 patients were compiled and the alternative specimen extraction sites studied were Natural Orifice Specimen Extraction-Vagina (n=8), Proposed Stoma Site Specimen Extraction (n=19), Trans Anal Specimen Extraction (n=5). All the patients had ease in the implementation of ERAS protocol and showed enhance recovery after the surgery with minimal wound related morbidity. The average duration of stay in the hospital was 5.8 days (SD=1.4) and the time to start adjuvant therapy when needed was an average of 21.7 days (SD= 5.46). Conclusion: Alternative Specimen extraction techniques other than routine laparotomy compliment ERAS protocol initiation and implementation in patients undergoing Minimally invasive GI Oncological Surgery.

Colorectal polyp is the leading cause of bleeding per rectum in children. The juvenile polyp is the most common kind of polyp identified in the pediatric age group. The term giant rectal polyp in the pediatric age group has not been reported in the literature. We treated two patients who presented with anemia, generalized weakness, and bleeding per rectum. A giant juvenile polyp was determined as the cause. To the best of our knowledge, this is the first description of giant rectal polyp in the pediatric population.

The whole world is reeling under coronavirus disease 2019 (COVID-19) pandemic due to highly infectious SARS CoV-2 virus. At this moment of global health crisis, all surgeons are facing difficult task to take care of their surgical patients and carrying a high risk of compromising their own safety. Among all surgical disciplines, colorectal surgeons are at higher risk as majority of surgical patients who require emergency surgical interventions are related to colorectal problems. Furthermore, after the respiratory tract, the digestive tract and fecal route of transmission are now being considered the next probable mode of transmission for SARS CoV-2 virus. In these circumstances, it has now become mandatory for all the colorectal surgeons to get well aware of the facts to counter the potential risk posed by COVID-19 pandemic. This is not only essential for their own safety but also for the safety of other health-care personnel and patients as well. They must know the measures to deal with all the challenges which could be encountered during the management of surgical patients at the current time of crisis created out of COVID-19 pandemic. The aim of this article is to prepare the brief note based on evidence-based literature and currently available recommendations to help our colorectal surgeons during the current pandemic time.