This article gives an overview of the 10 years' experience of the first dedicated geriatric surgery service in Khoo Teck Puat Hospital, Singapore. Frailty and its adverse impact on emergency and elective surgical procedures are elaborated and strategies to optimize outcomes explained. Via transdisciplinary transinstitutional collaboration, geriatric surgery service instituted trimodal intervention of prehabilitation, nutrition, and psychological support for frail patients, achieved consistent perioperative results, shortened length of hospital stay, and restored baseline function for patients undergoing major elective oncological surgery. Efforts are made to teach transdisciplinary collaboration to the next generation of doctors to meet the challenges of the Era of Geriatric Surgery.

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