Indocyanine Green (ICG) has significantly advanced minimally invasive surgery. It is widely recognized for its ability to visualize blood vessel patency in real-time across various surgical specialties. While its primary use in colorectal surgery is to evaluate anastomoses for leaks, numerous other applications have been documented in the literature. In this review, we aim to explore both established and emerging applications of ICG fluorescence in colorectal surgery, with the goal of improving patient outcomes. This includes preoperative tumor marking and the detection of metastatic disease. Some applications, such as lymphatic mapping, require further research to determine their impact on clinical practices. Conversely, others, like the intraoperative localizations of ureters, necessitate additional procedures and are not yet widely accepted by the surgical community. However, the development of alternative compounds could offer better solutions. Future research should focus on areas like quantitative ICG and protocol standardization in prospective multicenter studies.

Indocyanine Green (ICG) has significantly advanced minimally invasive surgery. It is widely recognized for its ability to visualize blood vessel patency in real-time across various surgical specialties. While its primary use in colorectal surgery is to evaluate anastomoses for leaks, nu-merous other applications have been documented in the literature. In this review, we aim to explore both established and emerging applications of ICG fluorescence in colorectal surgery, with the goal of improving patient outcomes. This includes preoperative tumor marking and the detection of metastatic disease. Some applications, such as lymphatic mapping, require further research to determine their impact on clinical practices. Conversely, oth-ers, like the intraoperative localizations of ureters, necessitate additional procedures and are not yet widely accepted by the surgical community. However, the development of alternative com-pounds could offer better solutions. Future research should focus on areas like quantitative ICG and protocol standardization in prospective multicenter studies.

Purpose of Review: Mpox, formerly known as monkeypox, is a zoonotic illness caused by a virus that is part of the Orthopoxvirus family. Originally identified in humans in the Democratic Republic of Congo in 1970, the disease has been endemic in central African nations. In 2022, an outbreak of Monkeypox warranted a declaration by the World Health Organization (WHO) that the virus was a Public Health Emergency of International Concern. Prior literature documented the dermatological manifestations of the disease, but fewer papers have described and navigated the complexities of mpox gastrointestinal manifestations. We aim to update the current literature on the gastrointestinal (GI) manifestations of mpox, through a review of the literature via PubMed search for English language papers reporting GI manifestations of the virus. Recent Findings: Individual reports of symptomatic manifestations of mpox have been reported. Upper and lower GI symptoms have been described and, in multiple cases, required multidisciplinary team care to successfully treat the patients. Summary: GI manifestations of mpox disease are reported in a variety of severities and, in some instances, may require multidisciplinary management.

Background/Objectives: Colorectal surgeons continue to care for an aging cancer population with increasing comorbidities and frailty. Frailty, characterized by a systemic physiologic decline associated with aging, is an increasingly popular focus in surgical outcomes research. This retrospective study investigates how frailty impacts outcomes in the octogenarian and nonagenarian populations undergoing surgical treatment for colon cancer. Methods: Data from the National Surgical Quality Improvement Program (NSQIP) colectomy-targeted variables dataset from 2015 to 2021 were utilized for this analysis, including patients 80 years of age and older. Frailty was assessed using the five-factor modified frailty index (mFI-5). The study examined post-operative outcomes across frailty groups in this population. Results: From 2015–2021, there were 10,671 patients aged 80 years and older who underwent colectomy for colon cancer, of whom 1259 (11.8%) were 90 years or older and 2844 (26.7%) were severely frail. Frailty significantly impacted post-operative colectomy outcomes in this population. On univariate analysis, frail patients had higher rates of pneumonia (p = 0.015), unplanned intubation (p = 0.012), stroke (p < 0.001), myocardial infarction (p = 0.011), readmission (p < 0.001), long length of stay (p < 0.001), and mortality (p < 0.001) compared to non-frail patients. On multivariate analysis, severe frailty (mFI-5 of 2 or more) was associated with an increased odds of unplanned intubation (aOR 2.41, 95% CI 1.27–4.59), long length of stay (aOR 1.73, 95% CI 1.44–2.09), readmission (aOR 1.84, 95% CI 1.42–2.39), and mortality (aOR 1.95, 95% CI 1.20–3.15) compared to non-frail patients. Conclusions: Frailty plays a critical role in influencing the outcomes of octogenarians and nonagenarians undergoing colectomy for colon cancer within the NSQIP dataset. Future work should investigate whether addressing frailty prior to surgery in this population can improve patients’ post-operative courses.

Background and Objective: Colorectal cancer (CRC) remains a critical public health concern, particularly in the United States, where it accounted for 7.6% of all newly diagnosed cancers in 2024. While the overall incidence of the disease has declined over the last two decades, particularly among patients over the age of 50 years, a concerning rise in early-onset CRC among patients requires a reassessment of screening strategies, the optimization of existing treatment strategies, and the adoption of new approaches to improve patient outcomes. While minimally invasive techniques have demonstrated clear benefits over open surgery (OS), there is limited consensus over long-term oncologic outcomes, cost-effectiveness, and applicability in locally advanced or recurrent CRC. The objective of this review is to provide a comprehensive review of current treatment modalities in the treatment of CRC and their long-term oncologic outcomes. Methods: For this narrative review, an updated review of the English literature was performed between 1993 and 2023 using the PubMed database. The authors reviewed and highlighted landmark papers at their time and the impact they had on the evolution of the management of CRC. Key Content and Findings: Despite significant advances in our understanding of tumor biology, chemotherapy, and screening recommendations, surgery remains a mainstay of treatment for CRC. Continued advancements in surgical technology, equipment, and training have revolutionized our surgical approaches to CRC. Procedures that once required a midline laparotomy can now often be performed in a minimally invasive fashion, which is associated with reduced postoperative pain, shortened length of stay, and overall improved patient satisfaction. Conclusions: With the advent of robotic surgery (RS) and increasingly sophisticated endoscopic procedures, the surgical treatment landscape in colorectal surgery continues to evolve. Over time, the use of laparoscopic surgery (LS) and RS has become the preferred option, given similar oncologic outcomes and improved pain, hospital length of stay, and decreased complication rates. The advancement in robotic technology, medical devices, and pharmaceuticals will continue to push the boundary on the minimally invasive approach that can provide safe oncologic outcomes in the management of CRC.