Background Real‐world data on outcomes following Hartmann's reversal is necessary to help optimize the patient experience. We have explored the timing between the index operation and its reversal; what investigations were carried out prior to this, and the associated short‐term outcomes. Methods A retrospective study of all patients who underwent Hartmann's reversal from 2010 to 2020 within a tertiary referral centre in Melbourne, Australia. One hundred from a total of 406 (25%) who underwent an emergency Hartmann's procedure had a subsequent reversal. Complete patient data was available for 83 of these patients. Results The average patient age was 60 years, and the median time for reversal was 14.0 (IQR 10–23) months. Seventy‐nine of 83 (95%) reversals had a preoperative endoscopic evaluation of both their rectal stump and a complete colonoscopy. Stoma stenosis (n = 2), patient refusal (n = 1) and emergency reversal (n = 1) were cited reasons for not undergoing preoperative endoscopic evaluation. A third (n = 28, 34%) had a computed tomography prior to reversal; the majority was due to their underlying cancer surveillance (n = 21, 75%). Reversal was associated with a morbidity rate of 47% (n = 39). Surgical site infections (SSIs) (n = 21, 25%) were the most common type of complications encountered, with the majority being superficial (n = 15, 71%). SSIs were associated with steroid use (5/21 versus 4/62, p = 0.03) and greater hospital length of stay (6 versus 10 days, p = 0.03). Conclusion Only a quarter of emergency Hartmann's procedures within our institution were reversed. A significant proportion developed postoperative complications. Surgical site infection was the most common morbidity.

Background: Web-based educational tools can support practitioners in their early years of surgical training. Such tools may be an alternative platform to meet the changing needs in surgical training and professional development and may help explain complex surgical principles providing a structured learning platform that is relevant in the day-to-day surgical operating room setting. We investigated the impact of an online surgical education initiative on inter-observer variability and accuracy of IOC interpretation. Methods: A convenience sample of seven surgical observers evaluated 100 IOCs before and after an online surgical series to evaluate their interpretation. The online video series characterized IOCs using nine key elements. The seven observers were surgical trainees of varying experience, from first-year surgical trainees to surgical fellows, within a metropolitan hospital in Melbourne, Australia. Results: Inter-observer variability improved within six of nine key elements following the online tutorial. The accuracy of three out of these interpretations also significantly improved following the tutorial. Inter-observer agreement of proximal biliary opacification improved from moderate (kappa (κ) = 0.491) to good (κ = 0.725), with an improvement in accuracy from 95% to 99% (P = 0.009). Similarly, inter-observer agreements of cystic duct leaks dramatically improved from no agreement (κ = À0.089) to moderate agreement (κ = 0.548), with detection rates improving from 67% to 82% (P < 0.05). Conclusion: Through an innovative pilot online surgical education, inter-observer agreement and overall accuracy in the key elements of IOC interpretation improved. A larger multicenter study evaluating the effect of online surgical education on intraoperative cholangiogram interpretation is justified.